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Human Vaccines & Immunotherapeutics Feb 2021In 2000, China was declared polio-free. However, in 2018, wild poliovirus (WPV) was still endemic in two of its neighboring countries, making WPV importation and...
In 2000, China was declared polio-free. However, in 2018, wild poliovirus (WPV) was still endemic in two of its neighboring countries, making WPV importation and outbreak alarming possibilities. This study documents the seroprevalence of poliovirus antibodies before and after the polio vaccine switch in 2012 and 2017 in Beijing. Cross-sectional population-based serologic surveys were conducted in 2012 and 2017 in Beijing. The study subjects were selected from 10 different age groups (<1, 1-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, and ≥40 y) using a multi-stage-stratified sampling method. Neutralizing antibody titers against poliovirus serotypes 1 (P1), 2 (P2), and 3 (P3) were assayed by World Health Organization standards. The seropositive rates (SR) and geometric mean titer (GMT) of the neutralizing antibodies were 91.71% and 1:130.26, respectively, for P1, 94.09% and 1:113.39, respectively, for P2, and 88.78% and 1:79.65, respectively, for P3 before the switch in 2012, and 87.78% and 1:108.93, respectively, for P1, and 81.67% and 1:70.56, respectively, for P3 after the switch in 2017, with a statistically significant difference for P1 and P3 between 2012 and 2017. The neutralizing antibodies for all poliovirus serotypes differed among different age and vaccination groups in both 2012 and 2017. After switching polio vaccines twice in 2014 and 2016, the P1 and P3 polio antibody levels were lower in 2017 than in 2012. The P2 antibody levels were determined from the first dose of IPV. The seroprevalence of poliovirus antibodies after adjustment of the immunization schedule of the polio vaccine on January 1, 2020, must be further monitored.
Topics: Antibodies, Viral; Beijing; China; Cross-Sectional Studies; Humans; Infant; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Inactivated; Poliovirus Vaccine, Oral; Poliovirus Vaccines; Seroepidemiologic Studies; Vaccination
PubMed: 32703060
DOI: 10.1080/21645515.2020.1778409 -
PloS One 2019The weekly NO-DO newsreels, official and of obligatory projection in cinemas, held an information monopoly during the Francoist dictatorship (1943-1975) in Spain. The...
The weekly NO-DO newsreels, official and of obligatory projection in cinemas, held an information monopoly during the Francoist dictatorship (1943-1975) in Spain. The NO-DO was used as an instrument of indoctrination and legitimation, building a discourse based on the regime's needs and interests. In this study, we examined newsreels on medical subjects related to vaccine-preventable diseases. A majority of reports centred on poliomyelitis, and two differentiated periods could be defined, coinciding with the evolution of the Franco regime's foreign policy. The first period reflected the regime's era of isolation and referred to polio as a foreign disease, with the NO-DO showing the US initiatives to fight against it, as it had become the scientific model to follow. Subsequently, the ambiguities of the news related to the disease reflected the dictatorship's refusal to confront the epidemic suffered by the Spanish population until the vaccination campaigns began in 1963. Even then, the consequences that the negligent management of the disease had for many families were concealed. Meanwhile, the image of a modernized country concerned about national public health was legitimized.
Topics: Health Promotion; Humans; Immunization Programs; Internet; Poliomyelitis; Propaganda; Public Health; Public Health Surveillance; Spain
PubMed: 31751398
DOI: 10.1371/journal.pone.0225324 -
Clinical Infectious Diseases : An... Oct 2018In May 2016, countries using oral polio vaccine for routine immunization switched from trivalent oral poliovirus vaccine (tOPV) to bivalent type 1 and 3 OPV (bOPV). This... (Review)
Review
In May 2016, countries using oral polio vaccine for routine immunization switched from trivalent oral poliovirus vaccine (tOPV) to bivalent type 1 and 3 OPV (bOPV). This was done in order to reduce risks from type 2 vaccine-derived polioviruses (VDPV2) and vaccine-associated paralytic poliomyelitis (VAPP) and to introduce ≥1 dose of inactivated poliovirus vaccine (IPV) to mitigate post-switch loss of type 2 immunity. We conducted a literature review of studies that assessed humoral and intestinal immunogenicity induced by the newly recommended schedules. Differences in seroconversion rates were closely associated with both timing of first IPV administration and number of doses administered. All studies demonstrated high levels of immunity for types 1 and 3 regardless of immunization schedule. When administered late in the primary series, a second dose of IPV closed the humoral immunity gap against polio type 2 associated with a single dose. IPV doses and administration schedules appear to have limited impact on type 2 excretion following challenge.
Topics: Disease Eradication; Global Health; Humans; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Inactivated; Poliovirus Vaccine, Oral; Vaccination
PubMed: 30376081
DOI: 10.1093/cid/ciy633 -
The Pan African Medical Journal 2023acute flaccid paralysis (AFP) surveillance is the gold standard of the Global Polio Eradication Initiative (GPEI) for detecting cases of poliomyelitis and tracking...
INTRODUCTION
acute flaccid paralysis (AFP) surveillance is the gold standard of the Global Polio Eradication Initiative (GPEI) for detecting cases of poliomyelitis and tracking poliovirus transmission. Nigeria's AFP surveillance performance indicators are among the highest in countries of the World Health Organization (WHO) African Region. The primary AFP surveillance performance indicators are the rate of non-polio AFP among children and the proportion of timely, adequate specimen collection. The surveillance working group of the National Emergency Operations Centre assessed the quality of AFP surveillance data in some reportedly high-performing states.
METHODS
we conducted a retrospective review of AFP surveillance performance indicators in Nigeria for 2010-2019. We also reviewed data in reports from four groups of surveillance peer reviews and validation visits (conducted by in-country GPEI partners) during August 2017-May 2019 in 16 states with high primary AFP surveillance indicators; the validation visits reviewed clinical information and the dates of specimen collection and onset of paralysis with caretakers.
RESULTS
there were consistently increasing AFP surveillance primary performance indicators during 2010-2016, followed by declines during 2017-2019. From the data for 16 states with peer reviews conducted from August 2017-May 2019, overall concordance of reported and "true" (validated) AFP indicator data in peer review investigations was highly variable. True AFP concordance ranged from 58%-100%, and stool timeliness concordance ranged from 56%-95%. The most common clinical causes of reported AFP cases that were not true AFP were spastic paralysis, malaria, sickle cell disease, and malnutrition. All the states that participated in peer reviews developed surveillance improvement plans based on the gaps identified.
CONCLUSION
Nigeria has highly sensitive AFP surveillance according to reported primary AFP performance indicators. The findings of peer reviews indicate that the AFP surveillance system needs to be strengthened and well-supervised to enhance data quality.
Topics: Child; Humans; Nigeria; alpha-Fetoproteins; Population Surveillance; Poliomyelitis; Poliovirus; Paralysis
PubMed: 38370096
DOI: 10.11604/pamj.supp.2023.45.2.39450 -
PLoS Biology Jun 2015Sustained and coordinated vaccination efforts have brought polio eradication within reach. Anticipating the eradication of wild poliovirus (WPV) and the subsequent...
Sustained and coordinated vaccination efforts have brought polio eradication within reach. Anticipating the eradication of wild poliovirus (WPV) and the subsequent challenges in preventing its re-emergence, we look to the past to identify why polio rose to epidemic levels in the mid-20th century, and how WPV persisted over large geographic scales. We analyzed an extensive epidemiological dataset, spanning the 1930s to the 1950s and spatially replicated across each state in the United States, to glean insight into the drivers of polio's historical expansion and the ecological mode of its persistence prior to vaccine introduction. We document a latitudinal gradient in polio's seasonality. Additionally, we fitted and validated mechanistic transmission models to data from each US state independently. The fitted models revealed that: (1) polio persistence was the product of a dynamic mosaic of source and sink populations; (2) geographic heterogeneity of seasonal transmission conditions account for the latitudinal structure of polio epidemics; (3) contrary to the prevailing "disease of development" hypothesis, our analyses demonstrate that polio's historical expansion was straightforwardly explained by demographic trends rather than improvements in sanitation and hygiene; and (4) the absence of clinical disease is not a reliable indicator of polio transmission, because widespread polio transmission was likely in the multiyear absence of clinical disease. As the world edges closer to global polio eradication and continues the strategic withdrawal of the Oral Polio Vaccine (OPV), the regular identification of, and rapid response to, these silent chains of transmission is of the utmost importance.
Topics: Epidemics; Geography, Medical; History, 20th Century; Humans; Incidence; Models, Theoretical; Poliomyelitis; Seasons; United States
PubMed: 26090784
DOI: 10.1371/journal.pbio.1002172 -
Vaccine Apr 2023Delivering inactivated poliovirus vaccine (IPV) with oral poliovirus vaccine (OPV) in campaigns has been explored to accelerate the control of type 2 circulating... (Review)
Review
Delivering inactivated poliovirus vaccine (IPV) with oral poliovirus vaccine (OPV) in campaigns has been explored to accelerate the control of type 2 circulating vaccine-derived poliovirus (cVDPV) outbreaks. A review of scientific literature suggests that among populations with high prevalence of OPV failure, a booster with IPV after at least two doses of OPV may close remaining humoral and mucosal immunity gaps more effectively than an additional dose of trivalent OPV. However, IPV alone demonstrates minimal advantage on humoral immunity compared with monovalent and bivalent OPV, and cannot provide the intestinal immunity that prevents infection and spread to those individuals not previously exposed to live poliovirus of the same serotype (i.e. type 2 for children born after the switch from trivalent to bivalent OPV in April 2016). A review of operational data from polio campaigns shows that addition of IPV increases the cost and logistic complexity of campaigns. As a result, campaigns in response to an outbreak often target small areas. Large campaigns require a delay to ensure logistics are in place for IPV delivery, and may need implementation in phases that last several weeks. Challenges to delivery of injectable vaccines through house-to-house visits also increases the risk of missing the children who are more likely to benefit from IPV: those with difficult access to routine immunization and other health services. Based upon this information, the Strategic Advisory Group of Experts in immunization (SAGE) recommended in October 2020 the following strategies: provision of a second dose of IPV in routine immunization to reduce the risk and number of paralytic cases in countries at risk of importation or new emergences; and use of type 2 OPV in high-quality campaigns to interrupt transmission and avoid seeding new type 2 cVDPV outbreaks.
Topics: Child; Humans; Poliovirus; Poliovirus Vaccine, Inactivated; Poliovirus Vaccine, Oral; Poliomyelitis; Disease Outbreaks
PubMed: 35365341
DOI: 10.1016/j.vaccine.2022.03.027 -
The Pan African Medical Journal 2023In 2011, a dedicated consortium of experts commenced work on the development of the novel oral poliovirus vaccine type 2 (nOPV2). After careful and rigorous analysis of... (Review)
Review
In 2011, a dedicated consortium of experts commenced work on the development of the novel oral poliovirus vaccine type 2 (nOPV2). After careful and rigorous analysis of data to enable early, targeted use of the vaccine, World Health Organization´s (WHO´s) Strategic Advisory Group of Experts on Immunization (SAGE) reviewed data from accelerated clinical development of nOPV2 and endorsed entering assessment under WHO´s Emergency Use Listing (EUL) procedure. In November 2020, nOPV2 received an interim recommendation for use under EUL to enable rapid field availability and potential wider rollout of the vaccine. In December 2020, Nigeria initiated preparation to meet all criteria for initial use of nOPV2 in the country and the documentation process to verify meeting them. The process entailed addressing the status of meeting 25 readiness criteria in nine categories for nOPV2 use in Nigeria for response efforts to ongoing cVDPV2 outbreaks. During January-February 2021, Nigeria submitted the required documentation for all required indicators for nOPV2 initial use. In February 2021, the country obtained approval from the GPEI nOPV2 Readiness Verification Team to introduce nOPV2 and in March 2021, rolled out the novel vaccine in mass vaccination campaigns for outbreak response in Bayelsa, Delta, Niger, Sokoto and Zamfara states, and one area council in the Federal Capital Territory (FCT). The lessons learned from this rollout experience in Nigeria are being applied as the country streamlines and strengthens the nOPV2 rollout process across the remaining states.
Topics: Humans; Poliovirus Vaccine, Oral; Poliomyelitis; Nigeria; Poliovirus; Global Health; Disease Outbreaks
PubMed: 38370105
DOI: 10.11604/pamj.supp.2023.45.2.38033 -
BMJ Open May 2022To document lessons from the Global Polio Eradication Initiative (GPEI) by determining factors associated with successful surveillance programme globally as well as at...
OBJECTIVES
To document lessons from the Global Polio Eradication Initiative (GPEI) by determining factors associated with successful surveillance programme globally as well as at national and subnational levels. The process of conducting surveillance has been previously recognised in the literature as important for the success of polio surveillance activities.
DESIGN
A cross-sectional survey with closed and open-ended questions.
SETTINGS
Survey of persons involved in the implementation of surveillance activities under the GPEI at the global level and in seven low-income and middle-income countries.
PARTICIPANTS
Individuals (n=802) with ≥12 months of experience implementing surveillance objective of the GPEI between 1988 and 2019.
MAIN OUTCOME MEASURES AND METHODS
Quantitative and qualitative analyses were conducted. Logistic regression analyses were used to assess factors associated with implementation process as a factor for successful surveillance programme. Horizontal analysis was used to analyse qualitative free-text responses on facilitators and barriers identified for conducting surveillance activities successfully.
RESULTS
Overall, participants who reported challenges relating to GPEI programme characteristics had 50% lower odds of reporting implementation process as a factor for successful surveillance (adjusted OR (AOR): 0.50, 95% CI: 0.29 to 0.85). Challenges were mainly perceptions of external intervention source (ie, surveillance perceived as 'foreign' to local communities) and the complexity of surveillance processes (ie, surveillance required several intricate steps). Those who reported organisational challenges were almost two times more likely to report implementation process as a factor for successful surveillance (AOR: 1.89, 95% CI: 1.07 to 3.31) overall, and over threefolds (AOR: 3.32, 95% CI: 1.14 to 9.66) at the national level.
CONCLUSIONS
Programme characteristics may have impeded the process of conducting surveillance under the GPEI, while organisational characteristics may have facilitated the process. Future surveillance programmes should be designed with inputs from local communities and frontline implementers.
Topics: Communicable Diseases; Cross-Sectional Studies; Disease Eradication; Global Health; Humans; Immunization Programs; Poliomyelitis
PubMed: 35551082
DOI: 10.1136/bmjopen-2022-060885 -
Risk Analysis : An Official Publication... Feb 2021This introduction for the third special issue on modeling poliovirus risks provides context for the current status of global polio eradication efforts and gives an...
This introduction for the third special issue on modeling poliovirus risks provides context for the current status of global polio eradication efforts and gives an overview of the individual papers included in the issue. Although risk analysis continues to support the Global Polio Eradication Initiative (GPEI), efforts to finish the job remained off track at the beginning of 2020 and prior to the COVID-19 pandemic, as discussed in the special issue. The disruptions associated with COVID-19 occurring now will inevitably change the polio eradication trajectory, and future studies will need to characterize the impacts of these disruptions on the polio endgame.
Topics: COVID-19; Disease Eradication; Global Health; Humans; Immunization Programs; Models, Theoretical; Pandemics; Poliomyelitis; Poliovirus; Poliovirus Vaccines; Risk Assessment
PubMed: 33590520
DOI: 10.1111/risa.13668 -
Orthopaedic Surgery Apr 2023Poliomyelitis is a rare neuromuscular disease that can cause hip osteoarthritis on the contralateral side due to an abnormal mechanical weight-bearing state, making some...
OBJECTIVE
Poliomyelitis is a rare neuromuscular disease that can cause hip osteoarthritis on the contralateral side due to an abnormal mechanical weight-bearing state, making some residual poliomyelitis patients candidates for total hip arthroplasty (THA). The aim of this study was to investigate the clinical outcome of THA in the nonparalytic limbs of these patients compared with those of non-poliomyelitis patients.
METHODS
Patients treated between January 2007 and May 2021 were retrospectively identified in a single center arthroplasty database. Eight residual poliomyelitis cases that met the inclusion criteria were matched to non-poliomyelitis cases in a ratio of 1:2 based on age, sex, body mass index (BMI), age-adjusted Charlson comorbidity index (aCCI), surgeon, and operation date. The hip function, health-related quality of life, radiographic outcomes, and complications were analyzed with unpaired Student's t test, Mann-Whitney test, Fisher's exact test or analysis of covariance (ANCOVA). Survivorship analysis was determined using the Kaplan-Meier estimator analysis and Gehan-Breslow-Wilcoxon test.
RESULTS
After a mean follow-up of about 5 years, patients with residual poliomyelitis had worse postoperative mobility outcomes(P < 0.05), but there was no difference in total modified Harris hip score (mHHS) or European quality of life-visual analogue scale (EQ-VAS) between the two groups (P > 0.05). There was no difference in radiographic outcomes or complications between the two groups, and patients had similar postoperative satisfaction (P > 0.05). No readmission or reoperation occurred in the poliomyelitis group (P > 0.05), but the postoperative limb length discrepancy (LLD) in the residual poliomyelitis group was greater than that in the control group (P < 0.05).
CONCLUSION
Functional outcomes, health-related quality of life improvement were similarly significantly improved in the nonparalytic limb of residual poliomyelitis patients after THA compared with conventional osteoarthritis patients. However, the residual LLD and weak muscle strength of the affected side will still influence mobility, so residual poliomyelitis patients should be fully informed of this outcome before surgery.
Topics: Humans; Arthroplasty, Replacement, Hip; Hip Joint; Retrospective Studies; Quality of Life; Propensity Score; Treatment Outcome; Osteoarthritis, Hip; Poliomyelitis
PubMed: 36810876
DOI: 10.1111/os.13685