The Pathology of Poliomyelitis and the Vaccines and Nonvaccine Therapy

Poliomyelitis is an exclusively human disease that mainly affects children. Clinical features of poliomyelitis can be varied, from mild illness to the most severe paralysis, and the factor why poliomyelitis has different performances in individuals has been proved strongly correlated with membrane protein CD155. The nervous system shows a special protecting phenomenon against the invasion of poliovirus, and the mechanism is not very clear at present. Vaccines are the main means of preventing and controlling polio, and many different vaccines have been invented in the process of fighting polio. Inactivated polio vaccine (IPV) and oral polio vaccine (OPV) are the two main vaccines. IPV is known for its safety while OPV is widely used in developing countries because of its relatively low cost. This usage also leads to some side effects: vaccine-associated paralytic polio (VAPP) and vaccine-derived poliovirus (VDPV). Now, for polio eradication, the elimination of these two diseases has become particularly important. Thus, a new type of vaccine was created: sequential IPV-OPV with the safety of IPV and the low cost of OPV. This paper will talk about the different polio vaccines and their effects. An enormous difference between people who have gotten the vaccine and people who have not got the vaccine. Comparing the two kinds of people, people who get normal poliovirus, and people who get poliovirus after taking a vaccine, known as VAPP (vaccine-associated paralytic poliomyelitis), the former cannot get full recovery whole life and the latter has a very low possibility. In conclusion, people should take vaccines if it is affordable for them.

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Impact of Maternal Antibody on the Immunogenicity of Inactivated Polio Vaccine in Infants Immunized With Bivalent Oral Polio Vaccine: Implications for the Polio Eradication Endgame

Clinical Infectious Diseases ◽

10.1093/cid/ciy649 ◽

2018 ◽

Vol 67 (suppl_1) ◽

pp. S57-S65 ◽

Cited By ~ 4

Author(s):

James T Gaensbauer ◽

Chris Gast ◽

Ananda S Bandyopadhyay ◽

Miguel O’Ryan ◽

Xavier Saez-Llorens ◽

...

Keyword(s):

Oral Polio Vaccine ◽

Polio Eradication ◽

Maternal Antibody ◽

Inactivated Polio Vaccine ◽

Polio Vaccine

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Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program

Microbiology Australia ◽

10.1071/ma20053 ◽

2020 ◽

Vol 41 (4) ◽

pp. 196

Author(s):

Margaret M Peel

Keyword(s):

Late Onset ◽

Oral Polio Vaccine ◽

The United States ◽

Polio Eradication ◽

Oral Route ◽

World Health ◽

Paralytic Poliomyelitis ◽

Polio Vaccine ◽

The Central Nervous System ◽

Health Organization

Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

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Corrigendum to: Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program

Microbiology Australia ◽

10.1071/ma20053_co ◽

2020 ◽

Vol 41 (4) ◽

pp. 223

Author(s):

Margaret M Peel

Keyword(s):

Late Onset ◽

Oral Polio Vaccine ◽

The United States ◽

Polio Eradication ◽

Oral Route ◽

World Health ◽

Paralytic Poliomyelitis ◽

Polio Vaccine ◽

The Central Nervous System ◽

Health Organization

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Μελέτη του μηχανισμού παρασκευής in vitro ανασυνδυασμένων στελεχών πολιοϊών και εντεροϊών της ομάδας EV-C

10.12681/eadd/40627 ◽

2017 ◽

Author(s):

Τηλέμαχος Δημητρίου

Keyword(s):

Multiplex Pcr ◽

Oral Polio Vaccine ◽

Paralytic Poliomyelitis ◽

Rt Pcr ◽

Stem Loop ◽

Inactivated Polio Vaccine ◽

Polio Vaccine

Οι εντεροϊοί ανήκουν στην οικογένεια Picornaviridae. Το γένωμα τους είναι μονόκλωνο RNA θετικής πολικότητας μήκους περίπου 7.500bp και περιβάλλεται από ένα εικοσαεδρικό πρωτεϊνικό καψίδιο. Οι εντεροϊοί που προσβάλλουν τον άνθρωπο ταξινομούνται σε τέσσερις ομάδες: EV-A, EV-B, EV-C και EV-D. Οι πολιοϊοί, το σημαντικότερο μέλος της ομάδας C, διακρίνονται σε τρεις ορότυπους (PV1, PV2, PV3) και είναι οι αιτιολογικοί παράγοντες της παραλυτικής πολιομυελίτιδας. Από το 1960 χρησιμοποιούνται δύο εμβόλια για την εξάλειψη της ασθένειας, αρχικά το IPV (inactivated polio vaccine) και κατόπιν το πιο αποτελεσματικό OPV (oral polio vaccine). Ωστόσο, το OPV εμφάνισε το μειονέκτημα της εμβολιοσυνδεόμενης παραλυτικής πολιομυελίτιδας (VAPP: Vaccine-associated paralytic poliomyelitis) και της κυκλοφορίας των εμβολιοπροερχόμενων πολιοϊών (VDPVs: Vaccine Derived Polioviruses) μέσω της συσσώρευσης μεταλλάξεων ή και ανασυνδυασμών στο γένωμα των εξασθενημένων εμβολιακών στελεχών Sabin.Στόχος της παρούσας διατριβής ήταν ο σχεδιασμός και η ανάπτυξη μεθόδων με σκοπό τη μελέτη του μηχανισμού παρασκευής in vitro ανασυνδυασμένων στελεχών πολιοϊών και εντεροϊών της ομάδας EV-C. Στο πρώτο μέρος της διατριβής σχεδιάστηκε και αναπτύχθηκε μια Multiplex-PCR για την ανίχνευση και ταυτοποίηση των εντεροϊών. Τα αποτελέσματα της τεχνικής αυτής σε πρότυπα αλλά και κλινικά στελέχη ανέδειξαν την τεχνική αυτή ως ένα χρήσιμο εργαλείο για την γρήγορη και ακριβή ανίχνευση και ταυτοποίηση των εντεροϊών.Στο δεύτερο μέρος της διατριβής, σχεδιάστηκε και αναπτύχθηκε μια τεχνική αλληλούχησης ολόκληρου του γονιδιώματος των εντεροϊών χρησιμοποιώντας μόνο τέσσερις PCR αντιδράσεις. Η δυνατότητα αυτή παρέχεται μέσω της χρήσης ενός ειδικού εκκινητή (DOP), μέσω του οποίου πραγματοποιήθηκε αρχικά μια προενίσχυση ολόκληρου του γονιδιώματος. Στο τρίτο μέρος της διατριβής σχεδιάστηκε και εφαρμόστηκε σε κλινικά δείγματα μια Multiplex-PCR για την ανίχνευση ανασυνδυασμών από τη VP1 έως και τη 3D γενωμική περιοχή εμβολιοσυνδεόμενων πολιοϊών. Τα αποτελέσματα της Multiplex-PCR απέδειξαν την ικανότητα της μεθόδου να ανιχνεύει και να ταυτοποιεί σπάνιους αλλά και κύριους τύπους ανασυνδυασμού με τη χρήση μόνο τεσσάρων Multiplex-PCR αντιδράσεων.Στο τέταρτο μέρος της διατριβής σχεδιάστηκε μια ειδική Stem-Loop RT-PCR μέθοδος για την ανίχνευση της αντιγραφικής ενεργότητας των εντεροϊών μέσω ανίχνευσης του αρνητικής πολικότητας RNA κλώνου. Η μέθοδος αυτή εφαρμόστηκε αρχικά στο πρότυπο στέλεχος Sabin 1, όπου ανιχνεύτηκε η αντιγραφική ενεργότητα του στελέχους σε υψηλό αλλά και χαμηλό ιικό τίτλο, αρκετά νωρίτερα από την εμφάνιση της χαρακτηριστικής εικόνας CPE, των ενεργών εντεροϊών σε κυτταροκαλλιέργεια. Επιπλέον, η μέθοδος αυτή χρησιμοποιήθηκε για την διάκριση μεταξύ αντιγραφικά ενεργών και ανενεργών πρότυπων στελεχών CAV που δεν εμφάνιζαν CPE σε κυτταροκαλλιέργειες. Στο τελευταίο μέρος της παρούσας διατριβής πραγματοποιήθηκε η μελέτη των ανασυνδυασμών που προέκυψαν έπειτα από ταυτόχρονη μόλυνση κυττάρων Rd με πρότυπο στέλεχος Sabin 1 και CAV13. Παράλληλα, με τη χρήση ειδικών προγραμμάτων βιοπληροφορικής σχεδιάστηκαν πιθανά μοντέλα της δευτεροταγούς δομής των RNA μορίων στις θέσεις ανασυνδυασμού. Τα αποτελέσματα της μελέτης αυτής επαλήθευσαν την αυξημένη συχνότητα εμφάνισης ετεροτυπικών ανασυνδυασμών στην 2Α ή 2Β γενωμική περιοχή και εμφάνισαν μια ένδειξη που επιβεβαιώνει τη σύνδεση μεταξύ ανασυνδυασμού και δευτεροταγούς δομής του RNA μορίου.

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The logic of causation and the risk of paralytic poliomyelitis for an American child

Epidemiology and Infection ◽

10.1017/s0950268899003350 ◽

2000 ◽

Vol 124 (1) ◽

pp. 113-120 ◽

Cited By ~ 1

Author(s):

D. RIDGWAY

Keyword(s):

Indirect Evidence ◽

Oral Polio Vaccine ◽

Paralytic Poliomyelitis ◽

American Child ◽

Inactivated Polio Vaccine ◽

Immunization Policy ◽

Polio Vaccine ◽

Vaccination Strategies ◽

The Usa ◽

Sequential Schedule

Beginning in January 1997, American immunization policy allowed parents and physicians to elect one of three approved infant vaccination strategies for preventing poliomyelitis. Although the three strategies likely have different outcomes with respect to prevention of paralytic poliomyelitis, the extreme rarity of the disease in the USA prevents any controlled comparison. In this paper, a formal inferential logic, originally described by Donald Rubin, is applied to the vaccination problem. Assumptions and indirect evidence are used to overcome the inability to observe the same subjects under varying conditions to allow the inference of causality from non-randomized observations. Using available epidemiologic information and explicit assumptions, it is possible to project the risk of paralytic polio for infants immunized with oral polio vaccine (1·3 cases per million vaccinees), inactivated polio vaccine (0·54 cases per million vaccinees), or a sequential schedule (0·54–0·92 cases per million vaccinees).

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Moving from oral poliovirus vaccine to inactivated poliovirus vaccine: The rationale and challenges

Bangladesh Journal of Medicine ◽

10.3329/bjm.v31i1.44749 ◽

2019 ◽

Vol 31 (1) ◽

pp. 22-28 ◽

Cited By ~ 1

Author(s):

Kazi Zulfiquer Mamun ◽

Nabeela Mahboob ◽

Kazi Taib Mamun ◽

Hasina Iqbal

Keyword(s):

Oral Polio Vaccine ◽

Sole Source ◽

Polio Eradication ◽

Oral Poliovirus Vaccine ◽

Routine Immunization ◽

Inactivated Polio Vaccine ◽

Polio Vaccine ◽

The Past ◽

Global Polio Eradication Initiative

Oral polio vaccine (OPV) has served as the cornerstone of polio eradication efforts over the past 30 years, trivalent inactivated polio vaccine (IPV) has re-ascended to prominence in the past year, now acting as the sole source of protective immunity against type 2 poliovirus in routine immunization programmes. The Polio Eradication and Endgame Strategic plan 2013–2018, developed by the Global Polio Eradication Initiative (GPEI) outlines the phased removal of OPVs, starting with type 2 poliovirus–containing vaccines and introduction of inactivated polio vaccine in routine immunization to mitigate against risk of vaccine-associated paralytic polio and circulating vaccine-derived poliovirus. Bangladesh J Medicine Jan 2020; 31(1) : 22-28

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The polio-eradication programme and issues of the end game

Journal of General Virology ◽

10.1099/vir.0.036988-0 ◽

2012 ◽

Vol 93 (3) ◽

pp. 457-474 ◽

Cited By ~ 40

Author(s):

Philip D. Minor

Keyword(s):

Oral Polio Vaccine ◽

Polio Eradication ◽

World Health ◽

Paralytic Poliomyelitis ◽

Public Health Issue ◽

Eradication Programme ◽

Middle Income ◽

Major Public Health Issue ◽

Polio Vaccine ◽

Health Organization

Poliovirus causes paralytic poliomyelitis, an ancient disease of humans that became a major public-health issue in the 20th century. The primary site of infection is the gut, where virus replication is entirely harmless; the two very effective vaccines developed in the 1950s (oral polio vaccine, or OPV, and inactivated polio vaccine, or IPV) induce humoral immunity, which prevents viraemic spread and disease. The success of vaccination in middle-income and developing countries encouraged the World Health Organization to commit itself to an eradication programme, which has made great advances. The features of the infection, including its largely silent nature and the ability of the live vaccine (OPV) to evolve and change in vaccine recipients and their contacts, make eradication particularly challenging. Understanding the pathogenesis and virology of the infection is of major significance as the programme reaches its conclusion.

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Assessing the stability of polio eradication after the withdrawal of oral polio vaccine

10.1101/084012 ◽

2016 ◽

Author(s):

Michael Famulare ◽

Christian Selinger ◽

Kevin A. McCarthy ◽

Philip A. Eckhoff ◽

Guillaume Chabot-Couture

Keyword(s):

Transmission Rate ◽

Oral Polio Vaccine ◽

Polio Eradication ◽

Paralytic Poliomyelitis ◽

Wild Poliovirus ◽

Susceptibility To Infection ◽

Polio Vaccine ◽

High Transmission ◽

Population Immunity ◽

The Stability

AbstractThe oral polio vaccine (OPV) contains live-attenuated polioviruses that induce immunity by causing low virulence infections in vaccine recipients and their close contacts. Widespread immunization with OPV has reduced the annual global burden of paralytic poliomyelitis by a factor of ten thousand or more and has driven wild poliovirus (WPV) to the brink of eradication. However, in instances that have so far been rare, OPV can paralyze vaccine recipients and generate vaccine-derived polio outbreaks. To complete polio eradication, OPV use should eventually cease, but doing so will leave a growing population fully susceptible to infection. If poliovirus is reintroduced after OPV cessation, under what conditions will OPV vaccination be required to interrupt transmission? Can conditions exist where OPV and WPV reintroduction present similar risks of transmission? To answer these questions, we built a multiscale mathematical model of infection and transmission calibrated to data from clinical trials and field epidemiology studies. At the within-host level, the model describes the effects of vaccination and waning immunity on shedding and oral susceptibility to infection. At the between-host level, the model emulates the interaction of shedding and oral susceptibility with sanitation and person-to-person contact patterns to determine the transmission rate in communities. Our results show that inactivated polio vaccine is sufficient to prevent outbreaks in low transmission rate settings, and that OPV can be reintroduced and withdrawn as needed in moderate transmission rate settings. However, in high transmission rate settings, the conditions that support vaccine-derived outbreaks have only been rare because population immunity has been high. Absent population immunity, the Sabin strains from OPV will be nearly as capable of causing outbreaks as WPV. If post-cessation outbreak responses are followed by new vaccine-derived outbreaks, strategies to restore population immunity will be required to ensure the stability of polio eradication.Author SummaryOral polio vaccine (OPV) has played an essential role in the elimination of wild poliovirus (WPV). OPV contains attenuated yet transmissible viruses that can spread from person-to-person. When OPV transmission persists uninterrupted, vaccine-derived outbreaks occur. After OPV is no longer used in routine immunization, as with the cessation of type 2 OPV in 2016, population immunity will decline. A key question is how this affects the potential of OPV viruses to spread within and across communities. To address this, we examined the roles of immunity, sanitation, and social contact in limiting OPV transmission. Our results derive from an extensive review and synthesis of vaccine trial data and community epidemiological studies. Shedding, oral susceptibility to infection, and transmission data are analyzed to systematically explain and model observations of WPV and OPV circulation. We show that in high transmission rate settings, falling population immunity after OPV cessation will lead to conditions where OPV and WPV are similarly capable of causing outbreaks, and that this conclusion is compatible with the known safety of OPV prior to global cessation. Novel strategies will be required to ensure the stability of polio eradication for all time.

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