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Journal of Medical Virology Mar 2023Polio cases can be missed by acute flaccid paralysis (AFP) case surveillance alone, emphasizing the importance of environmental surveillance (ES). In this study, to...
Polio cases can be missed by acute flaccid paralysis (AFP) case surveillance alone, emphasizing the importance of environmental surveillance (ES). In this study, to investigate the serotype distribution and epidemiological trends of poliovirus (PV), we characterized PV isolated from domestic sewage in Guangzhou City, Guangdong Province, China from 2009 to 2021. A total of 624 sewage samples were collected from the Liede Sewage Treatment Plant, and the positive rates of PV and non-polio enteroviruses were 66.67% (416/624) and 78.37% (489/624), respectively. After sewage sample treatment, each sewage sample was inoculated in six replicate tubes of three cell lines, and 3370 viruses were isolated during the 13-year surveillance period. Among these, 1086 isolates were identified as PV, including type 1 PV (21.36%), type 2 PV (29.19%), and type 3 PV (49.48%). Based on VP1 sequences, 1057 strains were identified as Sabin-like, 21 strains were high-mutant vaccines, and eight strains were vaccine-derived poliovirus (VDPV). The numbers and serotypes of PV isolates in sewage were influenced by the vaccine switch strategy. After type 2 OPV was removed from the trivalent oral PV (OPV) vaccine and a bivalent OPV (bOPV) was adopted in May 2016, the last type 2 PV strain was isolated from sewage, with no detection thereafter. Type 3 PV isolates increased significantly and became the dominant serotype. Before and after the second vaccine switch in January 2020, that is, from the first dose of IPV and second-fourth doses of bOPV to the first two doses of IPV and third-fourth doses of bOPV, there was also a statistical difference in PV positivity rates in sewage samples. Seven type 2 VDPVs and one type 3 VDPV were identified in sewage samples in 2009-2021, and phylogenetic analysis indicated that all VDPVs isolated from ES in Guangdong are newly discovered VDPVs, different from VDPV previously discovered in China, and were classified as ambiguous VDPV. It is noteworthy that no VDPV cases were reported in AFP case surveillance in the same period. In conclusion, continued PV ES in Guangzhou since April 2008 has been a useful supplement to AFP case surveillance, providing an important basis for evaluating the effectiveness of vaccine immunization strategies. ES improves early detection, prevention, and control; accordingly, this strategy can curb the circulation of VDPVs and provide a strong laboratory basis for maintaining a polio-free status.
Topics: Humans; Poliovirus; Sewage; Phylogeny; alpha-Fetoproteins; Poliovirus Vaccine, Oral; Poliomyelitis; Environmental Monitoring
PubMed: 36905116
DOI: 10.1002/jmv.28668 -
Nursing Mar 2023Chronic pain is a common problem for polio survivors. Nurses are on the front line to assess the scope, severity, and impact of reported pain. This article describes how...
Chronic pain is a common problem for polio survivors. Nurses are on the front line to assess the scope, severity, and impact of reported pain. This article describes how nurses can advocate for patients experiencing post-polio syndrome pain.
Topics: Humans; Poliomyelitis; Postpoliomyelitis Syndrome; Chronic Pain; Survivors
PubMed: 36820695
DOI: 10.1097/01.NURSE.0000905720.83240.9b -
Science (New York, N.Y.) Jan 2023Ban on female NGO staff hampers critical aid work and jeopardizes polio eradication campaign.
Ban on female NGO staff hampers critical aid work and jeopardizes polio eradication campaign.
Topics: Female; Humans; Afghanistan; Poliomyelitis; Disease Eradication; Women's Rights; Child
PubMed: 36656946
DOI: 10.1126/science.adg7351 -
Lancet (London, England) Aug 2022
Topics: Disease Eradication; Global Health; Humans; Immunization Programs; Poliomyelitis
PubMed: 35835128
DOI: 10.1016/S0140-6736(22)01274-0 -
BMJ (Clinical Research Ed.) Oct 2022
Topics: Disease Eradication; Global Health; Humans; Immunization Programs; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Inactivated; Poliovirus Vaccine, Oral
PubMed: 36195323
DOI: 10.1136/bmj.o2388 -
The Lancet. Infectious Diseases Aug 2021
Topics: Humans; Poliomyelitis; Poliovirus
PubMed: 33939959
DOI: 10.1016/S1473-3099(20)30774-X -
MMWR. Morbidity and Mortality Weekly... May 2022In 1988, the World Health Assembly established the Global Polio Eradication Initiative (GPEI). Since then, wild poliovirus (WPV) cases have decreased approximately...
In 1988, the World Health Assembly established the Global Polio Eradication Initiative (GPEI). Since then, wild poliovirus (WPV) cases have decreased approximately 99.99%, and WPV types 2 and 3 have been declared eradicated. Only Afghanistan and Pakistan have never interrupted WPV type 1 (WPV1) transmission. This report describes global progress toward polio eradication during January 1, 2020-April 30, 2022, and updates previous reports (1,2). This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.* Five WPV1 cases were reported from Afghanistan and Pakistan in 2021, compared with 140 in 2020. In 2022 (as of May 5), three WPV1 cases had been reported: one from Afghanistan and two from Pakistan. WPV1 genetically linked to virus circulating in Pakistan was identified in Malawi in a child with paralysis onset in November 2021. Circulating vaccine-derived polioviruses (cVDPVs), with neurovirulence and transmissibility similar to that of WPV, emerge in populations with low immunity following prolonged circulation of Sabin strain oral poliovirus vaccine (OPV) (3). During January 2020-April 30, 2022, a total of 1,856 paralytic cVDPV cases were reported globally: 1,113 in 2020 and 688 in 2021, including cases in Afghanistan and Pakistan. In 2022 (as of May 5), 55 cVDPV cases had been reported. Intensified programmatic actions leading to more effective outbreak responses are needed to stop cVDPV transmission. The 2022-2026 GPEI Strategic Plan objective of ending WPV1 transmission by the end of 2023 is attainable (4). However, the risk for children being paralyzed by polio remains until all polioviruses, including WPV and cVDPV, are eradicated.
Topics: Child; Disease Eradication; Humans; Immunization Programs; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral; Population Surveillance
PubMed: 35552352
DOI: 10.15585/mmwr.mm7119a2 -
MMWR. Morbidity and Mortality Weekly... Aug 2021In 1988, when the Global Polio Eradication Initiative (GPEI) began, polio paralyzed >350,000 children across 125 countries. Today, only one of three wild poliovirus...
In 1988, when the Global Polio Eradication Initiative (GPEI) began, polio paralyzed >350,000 children across 125 countries. Today, only one of three wild poliovirus serotypes, type 1 (WPV1), remains in circulation in only two countries, Afghanistan and Pakistan. This report summarizes progress toward global polio eradication during January 1, 2019-June 30, 2021 and updates previous reports (1,2). In 2020, 140 cases of WPV1 were reported, including 56 in Afghanistan (a 93% increase from 29 cases in 2019) and 84 in Pakistan (a 43% decrease from 147 cases in 2019). As GPEI focuses on the last endemic WPV reservoirs, poliomyelitis outbreaks caused by circulating vaccine-derived poliovirus (cVDPV) have emerged as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations (3). In 2020, 32 countries reported cVDPV outbreaks (four type 1 [cVDPV1], 26 type 2 [cVDPV2] and two with outbreaks of both); 13 of these countries reported new outbreaks. The updated GPEI Polio Eradication Strategy 2022-2026 (4) includes expanded use of the type 2 novel oral poliovirus vaccine (nOPV2) to avoid new emergences of cVDPV2 during outbreak responses (3). The new strategy deploys other tactics, such as increased national accountability, and focused investments for overcoming the remaining barriers to eradication, including program disruptions and setbacks caused by the COVID-19 pandemic.
Topics: Disease Eradication; Disease Outbreaks; Endemic Diseases; Global Health; Humans; Immunization Programs; Poliomyelitis; Poliovirus Vaccines; Population Surveillance
PubMed: 34437527
DOI: 10.15585/mmwr.mm7034a1 -
Pediatrics in Review Jul 2023
Topics: Humans; Poliomyelitis
PubMed: 37391633
DOI: 10.1542/pir.2022-005948 -
Nature Jul 2023
Topics: Humans; Poliomyelitis; Disease Eradication; Global Health; Poliovirus Vaccine, Oral; Poliovirus Vaccine, Inactivated
PubMed: 37316591
DOI: 10.1038/d41586-023-01773-9