scholarly journals Controlling polio outbreak due to imported wild poliovirus in Indonesia: A success story

2009 ◽  
Vol 49 (4) ◽  
pp. 234 ◽  
Author(s):  
Sumarmo Poorwo Soedarmo ◽  
Sidik Utoro
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Outbreak Response ◽  
Success Story ◽  
Wild Poliovirus ◽  
First Case ◽  
Supplementary Immunization Activities ◽  
Stool Samples ◽  
Outbreak Response Immunization

Background As a WHO member state, Indonesia is committed toGlobal Polio Eradication. The last indigenous polio case was found in 1995. However, we faced a big challenge with the occurrence of polio outbreak, beginning with a polio case caused by imported wild poliovirus (WPV) type 1 in Sukabumi in 2005. The virus was originated from Sudan and imported to Indonesia through Saudi Arabia. The outbreak ended with totally 305 cases throughout the country. The last one occurred on 20 February 2006 in Aceh Tenggara District, Nanggroe Aceh Darussalam Province. In addition and separated from the WPV type 1 outbreak, in August 2005, four Acute Flaccid Paralysis (AFP) cases with type 1 Vaccine Derived Poliovirus (VDPV) in stool samples were identified in Madura, East Java Province. The first case was on 9 June 2005 and ended with 45 cases in Madura and another case in Probolinggo District, East Jawa.Objective To report a success of controlling outbreak of importedWPV in Indonesia.Methods Outbreak Response Immunization (ORI) and mopup immunization were conducted immediately. To completelystop the transmission, three rounds of National ImmunizationDays (NIDs) were conducted in 2005 (August, September, andNovember). Some more Supplementary Immunization Activities(SIAs) were conducted in 2006 (mop up in January, NIDs inFebruary and early April, mop ups in June and August 2006).For the VDPV outbreak, ORI of 18,880 children in 83 villagestook place during the first week of August, beside three roundsofNIDs in 2005.Results All activities resulted in satisfactorily coverage, whereeach round always exceeded 95%.Conclusions Those activities were conducted successfully andproven to be effective to stop the outbreak. Then again, Indonesia can be a polio free country in the coming years.

scholarly journals Protecting investments in polio eradication: the past, present and future of surveillance for acute flaccid paralysis

2004 ◽  
Vol 132 (5) ◽  
pp. 779-780 ◽  
Author(s):  
D. L. HEYMANN ◽  
E. M. DE GOURVILLE ◽  
R. B. AYLWARD
Keyword(s):  
Acute Flaccid Paralysis ◽  
Oral Polio Vaccine ◽  
Policy Decision ◽  
Polio Eradication ◽  
Global Policy ◽  
Wild Poliovirus ◽  
The Road ◽  
Polio Vaccine ◽  
The Past ◽  
Consultation Group

In September 2003 a WHO consultation group on vaccine-derived polioviruses (VDPV) concluded that in order to prevent future generations of paralytic polio after interruption of transmission of wild poliovirus, the use of trivalent oral polio vaccine (OPV) must be stopped [1]. Another important global policy decision along the road to polio eradication thus became possible – cessation of OPV use at some time after eradication. The question now is not whether OPV must be stopped, but rather when.

scholarly journals Immunogenicity of Oral Polio Vaccine and Salk Inactive Polio Vaccine Against Xinjiang Imported Type 1 Wild Poliovirus

2019 ◽  
Vol 70 (9) ◽  
pp. 1980-1984 ◽  
Author(s):  
Dongmei Yan ◽  
Dongyan Wang ◽  
Shuangli Zhu ◽  
Yong Zhang ◽  
Xiaolei Li ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Oral Polio Vaccine ◽  
Neutralizing Antibody ◽  
Genomic Sequencing ◽  
Outbreak Response ◽  
Local Immunity ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Antibody Titers

Abstract Background An outbreak of an imported Type 1 wild poliovirus from Pakistan occurred in the Xinjiang Uygur Autonomous Region of China in 2011, although the local immunity status of the oral polio vaccine (OPV) was relatively satisfied. Methods Neutralizing antibody titers against the Xinjiang strain and Sabin 1 strain were measured in 237 sera from 3 groups of fully OPV-vaccinated persons and 1 group of infants fully vaccinated with the inactive polio vaccine (IPV). Additionally, 17 sera collected from 1 Xinjiang poliomyelitis case and his 16 contacts were also tested. Genomic sequencing was conducted the Xinjiang strain. Results The antibody titers against the Xinjiang strain in each of 237 sera were significantly lower than those against the Sabin 1 strain. Notably, 40.0% of children in Group 1 were seronegative against the Xinjiang strain, which indicated that they might play an important role in wild poliovirus transmission, although their antibody titers against the Sabin 1 strain varied between 1:8 and 1:512. Meanwhile, serological results of the Xinjiang poliomyelitis case and his contacts also provided evidence that a proportion of OPV-vaccinated children had indeed been involved in the transmission chain of the Xinjiang outbreak. Genomic sequencing indicated that the Xinjiang strain was greatly distinguishable from the Sabin 1 strain in neutralizing antigenic sites. Conclusion The lack of neutralizing antibodies against the Xinjiang strain in persons vaccinated by OPV may be associated with the transmission of Type 1 wild poliovirus in Xinjiang. Using Salk IPV along with OPV might be considered in a wild poliovirus outbreak response, especially in the countries which continued to have persistent wild poliovirus circulation.

scholarly journals Changes in Population Dynamics during Long-Term Evolution of Sabin Type 1 Poliovirus in an Immunodeficient Patient

2008 ◽  
Vol 82 (18) ◽  
pp. 9179-9190 ◽  
Author(s):  
John K. Odoom ◽  
Zaira Yunus ◽  
Glynis Dunn ◽  
Philip D. Minor ◽  
Javier Martín
Keyword(s):  
Disease Surveillance ◽  
Polio Eradication ◽  
Biological Properties ◽  
Temperature Sensitive ◽  
Genetic Lineages ◽  
Antigenic Properties ◽  
Polio Immunization ◽  
Global Polio Eradication Initiative ◽  
Stool Samples

ABSTRACT The evolution of the Sabin strain of type 1 poliovirus in a hypogammaglobulinemia patient for a period of 649 days is described. Twelve poliovirus isolates from sequential stool samples encompassing days 21 to 649 after vaccination with Sabin 1 were characterized in terms of their antigenic properties, virulence in transgenic mice, sensitivity for growth at high temperatures, and differences in nucleotide sequence from the Sabin 1 strain. Poliovirus isolates from the immunodeficient patient evolved gradually toward non-temperature-sensitive and neurovirulent phenotypes, accumulating mutations at key nucleotide positions that correlated with the observed reversion to biological properties typical of wild polioviruses. Analysis of plaque-purified viruses from stool samples revealed complex genetic and evolutionary relationships between the poliovirus strains. The generation of various coevolving genetic lineages incorporating different mutations was observed at early stages of virus excretion. The main driving force for genetic diversity appeared to be the selection of mutations at attenuation sites, particularly in the 5′ noncoding region and the VP1 BC loop. Recombination between virus strains from the two main lineages was observed between days 63 and 88. Genetic heterogeneity among plaque-purified viruses at each time point seemed to decrease with time, and only viruses belonging to a unique genotypic lineage were seen from day 105 after vaccination. The relevance of vaccine-derived poliovirus strains for disease surveillance and future polio immunization policies is discussed in the context of the Global Polio Eradication Initiative.

scholarly journals Genomic Characterization of Human and Environmental Polioviruses Isolated in Albania

1999 ◽  
Vol 65 (8) ◽  
pp. 3534-3539 ◽  
Author(s):  
Maurizio Divizia ◽  
Leonardo Palombi ◽  
Ersilia Buonomo ◽  
Domenica Donia ◽  
Vito Ruscio ◽  
...  
Keyword(s):  
Paralytic Poliomyelitis ◽  
Nucleotide Position ◽  
First Case ◽  
Genomic Characterization ◽  
Stool Samples ◽  
Intertypic Recombinant ◽  
Data Banks

ABSTRACT Between April and December 1996, a serious outbreak of poliomyelitis occurred in Albania; almost 140 subjects were involved, and the episode presented an unusually high mortality rate (12%). During the outbreak, water samples from the Lana River in Tirana, Albania, and stool samples from two cases of paralytic poliomyelitis were collected and analyzed for the presence of polioviruses. Six polioviruses were isolated from the environmental and human samples, according to standard methods. All the samples were characterized by partial genomic sequencing of 330 bases across the 5′ untranslated region (5′-UTR) (nucleotide positions 200 to 530) and of 300 bases across the VP1 region (nucleotide positions 2474 to 2774). Comparison of these sequences with those present in data banks permitted the identification of environmental isolates Lana A and Lana B as, respectively, a Sabin-like type 2 poliovirus and an intertypic recombinant poliovirus (Sabin-like type 2/wild type 1), both bearing a G instead of an A at nucleotide position 481. The two other environmental polioviruses were similar to the isolates from the paralytic cases. They were characterized by a peculiar 5′-UTR and by a VP1 region showing 98% homology with the Albanian epidemic type 1 isolates reported by other authors. This study confirms the environmental circulation in Albania of recombinant poliovirus strains, likely sustained by a massive vaccination effort and by the presence in the environment of a type 1 poliovirus, as isolated from the Lana River in Tirana about 2 months before the first case of symptomatic acute flaccid paralysis was reported in this town.

scholarly journals Molecular epidemiology of silent introduction and sustained transmission of wild poliovirus type 1, Israel, 2013

2014 ◽  
Vol 19 (7) ◽  
Author(s):  
L M Shulman ◽  
E Gavrilin ◽  
J Jorba ◽  
J Martin ◽  
C C Burns ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
Phylogenetic Analyses ◽  
Coding Region ◽  
Birth Cohorts ◽  
Wild Poliovirus ◽  
Population Immunity ◽  
Genes Encoding ◽  
Clock Analysis ◽  
Stool Samples

Poliovirus vaccine coverage in Israel is over 90%. The last nine birth cohorts have been vaccinated exclusively with inactivated polio vaccine (IPV). However, between February and July 2013 type 1 wild poliovirus (WPV1) was detected persistently in 10 and intermittently in 8 of 47 environmental surveillance sites in southern and central Israel and in 30 stool samples collected during July from healthy individuals in southern Israel. We report results of sequence and phylogenetic analyses of genes encoding capsid proteins to determine the source and transmission mode of the virus. WPV1 capsid protein 1 nucleotide sequences were most closely related to South Asia (SOAS) cluster R3A polioviruses circulating in Pakistan in 2012 and isolated from Egyptian sewage in December 2012. There was no noticeable geographical clustering within WPV1-positive sites. Uniform codon usage among isolates from Pakistan, Egypt and Israel showed no signs of optimisation or deoptimisation. Bayesian phylogenetic time clock analysis of the entire capsid coding region (2,643 nt) with a 1.1% evolutionary rate indicated that Israeli and Egyptian WPV1-SOAS lineages diverged in September 2012, while Israeli isolates split into two sub-branches after January 2013. This suggests one or more introduction events into Israel with subsequent silent circulation despite high population immunity.

scholarly journals Detection of Imported Wild Polioviruses and of Vaccine-Derived Polioviruses by Environmental Surveillance in Egypt

2012 ◽  
Vol 78 (15) ◽  
pp. 5406-5409 ◽  
Author(s):  
Soile Blomqvist ◽  
Laila El Bassioni ◽  
Eman M. El Maamoon Nasr ◽  
Anja Paananen ◽  
Svetlana Kaijalainen ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Environmental Surveillance ◽  
Wild Type ◽  
Wild Poliovirus ◽  
Afp Surveillance

ABSTRACTSystematic environmental surveillance for poliovirus circulation has been conducted in Egypt since 2000. The surveillance has revealed three independent importations of wild-type poliovirus. In addition, several vaccine-derived polioviruses have been detected in various locations in Egypt. In addition to acute flaccid paralysis (AFP) surveillance, environmental surveillance can be used to monitor the wild poliovirus and vaccine-derived poliovirus circulation in populations in support of polio eradication initiatives.

scholarly journals Surveillance optimisation to detect poliovirus in the pre-eradication era: a modelling study of England and Wales

2020 ◽  
Vol 148 ◽  
Author(s):  
K. M. O'Reilly ◽  
N. C. Grassly ◽  
D. J. Allen ◽  
M. Bannister-Tyrrell ◽  
A. Cameron ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Statistical Modelling ◽  
Polio Eradication ◽  
Environmental Sampling ◽  
Local Authorities ◽  
England And Wales ◽  
Wild Poliovirus ◽  
Spatial Risk ◽  
A Site ◽  
Free Status

Abstract Surveillance for acute flaccid paralysis (AFP) cases are essential for polio eradication. However, as most poliovirus infections are asymptomatic and some regions of the world are inaccessible, additional surveillance tools require development. Within England and Wales, we demonstrate how inclusion of environmental sampling (ENV) improves the sensitivity of detecting both wild and vaccine-derived polioviruses (VDPVs) when compared to current surveillance. Statistical modelling was used to estimate the spatial risk of wild and VDPV importation and circulation in England and Wales. We estimate the sensitivity of each surveillance mode to detect poliovirus and the probability of being free from poliovirus, defined as being below a pre-specified prevalence of infection. Poliovirus risk was higher within local authorities in Manchester, Birmingham, Bradford and London. The sensitivity of detecting wild poliovirus within a given month using AFP and enterovirus surveillance was estimated to be 0.096 (95% CI 0.055–0.134). Inclusion of ENV in the three highest risk local authorities and a site in London increased surveillance sensitivity to 0.192 (95% CI 0.191–0.193). The sensitivity of ENV strategies can be compared using the framework by varying sites and the frequency of sampling. The probability of being free from poliovirus slowly increased from the date of the last case in 1993. ENV within areas thought to have the highest risk improves detection of poliovirus, and has the potential to improve confidence in the polio-free status of England and Wales and detect VDPVs.

Genetic Epidemiology Reveals 3 Chronic Reservoir Areas With Recurrent Population Mobility Challenging Poliovirus Eradication in Pakistan

2019 ◽  
Vol 71 (7) ◽  
pp. e58-e67 ◽  
Author(s):  
Ribqa Akhtar ◽  
Nayab Mahmood ◽  
Muhammad Masroor Alam ◽  
Muhammad Naeem ◽  
Syed Sohail Zahoor Zaidi ◽  
...  
Keyword(s):  
Genetic Relatedness ◽  
Immunization Coverage ◽  
Polio Eradication ◽  
Genomic Diversity ◽  
Environmental Surveillance ◽  
Population Mobility ◽  
Coding Region ◽  
Wild Poliovirus ◽  
Effective Combination

Abstract Background Pakistan is among 3 countries endemic for wild poliovirus type 1 (WPV1) circulation that are still struggling for eradication of poliomyelitis. Active clinical and environmental surveillance with meticulous laboratory investigations provide insights into poliovirus transmission patterns and genomic diversity to inform decisions for strategic operations required to achieve eradication. Methods We analyzed epidemiological and virological data to comprehend the current epidemiological status of WPV1 in Pakistan during 2015–2017. Stool specimens of patients with acute flaccid paralysis (AFP) and sewage samples collected from 60 environmental sites were tested. Viral culturing, intratypic differentiation by real-time polymerase chain reaction, and nucleic acid sequencing of the VP1 region of the poliovirus genome to determine genetic relatedness among WPV1 strains were applied. Results Poliovirus isolates were grouped into 11 distinct clusters, which had ≥95% nucleotide homology in the VP1 coding region. Most of the poliovirus burden was shared by 3 major reservoirs: Karachi, Peshawar, and Quetta block (64.2% in 2015, 75.4% in 2016, and 76.7% in 2017). Conclusions Environmental surveillance reveals importations and pockets of unimmunized children that dictate intensive target mop-up campaigns to contain poliovirus transmission. A decrease in the number of orphan isolates reflects effective combination of AFP and environmental surveillance in Pakistan. The genetic data reflect sustained transmission within reservoir areas, further expanded by periodic importations to areas of high immunity reflected by immediate termination of imported viruses. Improved immunization coverage with high-quality surveillance is vital for global certification of polio eradication.

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 Overview of Polio Outbreak Response in Kenya, 2013 to 2015

2021 ◽  
Vol Special Issue (2) ◽  
pp. 3-13
Author(s):  
Chidiadi Nwogu ◽  
Johnny Musyoka ◽  
Carolyne Gathenji ◽  
Rosemary Nzunza ◽  
Iheoma Onuekwusi ◽  
...  
Keyword(s):  
Polio Eradication ◽  
Advisory Group ◽  
Case Detection ◽  
Outbreak Response ◽  
Surge Capacity ◽  
Polio Vaccine ◽  
The Third ◽  
First Case ◽  
Technical Advisory Group ◽  
Made In

Background: Globally, tremendous improvement has been made in Polio eradication since its inception in 1988. For the third time in a decade, Kenya has experienced a Polio outbreak along the border with Somalia. The affected areas were in Garissa County, replete with previous occurrences in 2006 and 2012. This article, give an account of series of events and activities that were used to stop the transmission within 13 weeks, an interval between the first and the last case of the 2013 outbreak. Methods: In an attempt to stop further transmission and time bound closure of the outbreak, many activities were brought to fore: the known traditional methods, innovative approaches, improved finances and surge capacity. These assisted in case detection, implementation, and coordination of activities. The external outbreak assessments and the six-monthly technical advisory group recommendations were also employed. Result: There were increased case detections of >=2/100,000, stool adequacy >=80%, due to enhanced surveillance, timely feedbacks from laboratory investigation and diagnosis. Sustained coverage in supplemental immunisation of > 90%, ensured that immune profile of >=3 polio vaccine doses was quickly attained to protect the targeted population, prevent further polio infection and eventual reduction of cases coming up with paralysis. Conclusion: Overall, the outbreak was stopped within the 120 days of the first case using 14 rounds of supplemental immunisation activities.

Sign in / Sign up

Export Citation Format

Share Document