Therapeutic Areas


With a steady focus on innovation and sound science, we work to deliver vaccines that can help millions in Malaysia, the region and around the world.

 

We are committed to developing newer and more effective vaccines through ongoing research with selected partners. These include paediatric and adult vaccines that are part of the National Immunisation Schedule of Malaysia and the Extended Programme of Immunisation (EPI) of various countries.

Cholera
Cholera
Cholera

Cholera is a rapidly dehydrating, watery diarrhoeal disease caused by intestinal infection with the bacterium Vibrio cholerae serogroups O1 and O139. 3 An estimated 3-5 million cases and over 100,000 deaths occur each year around the world. The infection is often mild or without symptoms, but can sometimes be severe. 1 Cases of cholera occur in both children and adults. 3

 

Transmission occur through consumption of contaminated water or food and is often the result of combined contamination. Contamination may be faecal, or from a natural marine reservoir of the organism. Severe cholera is characterized by acute diarrhoea and usually vomiting which lead rapidly (within 4 to 18 hours) to moderate or profound dehydration. The complications from cholera arise from the loss of fluid volume and electrolytes, especially sodium, potassium, and bicarbonate in the stool and vomitus. These losses result in hypovolemia, metabolic acidosis, and potassium deficiency. Secondary complications include renal failure, hypokalaemia, arterial occlusions, pulmonary oedema, and premature delivery or abortion. 3

 

Various methods can be taken to prevent and control cholera, and reduce deaths. Such methods are combination of surveillance, water sanitation and hygiene, social mobilization, treatment and oral cholera vaccine.2 Oral rehydration salt solution should be considered as the first treatment for cholera, although intravenous fluids with a polyelectrolyte solution (eg, Ringer’s lactate) are needed in case of severe dehydration or shock. In severe cholera cases, an effective antibiotic such as doxycycline or tetracycline can be used to reduce the volume of diarrhoea and the length of time the organism is excreted in the stool. Other clinically effective antibiotics include ciprofloxacin, cotrimoxazole, erythromycin, azithromycin, chloramphenicol and furazolidone. 3

 

References:

  1. US CDC (2016). Cholera-Vibrio Cholera infection. Available from: http://www.cdc.gov/cholera/general/index.html (Accessed: 14th August 2017)
  2. WHO (2017). Available from: http://www.who.int/mediacentre/factsheets/fs107/en/ (Accessed: 14th August 2017)
  3. John C., Sunheang S., Binod S., David., et al (2013). Cholera Vaccines Section 2, of Vaccines), pp: 142-152
Enterotoxigenic
E. coli (ETEC)
Enterotoxigenic
E. coli (ETEC)
Enterotoxigenic E. coli (ETEC)

Enterotoxigenic Escherichia coli (E.coli) or ETEC, is an important cause of bacterial diarrheal illness. Infection with ETEC is the leading cause of traveller’s diarrhoea and a major cause of diarrheal disease in lower-income countries, especially among children. 1  Acute infectious diarrhoea accounts for approximately 20% of all childhood deaths. 2 Since ETEC is a major cause of traveller’s diarrhoea in persons who travel to these areas, the organism is regularly imported to the developed world. 2

 

ETEC remains endemic all year round but is highest during the warm season, reflecting the seasonal difference of ETEC and other bacterial entero-pathogens in the country visited, suggesting that travellers are more vulnerable to the diarrheal illnesses at these times. 2 Escherichia coli is a bacterium that normally lives in the intestines of humans and other animals. Most types of E.coli are harmless, but some can cause disease. Enterotoxigenic Escherichia coli, or ETEC, is the name given to a group of E. coli that produce special toxins which stimulate the lining of the intestines causing them to secrete excessive fluids, thus producing diarrhoea. 1

 

Diarrhoea due to ETEC may be the result of ingestion of contaminated food and water. In any situation where drinking water and sanitation are inadequate, ETEC is usually a major cause of diarrhoeal disease.2 Infection occurs when a person eats food, or drinks water or ice contaminated with ETEC bacteria. Ultimate source of ETEC contamination are food or water contaminated with animal or human faeces. Infection with ETEC can cause profuse watery diarrhoea and abdominal cramping also with following symptoms: 1

 

  • Fever
  • Nausea with or without vomiting
  • Chills
  • Loss of appetite
  • Headache
  • Muscle aches
  • Bloating can also occur but are less common

Illness develops 1-3 days after exposure and usually last 3-4 days, some infections may take a week or longer to resolve. Symptoms rarely last more than 3 weeks. Infection can be prevented by avoiding or safely preparing foods and beverages that could be contaminated with the bacteria, as well as washing hands frequently. 1

 

The treatment of diarrheal disease due to ETEC is the same as that for cholera for any other acute secretory diarrheal disease. The correction and maintenance of hydration is always most important. Antimicrobials are useful only when the diagnosis is made. Provision of adequate nutrition is critical in children in the developing world, where all diarrheal diseases are frequent. 2

 

  1. US CDC (2014). Enterotoxigenic E.coli (ETEC). Available from: http://www.cdc.gov/ecoli/etec.html (Accessed 15th August 2017)
  2. Firdausi Q., Ann-Mari S., A.S.G Faruque., Bradley S., et al (2005). Enterotoxigenic Escherichia Coli in Developing Countries: Epidemiology, Microbiology, Clinical Features, Treatment and Prevention, Clinical Microbiology, 3 (18) pp: 465-483.
Leptospirosis
Leptospirosis
Leptospirosis

Leptospirosis is an infectious disease that affects both humans and animals. It is caused by pathogenic bacteria called leptospires.1 Humans get infected through direct contact with the urine of infected animals or indirectly with a urine-contaminated environment.1

 

Leptospirosis occurs worldwide however it is more common in humid subtropical and tropical areas with high rainfall.2 It often peaks seasonally, occurring in outbreaks and is often linked to climate changes, to poor urban slum communities, to occupation or to recreational activities. The number of human cases occurring worldwide is not known precisely as it could be overlooked and under reported. This is due to its clinical presentations which ranges from mild to fatal with a broad spectrum of symptoms and clinical signs. It may also mimic other diseases such as dengue fever and other viral haemorrhagic diseases.2

 

According to currently available reports, incidences range from approximately 0.1 – 1 per 100,000 persons per year in temperate climates to 10 – 100 per 100,000 in the humid tropics (WHO CDS, 2003). In high-exposure risk groups and during outbreaks, disease incidence may reach over 100 per 100,000 persons.2

 

The usual presentation of leptospirosis is an acute febrile illness with headache, muscle pain and weakness associated with the following signs and symptoms:1

  • Conjunctival suffusion
  • Jaundice
  • Cough and breathlessness
  • Bleeding from the intestines
  • Meningeal irritation
  • Skin rash
  • Cardiac arrhythmia/failure

Some other common symptoms include nausea, vomiting, abdominal pain, arthralgia and diarrhoea. Hence it is evident that clinical diagnosis is difficult where diseases with similar symptoms to those of leptospirosis occur frequently.1,2

 

Prevention strategies of human leptospirosis especially for high-risk groups include wearing protective clothing and avoid contact with animal urine, infected animals or an infected environment (i.e. swimming in contaminated waterfalls). Having awareness of the disease is important to allow early recognition and begin treatment as soon as possible.2

 

References:

 

  1. WHO (2012). Leptospirosis Factsheet. Available at: http://www.wpro.who.int/mediacentre/factsheets/fs_13082012_leptospirosis/en/ (Accessed: 14 Aug 2017).

 

  1. WHO (2003). Human Leptospirosis: guidance for diagnosis, surveillance and control. Geneva: World Health Organisation. Available at: http://whqlibdoc.who.int/hq/2003/WHO_CDS_CSR_EPH_2002.23.pdf Accessed: 14 Aug 2017
Influenza
Influenza
Influenza

Influenza also called the flu, is a contagious respiratory illness caused by influenza viruses that infect the nose, throat and lungs. Seasonal influenza circulate worldwide and can affect people of any age group.1,2

 

There are 3 types of seasonal influenza viruses, types A, B, and C. The common influenza type A viruses circulating amongst humans are influenza A(H1N1) and A(H3N2) subtypes.1 Influenza B viruses can be divided into 2 main lineages referred to as B/Yamagata and B/Victoria lineages. Influenza A and B viruses causes outbreaks and epidemics hence relevant strains of these two influenza types are included in seasonal influenza vaccines. Influenza type C virus typically cause mild infections and is detected much less frequently hence presents less significant health implications.1

 

Illnesses range from mild to severe cases and can even lead to death. Worldwide, these annual epidemics are estimated to cause about 3 to 5 million cases of severe respiratory illness and about 250,000 to 500,000 deaths.1 In industrialised countries, most influenza-associated deaths occur in people above the age of 65.3 Epidemics may also result in high levels of work or school absenteeism and loss of productivity. In developing countries on the other hand, the effects of seasonal influenza epidemics are not fully understood however research estimates indicate that 99% of deaths in children under 5 years of age with influenza related lower respiratory tract infections occur in this region.4

 

People who have flu (or influenza) often feel some or all of the following signs and symptoms:1,2

  • Fever* or feverish/chills
  • Cough
  • Sore throat
  • Runny nose (or stuff nose)
  • Headaches
  • Fatigue (Tiredness)

Some people may have vomiting and diarrhoea although this is more commonly seen in children than in adults.2

* Note that is not everyone with flu will have fever

 

Influenza spreads easily and rapidly especially in crowded areas including schools and nursing homes.1 When an infected person coughs or sneezes, viruses in the droplets are dispersed into the air and spread to the next person in close proximity who breathe these droplets in. The virus can also be spread by contaminated hands with influenza viruses and then touching their own mouth, eyes or nose, although less often.1

 

To help reduce and prevent transmission, people should cover their mouth and nose with a tissue when coughing and wash their hands regularly. The most effective way to prevent the disease is via vaccination as recommended by international health agency such as the World Health Organisation.1

 

References:

  1. WHO (2016). Influenza (Seasonal) – Factsheet. Available at: http://www.who.int/mediacentre/factsheets/fs211/en/ (Accessed: 16 Aug 2017).
  2. US CDC (2016). Influenza (Flu): Key Facts About Influenza (Flu). Available at: https://www.cdc.gov/flu/keyfacts.htm (Accessed: 16 Aug 2017).
  3. Thompson W.W, Weintraub E., Dhankhar P. Cheng O.Y. et al (2009). Estimates of US influenza-associated deaths made using four different methods, Influenza Other Respi Viruses, 3(1), pp. 37-49. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19453440 (Accessed: 16 Aug 2017).
  4. Nair H., Abdullah Brooks W., Katz M. et al (2011). Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis, Lancet, 3(378), pp. 1917-1930. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22078723 (Accessed: 16 Aug 2017).
Cholera

Cholera is a rapidly dehydrating, watery diarrhoeal disease caused by intestinal infection with the bacterium Vibrio cholerae serogroups O1 and O139. 3 An estimated 3-5 million cases and over 100,000 deaths occur each year around the world. The infection is often mild or without symptoms, but can sometimes be severe. 1 Cases of cholera occur in both children and adults. 3

 

Transmission occur through consumption of contaminated water or food and is often the result of combined contamination. Contamination may be faecal, or from a natural marine reservoir of the organism. Severe cholera is characterized by acute diarrhoea and usually vomiting which lead rapidly (within 4 to 18 hours) to moderate or profound dehydration. The complications from cholera arise from the loss of fluid volume and electrolytes, especially sodium, potassium, and bicarbonate in the stool and vomitus. These losses result in hypovolemia, metabolic acidosis, and potassium deficiency. Secondary complications include renal failure, hypokalaemia, arterial occlusions, pulmonary oedema, and premature delivery or abortion. 3

 

Various methods can be taken to prevent and control cholera, and reduce deaths. Such methods are combination of surveillance, water sanitation and hygiene, social mobilization, treatment and oral cholera vaccine.2 Oral rehydration salt solution should be considered as the first treatment for cholera, although intravenous fluids with a polyelectrolyte solution (eg, Ringer’s lactate) are needed in case of severe dehydration or shock. In severe cholera cases, an effective antibiotic such as doxycycline or tetracycline can be used to reduce the volume of diarrhoea and the length of time the organism is excreted in the stool. Other clinically effective antibiotics include ciprofloxacin, cotrimoxazole, erythromycin, azithromycin, chloramphenicol and furazolidone. 3

 

References:

  1. US CDC (2016). Cholera-Vibrio Cholera infection. Available from: http://www.cdc.gov/cholera/general/index.html (Accessed: 14th August 2017)
  2. WHO (2017). Available from: http://www.who.int/mediacentre/factsheets/fs107/en/ (Accessed: 14th August 2017)
  3. John C., Sunheang S., Binod S., David., et al (2013). Cholera Vaccines Section 2, of Vaccines), pp: 142-152
Enterotoxigenic E. coli (ETEC)

Enterotoxigenic Escherichia coli (E.coli) or ETEC, is an important cause of bacterial diarrheal illness. Infection with ETEC is the leading cause of traveller’s diarrhoea and a major cause of diarrheal disease in lower-income countries, especially among children. 1  Acute infectious diarrhoea accounts for approximately 20% of all childhood deaths. 2 Since ETEC is a major cause of traveller’s diarrhoea in persons who travel to these areas, the organism is regularly imported to the developed world. 2

 

ETEC remains endemic all year round but is highest during the warm season, reflecting the seasonal difference of ETEC and other bacterial entero-pathogens in the country visited, suggesting that travellers are more vulnerable to the diarrheal illnesses at these times. 2 Escherichia coli is a bacterium that normally lives in the intestines of humans and other animals. Most types of E.coli are harmless, but some can cause disease. Enterotoxigenic Escherichia coli, or ETEC, is the name given to a group of E. coli that produce special toxins which stimulate the lining of the intestines causing them to secrete excessive fluids, thus producing diarrhoea. 1

 

Diarrhoea due to ETEC may be the result of ingestion of contaminated food and water. In any situation where drinking water and sanitation are inadequate, ETEC is usually a major cause of diarrhoeal disease.2 Infection occurs when a person eats food, or drinks water or ice contaminated with ETEC bacteria. Ultimate source of ETEC contamination are food or water contaminated with animal or human faeces. Infection with ETEC can cause profuse watery diarrhoea and abdominal cramping also with following symptoms: 1

 

  • Fever
  • Nausea with or without vomiting
  • Chills
  • Loss of appetite
  • Headache
  • Muscle aches
  • Bloating can also occur but are less common

Illness develops 1-3 days after exposure and usually last 3-4 days, some infections may take a week or longer to resolve. Symptoms rarely last more than 3 weeks. Infection can be prevented by avoiding or safely preparing foods and beverages that could be contaminated with the bacteria, as well as washing hands frequently. 1

 

The treatment of diarrheal disease due to ETEC is the same as that for cholera for any other acute secretory diarrheal disease. The correction and maintenance of hydration is always most important. Antimicrobials are useful only when the diagnosis is made. Provision of adequate nutrition is critical in children in the developing world, where all diarrheal diseases are frequent. 2

 

  1. US CDC (2014). Enterotoxigenic E.coli (ETEC). Available from: http://www.cdc.gov/ecoli/etec.html (Accessed 15th August 2017)
  2. Firdausi Q., Ann-Mari S., A.S.G Faruque., Bradley S., et al (2005). Enterotoxigenic Escherichia Coli in Developing Countries: Epidemiology, Microbiology, Clinical Features, Treatment and Prevention, Clinical Microbiology, 3 (18) pp: 465-483.
Leptospirosis

Leptospirosis is an infectious disease that affects both humans and animals. It is caused by pathogenic bacteria called leptospires.1 Humans get infected through direct contact with the urine of infected animals or indirectly with a urine-contaminated environment.1

 

Leptospirosis occurs worldwide however it is more common in humid subtropical and tropical areas with high rainfall.2 It often peaks seasonally, occurring in outbreaks and is often linked to climate changes, to poor urban slum communities, to occupation or to recreational activities. The number of human cases occurring worldwide is not known precisely as it could be overlooked and under reported. This is due to its clinical presentations which ranges from mild to fatal with a broad spectrum of symptoms and clinical signs. It may also mimic other diseases such as dengue fever and other viral haemorrhagic diseases.2

 

According to currently available reports, incidences range from approximately 0.1 – 1 per 100,000 persons per year in temperate climates to 10 – 100 per 100,000 in the humid tropics (WHO CDS, 2003). In high-exposure risk groups and during outbreaks, disease incidence may reach over 100 per 100,000 persons.2

 

The usual presentation of leptospirosis is an acute febrile illness with headache, muscle pain and weakness associated with the following signs and symptoms:1

  • Conjunctival suffusion
  • Jaundice
  • Cough and breathlessness
  • Bleeding from the intestines
  • Meningeal irritation
  • Skin rash
  • Cardiac arrhythmia/failure

Some other common symptoms include nausea, vomiting, abdominal pain, arthralgia and diarrhoea. Hence it is evident that clinical diagnosis is difficult where diseases with similar symptoms to those of leptospirosis occur frequently.1,2

 

Prevention strategies of human leptospirosis especially for high-risk groups include wearing protective clothing and avoid contact with animal urine, infected animals or an infected environment (i.e. swimming in contaminated waterfalls). Having awareness of the disease is important to allow early recognition and begin treatment as soon as possible.2

 

References:

 

  1. WHO (2012). Leptospirosis Factsheet. Available at: http://www.wpro.who.int/mediacentre/factsheets/fs_13082012_leptospirosis/en/ (Accessed: 14 Aug 2017).

 

  1. WHO (2003). Human Leptospirosis: guidance for diagnosis, surveillance and control. Geneva: World Health Organisation. Available at: http://whqlibdoc.who.int/hq/2003/WHO_CDS_CSR_EPH_2002.23.pdf Accessed: 14 Aug 2017
Influenza

Influenza also called the flu, is a contagious respiratory illness caused by influenza viruses that infect the nose, throat and lungs. Seasonal influenza circulate worldwide and can affect people of any age group.1,2

 

There are 3 types of seasonal influenza viruses, types A, B, and C. The common influenza type A viruses circulating amongst humans are influenza A(H1N1) and A(H3N2) subtypes.1 Influenza B viruses can be divided into 2 main lineages referred to as B/Yamagata and B/Victoria lineages. Influenza A and B viruses causes outbreaks and epidemics hence relevant strains of these two influenza types are included in seasonal influenza vaccines. Influenza type C virus typically cause mild infections and is detected much less frequently hence presents less significant health implications.1

 

Illnesses range from mild to severe cases and can even lead to death. Worldwide, these annual epidemics are estimated to cause about 3 to 5 million cases of severe respiratory illness and about 250,000 to 500,000 deaths.1 In industrialised countries, most influenza-associated deaths occur in people above the age of 65.3 Epidemics may also result in high levels of work or school absenteeism and loss of productivity. In developing countries on the other hand, the effects of seasonal influenza epidemics are not fully understood however research estimates indicate that 99% of deaths in children under 5 years of age with influenza related lower respiratory tract infections occur in this region.4

 

People who have flu (or influenza) often feel some or all of the following signs and symptoms:1,2

  • Fever* or feverish/chills
  • Cough
  • Sore throat
  • Runny nose (or stuff nose)
  • Headaches
  • Fatigue (Tiredness)

Some people may have vomiting and diarrhoea although this is more commonly seen in children than in adults.2

* Note that is not everyone with flu will have fever

 

Influenza spreads easily and rapidly especially in crowded areas including schools and nursing homes.1 When an infected person coughs or sneezes, viruses in the droplets are dispersed into the air and spread to the next person in close proximity who breathe these droplets in. The virus can also be spread by contaminated hands with influenza viruses and then touching their own mouth, eyes or nose, although less often.1

 

To help reduce and prevent transmission, people should cover their mouth and nose with a tissue when coughing and wash their hands regularly. The most effective way to prevent the disease is via vaccination as recommended by international health agency such as the World Health Organisation.1

 

References:

  1. WHO (2016). Influenza (Seasonal) – Factsheet. Available at: http://www.who.int/mediacentre/factsheets/fs211/en/ (Accessed: 16 Aug 2017).
  2. US CDC (2016). Influenza (Flu): Key Facts About Influenza (Flu). Available at: https://www.cdc.gov/flu/keyfacts.htm (Accessed: 16 Aug 2017).
  3. Thompson W.W, Weintraub E., Dhankhar P. Cheng O.Y. et al (2009). Estimates of US influenza-associated deaths made using four different methods, Influenza Other Respi Viruses, 3(1), pp. 37-49. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19453440 (Accessed: 16 Aug 2017).
  4. Nair H., Abdullah Brooks W., Katz M. et al (2011). Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis, Lancet, 3(378), pp. 1917-1930. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22078723 (Accessed: 16 Aug 2017).