scholarly journals Insidious reintroduction of wild poliovirus into Israel, 2013

2013 ◽  
Vol 18 (38) ◽  
Author(s):  
E Anis ◽  
E Kopel ◽  
S R Singer ◽  
E Kaliner ◽  
L Moerman ◽  
...  
Keyword(s):  
Oral Polio Vaccine ◽  
World Health ◽  
Wild Type ◽  
Polio Virus ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Southern District ◽  
Specific Analysis ◽  
Two Cities ◽  
Health Organization

Israel was certified as polio-free country in June 2002, along with the rest of the World Health Organization European Region. Some 11 years later, wild-type polio virus 1 (WPV1) was isolated initially from routine sewage samples collected between 7 and 13 April 2013 in two cities in the Southern district. WPV1-specific analysis of samples indicated WPV1 introduction into that area in early February 2013. National supplementary immunisation with oral polio vaccine has been ongoing since August 2013.

scholarly journals Post-polio eradication: vaccination strategies and options for India

2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Jayakrishnan Thayyil ◽  
Thejus Jayakrishnan
Keyword(s):  
International Health ◽  
Main Tool ◽  
Oral Polio Vaccine ◽  
Polio Eradication ◽  
World Health ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Vaccination Strategies ◽  
Health Agencies ◽  
Health Organization

In 1988, the World Health Organization (WHO) resolved to eradicate poliomyelitis globally. Since then, the initiative has reported dramatic progress in decreasing the incidence of poliomyelitis and limiting the geographical extent of transmission. 2013 is recorded as the second consecutive year not reporting wild poliovirus (WPV) from India. If the country can retain this position for one more year India will be declared as polio eradicated. What should be the future vaccination strategies? We searched and reviewed the full text of the available published literature on polio eradication via PubMed and examined Internet sources and websites of major international health agencies. The oral polio vaccine (OPV) has been the main tool in the polio eradication program. Once WPV transmission is interrupted, the poliomyelitis will be caused only by OPV. India could expect 1 vaccine-associated paralytic polio per 4.2-4.6 million doses of OPV. Considering the threat of vaccine-derived viruses to polio eradication, WHO urged to develop a strategy to safely discontinue OPV after certification. The ultimate aim is to stop OPV safely and effectively, and eventually substitute with inactivated polio vaccine (IPV). The argument against the use of IPV is its cost. From India, field based data were available on the efficacy of IPV, which was better than OPV. IPV given intradermally resulted in seroconversion rates similar to full-dose intramuscular vaccine. The incremental cost of adopting IPV to replace OPV is relatively low, about US $1 per child per year, and most countries should be able to afford this additional cost.

scholarly journals Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program

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.

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

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

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.

scholarly journals Efforts Towards Polio Eradication in Madagascar: 1997 to 2017

2021 ◽  
Vol Special Issue (2) ◽  
pp. 102-111
Author(s):  
Marcellin Mengouo Nimpa ◽  
Noëline Ravelomanana Razafiarivao ◽  
Annick Robinson ◽  
Mamy Randriatsarafara Fidiniaina ◽  
Richter Razafindratsimandresy ◽  
...  
Keyword(s):  
Health System ◽  
Oral Polio Vaccine ◽  
Polio Eradication ◽  
Routine Immunization ◽  
World Health ◽  
Political Commitment ◽  
African Region ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Free Status

Background: In 1988, the World Health Assembly launched the Global Polio Eradication Initiative. WHO AFRO is close to achieve this goal with the last wild poliovirus detected in 2014 in Borno States in Nigeria. The certification of the WHO African Region requires that all the 47 member states meet the critical indicators for a polio free status. Madagascar started implementing polio eradication activities in 1996 and was declared polio free in June 2018 in Abuja. This study describes the progress achieved towards polio eradication activities in Madagascar from 1977- 2017 and highlights the remaining challenges to be addressed. Methods: Data were collected from the national routine immunization services, Country Acute Flaccid surveillance databases and national reports of SIAS and Mop Up campaign. Country complete polio and immunization related documentation provided detailed historical information’s. Results: From 1997 to 2017, Madagascar reported one wild poliovirus (WPV) outbreak and four circulating Vaccine Derived Polio Virus (cVDPV) oubreaks with a total of 21 polioviruses (1 WPV and 21 cVDPV). The last WPV and cVDPV were notified in 1997 in Antananarivo and 2015 in Sakaraha health districts respectively. Madagascar met the main polio surveillance indicators over the last ten years and made significant progress following the last cVDPV2 outbreak in 2014 -2015. In addition, the country successfully implemented the switch from trivalent Oral Polio Vaccine (tOPV) to bivalent Oral Polio vaccine (bOPV) and containment activities. Environmental Surveillance established since 2015 did not reveal any poliovirus. The administrative coverage of the 3rd dose of oral polio vaccine (OPV3) varied across the years from 55% in 1991 to a maximum of 95% in 2007 before a progressive decrease to 86% in 2017. The percentage of AFP cases with more than 3 doses of oral polio vaccines increased from 56% in 2014 to 88% in 2017. A total of 19 supplementary immunization activities (SIA) were conducted in Madagascar from 1997 to 2017, among which 3 were subnational immunization days (sNID) and 16 were national immunization days (NIDs). Poor routine coverage contributed to the occurrence of cVDPC outbreaks in the country; addressing this should remain a key priority for the country to maintain the polio free status. From 2015 to June 2017, Madagascar achieved the required criteria leading to the acceptance of the country’s polio-free documentation in June 2018 by ARCC. However, continuous efforts will be needed to maintain a highly sensitive polio surveillance system with emphasis on security compromised areas. Finally strengthening the health system and governance at all levels will be necessary if these achievements are to be sustained. Conclusions: High national political commitment and support of the Global Polio Eradication Partnership were critical for Madagascar to achieve polio free status. Socio-political instability, weakness of the health system, sub-optimal routine immunization performance, insufficient SIA quality and existing security compromised areas remain critical program challenges to address in order to maintaining the polio free status. Continuous high-level advocacy should be kept in order to ensure that new government authorities maintain polio eradication among the top priorities of the country.

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 Australian National Enterovirus Reference Laboratory annual report, 2015

2020 ◽  
Vol 44 ◽  
Author(s):  
Jason A Roberts ◽  
Linda K Hobday ◽  
Aishah Ibrahim ◽  
Thomas Aitken ◽  
Bruce R Thorley
Keyword(s):  
Surveillance System ◽  
Oral Polio Vaccine ◽  
World Health ◽  
Surveillance Program ◽  
Reference Laboratory ◽  
Poliovirus Type ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Clinical Surveillance

Australia conducts surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years as recommended by the World Health Organization (WHO) as the main method to monitor its polio-free status. Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2015, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.2 non-polio AFP cases per 100,000 children, meeting the WHO performance criterion for a sensitive surveillance system. Two non-polio enteroviruses, enterovirus A71 and coxsackievirus B3, were identified from clinical specimens collected from AFP cases. Australia complements the clinical surveillance program with enterovirus and environmental surveillance for poliovirus. Two Sabin-like polioviruses were isolated from sewage collected in Melbourne in 2015, which would have been imported from a country that uses the oral polio vaccine. The global eradication of wild poliovirus type 2 was certified in 2015 and Sabin poliovirus type 2 will be withdrawn from oral polio vaccine in April 2016. Laboratory containment of all remaining wild and vaccine strains of poliovirus type 2 will occur in 2016 and the National Enterovirus Reference Laboratory was designated as a polio essential facility. Globally, in 2015, 74 cases of polio were reported, only in the two remaining countries endemic for wild poliovirus: Afghanistan and Pakistan. This is the lowest number reported since the global polio eradication program was initiated.

scholarly journals Sabin Vaccine Reversion in the Field: a Comprehensive Analysis of Sabin-Like Poliovirus Isolates in Nigeria

2015 ◽  
Vol 90 (1) ◽  
pp. 317-331 ◽  
Author(s):  
Michael Famulare ◽  
Stewart Chang ◽  
Jane Iber ◽  
Kun Zhao ◽  
Johnson A. Adeniji ◽  
...  
Keyword(s):  
Virus Type ◽  
Oral Polio Vaccine ◽  
Wild Type ◽  
Recombination Rates ◽  
Substitution Rates ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Routine Surveillance ◽  
Type 3

ABSTRACTTo assess the dynamics of genetic reversion of live poliovirus vaccine in humans, we studied molecular evolution in Sabin-like poliovirus isolates from Nigerian acute flaccid paralysis cases obtained from routine surveillance. We employed a novel modeling approach to infer substitution and recombination rates from whole-genome sequences and information about poliovirus infection dynamics and the individual vaccination history. We confirmed observations from a recent vaccine trial that VP1 substitution rates are increased for Sabin-like isolates relative to the rate for the wild type due to increased nonsynonymous substitution rates. We also inferred substitution rates for attenuating nucleotides and confirmed that reversion can occur in days to weeks after vaccination. We combine our observations for Sabin-like virus evolution with the molecular clock for VP1 of circulating wild-type strains to infer that the mean time from the initiating vaccine dose to the earliest detection of circulating vaccine-derived poliovirus (cVDPV) is 300 days for Sabin-like virus type 1, 210 days for Sabin-like virus type 2, and 390 days for Sabin-like virus type 3. Phylogenetic relationships indicated transient local transmission of Sabin-like virus type 3 and, possibly, Sabin-like virus type 1 during periods of low wild polio incidence. Comparison of Sabin-like virus recombinants with known Nigerian vaccine-derived poliovirus recombinants shows that while recombination with non-Sabin enteroviruses is associated with cVDPV, the recombination rates are similar for Sabin isolate-Sabin isolate and Sabin isolate–non-Sabin enterovirus recombination after accounting for the time from dosing to the time of detection. Our study provides a comprehensive picture of the evolutionary dynamics of the oral polio vaccine in the field.IMPORTANCEThe global polio eradication effort has completed its 26th year. Despite success in eliminating wild poliovirus from most of the world, polio persists in populations where logistical, social, and political factors have not allowed vaccination programs of sustained high quality. One issue of critical importance is eliminating circulating vaccine-derived polioviruses (cVDPVs) that have properties indistinguishable from those of wild poliovirus and can cause paralytic disease. cVDPV emerges due to the genetic instability of the Sabin viruses used in the oral polio vaccine (OPV) in populations that have low levels of immunity to poliovirus. However, the dynamics responsible are incompletely understood because it has historically been difficult to gather and interpret data about evolution of the Sabin viruses used in OPV in regions where cVDPV has occurred. This study is the first to combine whole-genome sequencing of poliovirus isolates collected during routine surveillance with knowledge about the intrahost dynamics of poliovirus to provide quantitative insight into polio vaccine evolution in the field.

scholarly journals Vaccines: World Health Organization versus Federal Drug Administration recommended formula

2000 ◽  
Vol 6 (4) ◽  
pp. 644-651
Author(s):  
M. K. Khalil ◽  
Y. Y. Al Mazrou ◽  
Y. S. Al Ghamdi
Keyword(s):  
Oral Polio Vaccine ◽  
Oral Poliovirus Vaccine ◽  
World Health ◽  
Haemophilus Influenzae Type ◽  
Federal Drug Administration ◽  
Polio Vaccine ◽  
Polyribosylribitol Phosphate ◽  
Health Organization ◽  
Antibody Levels ◽  
To Receive

Vaccines produced in accordance with WHO formulas, differ in concentration from those used in United States according to FDA formulas. We aimed to compare the immunogenicity of both formulas. Infants who were 6 weeks old were randomly put into 3 groups to receive 3 doses of vaccines at 6 weeks, 3 months and 5 months of age. The vaccines consisted of Haemophilus influenzae type b vaccine, diphtheria-tetanus-pertussis and oral polio vaccine. Antibody levels for polyribosylribitol phosphate [PRP], tetanus, diphtheria and poliovirus were measured 1 month after the third dose of vaccines. Although diphtheria and tetanus antigens in the FDA formula are half the concentration of the WHO formula, anti-tetanus and anti-diphtheria antibodies were significantly higher. No difference was found between groups regarding oral poliovirus vaccine

scholarly journals The polio-eradication programme and issues of the end game

2012 ◽  
Vol 93 (3) ◽  
pp. 457-474 ◽  
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.

scholarly journals Inferring Numbers of Wild Poliovirus Excretors Using Quantitative Environmental Surveillance

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 870
Author(s):  
Yuri Perepliotchikov ◽  
Tomer Ziv-Baran ◽  
Musa Hindiyeh ◽  
Yossi Manor ◽  
Danit Sofer ◽  
...  
Keyword(s):  
Oral Polio Vaccine ◽  
Turnaround Time ◽  
Quantitative Detection ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Kinetic Information ◽  
Using Data ◽  
Number Of Individuals

Response to and monitoring of viral outbreaks can be efficiently focused when rapid, quantitative, kinetic information provides the location and the number of infected individuals. Environmental surveillance traditionally provides information on location of populations with contagious, infected individuals since infectious poliovirus is excreted whether infections are asymptomatic or symptomatic. Here, we describe development of rapid (1 week turnaround time, TAT), quantitative RT-PCR of poliovirus RNA extracted directly from concentrated environmental surveillance samples to infer the number of infected individuals excreting poliovirus. The quantitation method was validated using data from vaccination with bivalent oral polio vaccine (bOPV). The method was then applied to infer the weekly number of excreters in a large, sustained, asymptomatic outbreak of wild type 1 poliovirus in Israel (2013) in a population where >90% of the individuals received three doses of inactivated polio vaccine (IPV). Evidence-based intervention strategies were based on the short TAT for direct quantitative detection. Furthermore, a TAT shorter than the duration of poliovirus excretion allowed resampling of infected individuals. Finally, the method documented absence of infections after successful intervention of the asymptomatic outbreak. The methodologies described here can be applied to outbreaks of other excreted viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where there are (1) significant numbers of asymptomatic infections; (2) long incubation times during which infectious virus is excreted; and (3) limited resources, facilities, and manpower that restrict the number of individuals who can be tested and re-tested.

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