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Vaccine Jun 2023Prior modeling studies showed that current outbreak management strategies are unlikely to stop outbreaks caused by type 1 wild polioviruses (WPV1) or circulating...
Prior modeling studies showed that current outbreak management strategies are unlikely to stop outbreaks caused by type 1 wild polioviruses (WPV1) or circulating vaccine-derived polioviruses (cVDPVs) in many areas, and suggested increased risks of outbreaks with cocirculation of more than one type of poliovirus. The surge of type 2 poliovirus transmission that began in 2019 and continues to date, in conjunction with decreases in preventive supplemental immunization activities (SIAs) for poliovirus types 1 and 3, has led to the emergence of several countries with cocirculation of more than one type of poliovirus. Response to these emerging cocirculation events is theoretically straightforward, but the different formulations, types, and inventories of oral poliovirus vaccines (OPVs) available for outbreak response present challenging practical questions. In order to demonstrate the implications of using different vaccine options and outbreak campaign strategies, we applied a transmission model to a hypothetical population with conditions similar to populations currently experiencing outbreaks of cVDPVs of both types 1 and 2. Our results suggest prevention of the largest number of paralytic cases occurs when using (1) trivalent OPV (tOPV) (or coadministering OPV formulations for all three types) until one poliovirus outbreak type dies out, followed by (2) using a type-specific OPV until the remaining poliovirus outbreak type also dies out. Using tOPV first offers a lower overall expected cost, but this option may be limited by the willingness to expose populations to type 2 Sabin OPV strains. For strategies that use type 2 novel OPV (nOPV2) concurrently administered with bivalent OPV (bOPV, containing types 1 and 3 OPV) emerges as a leading option, but questions remain about feasibility, logistics, type-specific take rates, and coadministration costs.
Topics: Humans; Disease Outbreaks; Global Health; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Inactivated; Poliovirus Vaccine, Oral
PubMed: 37121801
DOI: 10.1016/j.vaccine.2023.04.037 -
European Journal of Physical and... Apr 2024Poliomyelitis is a global disabling disease affecting 12-20 million of people. Post poliomyelitis syndrome (PPS) may affect up to 80% of polio survivors: increased...
BACKGROUND
Poliomyelitis is a global disabling disease affecting 12-20 million of people. Post poliomyelitis syndrome (PPS) may affect up to 80% of polio survivors: increased muscle weakness, pain, fatigue, functional decline. It relies on aging of an impaired neuro-muscular system with ongoing denervation processes. A late involvement of humoral or cellular pro-inflammatory phenomena is also suspected.
AIM
To assess the dysimmune hypothesis of PPS by comparing lymphocyte subpopulations and humoral immune factors between PPS patients and controls.
DESIGN
Cross-sectional study.
SETTING
Montpellier University Hospital.
POPULATION
Forty-seven PPS and 27 healthy controls.
METHODS
PPS patients and controls were compared on their lymphocyte subpopulations and humoral immune factors (IL-1β, IL-6, IL-8, IL-17, IL-21, IL-22, IL-23, IFN-γ, TNF-α, GM-CSF, RANTES, MCP1, MIP-3a, IL-10, TGF-β, IL4, IL13). Patients were further compared according to their dominant clinical symptoms. Sample size guaranteed a power >90% for all comparisons.
RESULTS
PPS patients and controls were comparable in gender, age and corpulence. Most patients had lower limb motor sequelae (N.=45, 95.7%), a minority had upper limb motor impairment (N.=16, 34.0%). Forty-five were able to walk (94%), 35/45 with technical aids. The median of the two-minute walking test was 110 meters (interquartile range 55; 132). Eighteen (38%) required help in their daily life. Their quality of life was low (SF36). All described an increased muscular weakness, 40 (85%) a general fatigue, and 39 (83%) muscular or joint pain. Blood count, serum electrolytes, T and B lymphocyte subpopulations and cytokines were comparable between patients and controls, except for creatine phospho kinase that was significantly higher in PPS patients. None of these variables differed between the 20/47 patients whose late main symptoms were pain or fatigue, and other patients.
CONCLUSIONS
Our results suggest that PPS is not a dysimmune disease.
CLINICAL REHABILITATION IMPACT
Our results do not sustain immunotherapy for PPS. Our work suggest that PPS may be mostly linked to physiological age-related phenomena in a disabled neuromuscular condition. Thus, our results emphasize the role of prevention and elimination of aggravating factors to avoid late functional worsening, and the importance of rehabilitation programs that should be adapted to patients' specific conditions.
Topics: Humans; Postpoliomyelitis Syndrome; Cross-Sectional Studies; Quality of Life; Poliomyelitis; Pain; Fatigue; Muscle Weakness; Immunologic Factors
PubMed: 38252127
DOI: 10.23736/S1973-9087.23.08158-3 -
Quality of Life Research : An... Sep 2019Quality of life evaluation is essential to explore the effect of paralytic polio on the daily life experience of the polio survivor. Researchers have employed a range of... (Review)
Review
BACKGROUND
Quality of life evaluation is essential to explore the effect of paralytic polio on the daily life experience of the polio survivor. Researchers have employed a range of assessment instruments to evaluate quality of life among polio survivors. Hence, to select the appropriate scale, it is crucial to compare the contents and psychometric properties of these instruments.
PURPOSE
This scoping review explores quality of life instruments that are used in polio literature and analyzes their contents and psychometric properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.
METHOD
Using the Arksey and O'Malley framework, we conducted a literature search in the following electronic databases Medline, CINAHL, Web of Science, Embase, and Google Scholar to identify relevant studies that focused on quality of life of polio survivors. Of the 88 articles that qualify for full-text screening, 34 studies met our inclusion criteria. Two independent reviewers extracted data from the selected studies via Covidence, a reference manager that allows for blinding of reviews.
RESULTS
Most of the instruments included in this review are generic, self-reported, and multidimensional. Despite having mostly adequate psychometric properties, these properties were not evaluated in polio survivors.
CONCLUSION
The information provided in this review could be used to guide instrument selection and identify the need to develop a new tool or to adapt a pre-existing scale for measuring quality of life among polio survivors.
Topics: Humans; Poliomyelitis; Psychometrics; Quality of Life; Survivors
PubMed: 31028511
DOI: 10.1007/s11136-019-02185-x -
The American Journal of Tropical... Jul 2023In 1988, the WHO launched the Global Poliomyelitis Eradication Initiative with the goal of eradication by 2000. Not only has this goal, which has been repeatedly...
In 1988, the WHO launched the Global Poliomyelitis Eradication Initiative with the goal of eradication by 2000. Not only has this goal, which has been repeatedly postponed, still not been achieved, but while the wild polio virus is still endemic in two Asian countries, a new epidemic caused by a vaccine-derived virus is spreading and is now affecting numerous developing and industrialized countries, including the United Kingdom and the United States. In addition to biological explanations for the failure of eradication, vaccination refusal by communities in mainly two regions of Africa and Asia has prevented mass vaccination campaigns from achieving their immunization coverage targets. The way these campaigns have been deployed has contributed to mistrust and hostility. The negative reactions of some communities, expressed from the first vaccination campaigns, were belatedly considered, which gave time for rumors to flourish and settle permanently. This failure underscores the importance of taking into account, before any vaccination campaign begins, the "health culture" of target populations-meaning their representations of the vaccines and the health authorities that promote vaccination, as well as their knowledge, fears, and hopes.
Topics: Humans; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral; Vaccination; Immunization Programs; Vaccination Refusal; Global Health; Disease Eradication
PubMed: 37188348
DOI: 10.4269/ajtmh.23-0154 -
Human Vaccines & Immunotherapeutics Dec 2022Implementation of inactivated polio vaccines (IPV) containing Sabin strains (sIPV) will further enable global polio eradication efforts by improving vaccine safety... (Review)
Review
Implementation of inactivated polio vaccines (IPV) containing Sabin strains (sIPV) will further enable global polio eradication efforts by improving vaccine safety during use and containment during manufacturing. Moreover, sIPV-containing vaccines will lower costs and expand production capacity to facilitate more widespread use in low- and middle-income countries (LMICs). This review focuses on the role of vaccine formulation in these efforts including traditional Salk IPV vaccines and new sIPV-containing dosage forms. The physicochemical properties and stability profiles of poliovirus antigens are described. Formulation approaches to lower costs include developing multidose and combination vaccine formats as well as improving storage stability. Formulation strategies for dose-sparing and enhanced mucosal immunity include employing adjuvants (e.g. aluminum-salt and newer adjuvants) and/or novel delivery systems (e.g. ID administration with microneedle patches). The potential for applying these low-cost formulation development strategies to other vaccines to further improve vaccine access and coverage in LMICs is also discussed.
Topics: Humans; Poliovirus; Poliomyelitis; Poliovirus Vaccine, Inactivated; Adjuvants, Immunologic; Drug Delivery Systems; Poliovirus Vaccine, Oral; Antibodies, Viral
PubMed: 36576132
DOI: 10.1080/21645515.2022.2154100 -
Journal of the American College of... Dec 2020
Topics: Civil Defense; Communicable Disease Control; Global Health; History; Humans; Influenza, Human; Pandemics; Poliomyelitis; Vaccines
PubMed: 33139120
DOI: 10.1016/j.jacc.2020.10.025 -
Annals of the Academy of Medicine,... Jan 2023Poliomyelitis, or polio, is a highly infectious disease and can result in permanent flaccid paralysis of the limbs. Singapore was certified polio-free by the World...
Poliomyelitis, or polio, is a highly infectious disease and can result in permanent flaccid paralysis of the limbs. Singapore was certified polio-free by the World Health Organization (WHO) on 29 October 2000, together with 36 other countries in the Western Pacific Region. The last imported case of polio in Singapore was in 2006. Fortunately, polio is vaccine-preventable-the world saw the global eradication of wild poliovirus types 2 and 3 achieved in 2015 and 2019, respectively. However, in late 2022, a resurgence of paralytic polio cases from vaccine-derived poliovirus (VDPV) was detected in countries like Israel and the US (specifically, New York); VDPV was also detected during routine sewage water surveillance with no paralysis cases in London, UK. Without global eradication, there is a risk of re-infection from importation and spread of wild poliovirus or VDPV, or new emergence and circulation of VDPV. During the COVID-19 pandemic, worldwide routine childhood vaccination coverage fell by 5% to 81% in 2020-2021. Fortunately, Singapore has maintained a constantly high vaccination coverage of 96% among 1-year-old children as recorded in 2021. All countries must ensure high poliovirus vaccination coverage in their population to eradicate poliovirus globally, and appropriate interventions must be taken to rectify this if the coverage falters. In 2020, WHO approved the emergency use listing of a novel oral polio vaccine type 2 for countries experiencing circulating VDPV type 2 outbreaks. Environmental and wastewater surveillance should be implemented to allow early detection of "silent" poliovirus transmission in the population, instead of relying on clinical surveillance of acute flaccid paralysis based on case definition alone.
Topics: Child; Humans; Infant; Public Health Surveillance; Pandemics; Wastewater; Wastewater-Based Epidemiological Monitoring; COVID-19; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral; Vaccination; Global Health
PubMed: 36730802
DOI: 10.47102/annals-acadmedsg.2022390 -
Anasthesiologie, Intensivmedizin,... Sep 2021Due to the numerous poliomyelitis epidemics that have continued over the last decades and the post-polio syndrome (PPS) that occurs 10 - 30 years after poliomyelitis...
Due to the numerous poliomyelitis epidemics that have continued over the last decades and the post-polio syndrome (PPS) that occurs 10 - 30 years after poliomyelitis infection, the prevalence of PPS is also expected to increase in Europe. At the same time, due to the musculoskeletal disorders associated with the underlying disease, PPS patients often require surgery for which special anaesthetic requirements must be taken into account. In this analysis we summarise the current evidence and recommendations.
Topics: Europe; Humans; Poliomyelitis; Postpoliomyelitis Syndrome; Prevalence
PubMed: 34507385
DOI: 10.1055/a-1220-4689 -
Revista Brasileira de Epidemiologia =... 2023To analyze the coverage of MMR and polio vaccines, the temporal trend and spatial dependence, in children up to one year of age in Brazil, between 2011 and 2021.
OBJECTIVE
To analyze the coverage of MMR and polio vaccines, the temporal trend and spatial dependence, in children up to one year of age in Brazil, between 2011 and 2021.
METHODS
Ecological study with secondary data on vaccination coverage rates, made available by the National Immunization Program Information System. Trend analysis was carried out using the joinpoint method, according to geographic regions, estimating the annual percentage change (APC) and its respective confidence interval (95%CI). Choropleth maps of distribution by health region were constructed and, subsequently, the spatial dependence was verified using Moran's statistics.
RESULTS
Between 2011 and 2021, vaccination coverage declined in Brazil, both for MMR (APC: -6.4%; 95%CI -9.0; -3.8) and for poliomyelitis (APC: -4. 5%; 95%CI -5.5; -3.6). There was a decline in coverage of both vaccines in all geographic regions over the years of the study, except in the South and Midwest for the MMR vaccine. Since 2015, few health regions in the country have achieved adequate vaccination coverage (≥95.0% to <120.0%). The North and Northeast health regions showed low-low clusters in the univariate analysis for both immunobiological.
CONCLUSIONS
It is urgent to consider studies like this one for the planning of more effective strategies for immunizing children, especially in areas with higher falls. In this way, barriers to access to immunization can be broken, given Brazil's heterogeneity, and access to reliable information that increases confidence in vaccine efficacy can be expanded.
Topics: Child; Humans; Vaccination Coverage; Brazil; Vaccination; Poliomyelitis; Vaccines; Spatial Analysis
PubMed: 37878834
DOI: 10.1590/1980-549720230047 -
Revista Latino-americana de Enfermagem 2022to identify spatial clusters corresponding to abandonment of routine vaccines in children.
OBJECTIVE
to identify spatial clusters corresponding to abandonment of routine vaccines in children.
METHOD
an ecological study, according to data from the 853 municipalities of a Brazilian state. The records analyzed were those of the multidose pentavalent, pneumococcal 10-valent, inactivated poliomyelitis and oral human rotavirus vaccines of 781,489 children aged less than one year old. The spatial scan statistics was used to identify spatial clusters and assess the relative risk based on the vaccination abandonment indicator.
RESULTS
the spatial scan statistics detected the presence of statistically significant clusters for abandonment regarding the four vaccines in all the years analyzed. However, the highest number of clusters with high relative risk estimates was identified in 2020. The Vale do Aço and West, North and West, and Southwest regions stand out for the pentavalent, poliomyelitis and rotavirus vaccines, respectively.
CONCLUSION
in an attempt to mitigate the devastating impact of the COVID-19 pandemic, the immunization program experienced setbacks. The presence of clusters points to the need to implement integrated strategies that may involve different sectors for an active search for children and prevent outbreaks of vaccine-preventable diseases in the near future.
Topics: COVID-19; Child; Humans; Infant; Pandemics; Poliomyelitis; Rotavirus Vaccines; Vaccination
PubMed: 36228235
DOI: 10.1590/1518-8345.6132.3642