Epidemiological Characteristics of Poliomyelitis during the 21st century (2000-2013)

2014 ◽  
Vol 3 (3) ◽  
pp. 143
Author(s):  
Tahir Ahmad ◽  
Sania Arif ◽  
Nazia Chaudry ◽  
Sadia Anjum
Keyword(s):  
Polio Eradication ◽  
Severe Form ◽  
Paralytic Poliomyelitis ◽  
Late Nineteenth Century ◽  
Wild Poliovirus ◽  
Eighteenth Dynasty ◽  
Distinct Disease ◽  
Eradicate Polio ◽  
Year 2000 ◽  
Epidemiological Characteristics

<p>Poliovirus is the pathogenic agent of paralytic poliomyelitis that belongs to the picornaviridae family. Poliomyelitis has an extended history dating over to the Egyptian eighteenth dynasty. It was recognized as distinct disease in the late nineteenth century when the world was ravaged by large number of outbreaks and epidemics in many countries. Paralytic Polio, the rarest but the most severe form of the disease, is characterized by acute flaccid paralysis of any or rarely both of the limbs. Increasing epidemics during the late 19<sup>th</sup> and 20<sup>th</sup> centuries lead to the initiation of a worldwide global effort for polio eradication in 1988, super headed by WHO and various other organizations. The launch of Global Polio Eradication Initiative together with the introduction of two polio vaccines resulted in 99% reduction of wild poliovirus cases worldwide while the total number of polio-endemic countries dropped from 24 countries in the year 2000 to only three countries in 2012; Afghanistan, Nigeria and Pakistan. This review will focus on the general biology of poliovirus, some historic and geographic epidemiological aspects of poliomyelitis eradication during the year 2000-2012 and also on the major failing factors associated with the efficiency of the vaccines to eradicate polio in Pakistan.</p>

scholarly journals Epidemiological Characteristics of Poliomyelitis during the 21st century (2000-2013)

2014 ◽  
Vol 3 (3) ◽  
pp. 143
Author(s):  
Tahir Ahmad ◽  
Sania Arif ◽  
Nazia Chaudry ◽  
Sadia Anjum
Keyword(s):  
Polio Eradication ◽  
Severe Form ◽  
Paralytic Poliomyelitis ◽  
Late Nineteenth Century ◽  
Wild Poliovirus ◽  
Eighteenth Dynasty ◽  
Distinct Disease ◽  
Eradicate Polio ◽  
Year 2000 ◽  
Epidemiological Characteristics

<p>Poliovirus is the pathogenic agent of paralytic poliomyelitis that belongs to the picornaviridae family. Poliomyelitis has an extended history dating over to the Egyptian eighteenth dynasty. It was recognized as distinct disease in the late nineteenth century when the world was ravaged by large number of outbreaks and epidemics in many countries. Paralytic Polio, the rarest but the most severe form of the disease, is characterized by acute flaccid paralysis of any or rarely both of the limbs. Increasing epidemics during the late 19<sup>th</sup> and 20<sup>th</sup> centuries lead to the initiation of a worldwide global effort for polio eradication in 1988, super headed by WHO and various other organizations. The launch of Global Polio Eradication Initiative together with the introduction of two polio vaccines resulted in 99% reduction of wild poliovirus cases worldwide while the total number of polio-endemic countries dropped from 24 countries in the year 2000 to only three countries in 2012; Afghanistan, Nigeria and Pakistan. This review will focus on the general biology of poliovirus, some historic and geographic epidemiological aspects of poliomyelitis eradication during the year 2000-2012 and also on the major failing factors associated with the efficiency of the vaccines to eradicate polio in Pakistan.</p>

Polio Eradication—Within Our Reach?

2017 ◽  
pp. 1-32
Author(s):  
David Besanko ◽  
Sarah Gillis ◽  
Sisi Shen
Keyword(s):  
Infectious Disease ◽  
Public Good ◽  
Polio Eradication ◽  
Global Strategy ◽  
Global Public Good ◽  
List Type ◽  
Global Public Health ◽  
Wild Poliovirus ◽  
Global Polio Eradication Initiative ◽  
Epidemiological Characteristics

The years 2011, 2012, and 2013 witnessed both significant developments and setbacks in global polio eradication efforts. On the positive side, January 13, 2012, marked a full year since India had detected a case of wild poliovirus. On the negative side, polio continued to be endemic in three countries-Pakistan, Afghanistan, and Nigeria-and in those countries the goal of eliminating polio seemed more challenging than ever. Between December 2012 and January 2013, sixteen polio workers were killed in Pakistan, and in February 2013, nine women vaccinating children against polio in Kano, Nigeria, were shot dead by gunmen suspected of belonging to a radical Islamist sect. In addition, after a 95 percent decline in polio cases in 2010, the number of cases in Nigeria rebounded in 2011. Recognizing that polio was unlikely to be eliminated in these countries in the near term, the Global Polio Eradication Initiative moved its target date for eradication from 2013 to 2018.These setbacks sparked a debate about the appropriate strategy for global eradication of polio. Indeed, some experts believed that recent setbacks were not caused by poor management but were instead the result of epidemiological characteristics and preconditions that might render polio eradication unachievable. These experts argued that global health efforts should focus on the control or elimination of polio rather than on the eradication of the disease.This case presents an overview of polio and the Global Polio Eradication Initiative and recounts the successful effort to eradicate smallpox. The case enables a rich discussion of the current global strategy to eradicate polio, as well as the issue of whether eradication is the appropriate global public health objective. More generally, the case provides a concrete example of a particular type of global public good, namely infectious disease eradication.After analyzing and discussing the case, students will be able to: Understand the nature of a global public good Perform a back-of-the-envelope benefit-cost analysis of polio eradication Discuss the appropriate strategy for eradicating an infectious disease Apply game theory to analyzing which countries would be likely to contribute funds toward global polio eradication Discuss the role of private organizations in the provision of global public goods

scholarly journals The global polio eradication initiative in Pakistan: Lessons learnt and prospects for success

2019 ◽  
Vol 2 (2) ◽  
pp. 45-46
Author(s):  
Sajida Naseem
Keyword(s):  
Infectious Disease ◽  
Polio Eradication ◽  
Oral Route ◽  
World Health ◽  
Polio Virus ◽  
World Health Assembly ◽  
The World ◽  
Global Polio Eradication Initiative ◽  
Eradicate Polio ◽  
Year 2000

Poliomyelitis commonly called polio is a highly infectious disease caused by three sero types of polio virus 1, 2 and 3, which attacks the nervous system. The virus is transmitted mostly through feco-oral route, less often it is transmitted through polluted food or water. Since there is no treatment or cure to poliomyelitis, this disease can be prevented only. The World Health Assembly in 1988 set the target to eradicate polio globally by the year 2000 through multiple doses of childhood vaccinations that protect a child for whole life.

The polio endgame: rationale behind the change in immunisation

2017 ◽  
Vol 102 (4) ◽  
pp. 362-365 ◽  
Author(s):  
Julie Garon ◽  
Manish Patel
Keyword(s):  
Scale Up ◽  
Oral Polio Vaccine ◽  
Polio Eradication ◽  
World Health ◽  
Routine Immunisation ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Global Coordination ◽  
Eradicate Polio

The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort.

scholarly journals Reported Polio cases in Pakistan during 2019

2020 ◽  
Vol 7 (3) ◽  
pp. 3693-3696
Author(s):  
Tauseef Ahmad ◽  
Haroon Haroon ◽  
Taha Hussein Musa ◽  
Muhammad Khan ◽  
Mukhtiar Baig ◽  
...  
Keyword(s):  
Local Community ◽  
Polio Eradication ◽  
Vaccination Program ◽  
Annual Number ◽  
Online Search ◽  
Khyber Pakhtunkhwa ◽  
Wild Poliovirus ◽  
Government Documents ◽  
Polio Vaccination ◽  
Eradicate Polio

This report describes polio cases, vaccination uncertainty and challenges, and the way forward to eradicate polio from Pakistan. Numerous articles, government and non-government documents, and survey reports were studied and an online search was made to collect information on polio in Pakistan. Once again the polio vaccination program has been stopped and accused by the local community in Pakistan as a result an increase has been seen in polio cases in the last year. In 2019, a total of 117 wild poliovirus (WPV) and 18 circulating vaccine-derived poliovirus (cVDPV2) cases were reported from the country. The majority of cases were from the Khyber Pakhtunkhwa (KP) province as a result of polio vaccination uncertainty and many challenges faced by the vaccination program in the region. Pakistan reported their highest annual number of WPV cases as compared to last few years. This increase is not only an alarming threat for the country but also a key challenge for the global polio eradication movement. Increase awareness and raising immunization to over 100% in some areas especially in the remote area where every year many children missed vaccination to achieve global polio eradication goals.  

scholarly journals Protocol for the investigation of acute flaccid paralysis and suspected paralytic poliomyelitis

1997 ◽  
Vol 2 (6) ◽  
pp. 409-412 ◽  
Author(s):  
Adwoa Bentsi-Enchill ◽  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Clinical Symptoms ◽  
Incidental Finding ◽  
Wild Strain ◽  
Clinical Specimen ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Paralytic Poliomyelitis ◽  
Surveillance Program ◽  
Wild Poliovirus

Abstract Despite the elimination of indigenous wild poliovirus in Canada, ongoing surveillance for poliomyelitis is important because of the risk of wild virus importation from endemic regions. Most recently, importation of wild poliovirus into Canada occurred in 1993 and 1996,inboth instances with no associated clinical illness. Since 1991, the active surveillance of acute flaccid paralysis (AFP) in children less than 15 years old has been carried out in Canada to monitor for suspected cases of paralytic poliomyelitis. AFP surveillance is currently implemented through the Canadian Paediatric Surveillance Program. All suspected cases of paralytic poliomyelitis reported to the Laboratory Centre for Disease Control are evaluated by the national Working Group on Polio Eradication. The proper laboratory and neurological investigation of all AFP cases younger than 15 years old and suspected cases of poliomyelitis of any age is essential for the rapid detection of paralytic poliomyelitis, the most important clinical specimen for laboratory investigation being a stool sample collected within two weeks after the onset of paralysis for viral studies. This paper provides guidelines for investigating all suspected cases of paralytic poliomyelitis, including AFP cases less than 15 years old. Guidelines are also provided for reporting confirmed or suspected cases of paralytic poliomyelitis as well as the incidental finding of wild strain poliovirus, with or without any clinical symptoms.

scholarly journals Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019–2023

2020 ◽  
Vol 86 (15) ◽  
Author(s):  
Peng Chen ◽  
Yao Liu ◽  
Haiyan Wang ◽  
Guifang Liu ◽  
Xiaojuan Lin ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
World Health ◽  
Paralytic Poliomyelitis ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
The World ◽  
Afp Surveillance ◽  
Case Based

ABSTRACT The Polio Endgame Strategy 2019–2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance. IMPORTANCE Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillance, provides continued high-quality surveillance performance in achieving the GPEI and detecting the circulation of enterovirus. Given the ongoing cVDPV outbreaks in the world, we present the surveillance capacity of environmental surveillance in capturing enterovirus circulation. The final poliovirus (especially VDPV) elimination has become increasingly complex, and the case-based AFP surveillance alone will lead to difficulties in early detecting dynamics of poliovirus transmission and monitoring the extent of environmental circulation. This study goes beyond previous work to provide a detailed comprehensive evaluation of the enterovirus surveillance and can be used to formulate a set of implementation plan and performance indicators for environmental surveillance.

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

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.

scholarly journals Poliovirus excretion among children with primary immune deficiency in Pakistan: a pilot surveillance study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045904
Author(s):  
Asma Sadruddin Pethani ◽  
Zaubina Kazi ◽  
Ujala Nayyar ◽  
Muhammad Shafiq-ur-Rehman ◽  
Muhammad Tahir Yousafzai ◽  
...  
Keyword(s):  
Viral Infections ◽  
Scientific Journal ◽  
Polio Eradication ◽  
Warning Signs ◽  
Paralytic Poliomyelitis ◽  
Primary Immune Deficiency ◽  
Increased Risk ◽  
Group Members ◽  
Poster Presentations ◽  
Study Context

IntroductionChildren with primary immunodeficiency disorders (PID) are more susceptible to developing viral infections and are at a substantially increased risk of developing paralytic poliomyelitis. Such children, if given oral polio vaccines tend to excrete poliovirus chronically that may lead to the propagation of highly divergent vaccine-derived poliovirus (VDPV). Consequently, they may act as a reservoir for the community by introducing an altered virus potentially imposing a risk to global polio eradication. However, the risks of chronic and prolonged excretion are not well characterised in the study context. This study seeks to establish a pilot surveillance system for successful identification and monitoring of VDPV excretion among children with PID. It will assess whether the Jeffrey Modell warning signs of PID can be used as an appropriate screening tool for PID in Pakistan.Methods and analysisIn this pilot surveillance, recruitment of PID cases is currently done at participating hospitals in Pakistan. Potential children are screened and tested against the Jeffrey Modell Foundation (JMF) warning signs for immunodeficiency and their stool is collected to test for poliovirus excretion. Cases excreting poliovirus are followed until the two consecutive negative stool samples are obtained over a period of 6 months. The data will be analysed to calculate hospital-based proportions of total Immunodeficiency-related vaccine-derived poliovirus (iVDPV) cases over a 2-year period and to determine the sensitivity and specificity of the JMF signs.Ethics and disseminationThis protocol was reviewed and approved by the WHO (WHO Reference-2018/811124-0), Aga Khan University (AKU ERC-2018-0380-1029) and National Bioethics Committee (Ref No. 4-87 NBC-308-Y2). The results will be published in an open access peer-reviewed scientific journal and presented to the iVDPV Working Group members, policy-makers, paediatric consultants and fellow researchers with the same domain interest. It may be presented in scientific conferences and seminars in the form of oral or poster presentations.

scholarly journals A Collaborative Initiative to Strengthen Sustainable Public Health Capacity for Polio Eradication and Routine Immunization Activities in the Eastern Mediterranean Region

10.2196/14664 ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. e14664
Author(s):  
Magid Al Gunaid ◽  
Faris Lami ◽  
Najwa Jarour
Keyword(s):  
Public Health ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Polio Eradication ◽  
Routine Immunization ◽  
Vaccine Preventable Diseases ◽  
Global Polio Eradication Initiative ◽  
Eradicate Polio ◽  
And Control

The many challenges in the Eastern Mediterranean region put the involved countries at risk of polio transmission and affect their ability to meet progress targets in eliminating vaccine-preventable diseases. The Global Health Development (GHD) and Eastern Mediterranean Public Health Network (EMPHNET) are working together on the project “Strengthening sustainable public health capacity in the Eastern Mediterranean region for polio eradication and routine immunization activities” with an overall goal of improving routine immunization, eradicating poliovirus, and controlling/eliminating or eradicating other vaccine-preventable diseases in the Eastern Mediterranean region. The aim of this manuscript is to describe the project and the achievements of GHD/EMPHNET over the last 3 years (2016-2018) to build effective surveillance and immunization systems in the Eastern Mediterranean region through the development of a sustainable and competent public health system to eradicate polio and control/eliminate vaccine-preventable diseases. This project assists the targeted Eastern Mediterranean region countries to build effective surveillance and immunization systems in an effort to expand their capacities to eradicate polio and control/eliminate other vaccine-preventable diseases. The project is streamlined with the Global Polio Eradication Initiative, the Centers for Disease Control and Prevention’s Strategic Framework for Global Immunization 2016-2020, and the Polio Eradication and Endgame Strategic Plan 2013-2018. The project also supports the Global Health Security Agenda by focusing on efforts to accelerate progress toward a world safe and secure from infectious disease threats. Project activities were designed to respond to countries’ needs and assist them in building their institutional and workforce capacity to effectively plan, implement, and evaluate activities to eradicate polio and strengthen routine immunization activities. The project activities covered a set of areas including surveillance of acute flaccid paralysis and other vaccine-preventable diseases, family and community engagement, workforce capacity building, improvement of data quality, management and use of information systems, use of polio assets to control/eliminate other vaccine-preventable diseases, support of countries to develop national strategies, piloting of innovative initiatives, program evaluation and accountability, and immunization strengthening. The project adopts the Global Polio Eradication Initiative strategies for assisting countries to strengthen routine immunization services, maintain highly sensitive acute flaccid paralysis surveillance, and sustain polio eradication functions.

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