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Risk Analysis : An Official Publication... Apr 2013With the intensifying global efforts to eradicate wild polioviruses, policymakers face complex decisions related to achieving eradication and managing posteradication... (Review)
Review
With the intensifying global efforts to eradicate wild polioviruses, policymakers face complex decisions related to achieving eradication and managing posteradication risks. These decisions and the expanding use of inactivated poliovirus vaccine (IPV) trigger renewed interest in poliovirus immunity, particularly the role of mucosal immunity in the transmission of polioviruses. Sustained high population immunity to poliovirus transmission represents a key prerequisite to eradication, but poliovirus immunity and transmission remain poorly understood despite decades of studies. In April 2010, the U.S. Centers for Disease Control and Prevention convened an international group of experts on poliovirus immunology and virology to review the literature relevant for modeling poliovirus transmission, develop a consensus about related uncertainties, and identify research needs. This article synthesizes the quantitative assessments and research needs identified during the process. Limitations in the evidence from oral poliovirus vaccine (OPV) challenge studies and other relevant data led to differences in expert assessments, indicating the need for additional data, particularly in several priority areas for research: (1) the ability of IPV-induced immunity to prevent or reduce excretion and affect transmission, (2) the impact of waning immunity on the probability and extent of poliovirus excretion, (3) the relationship between the concentration of poliovirus excreted and infectiousness to others in different settings, and (4) the relative role of fecal-oral versus oropharyngeal transmission. This assessment of current knowledge supports the immediate conduct of additional studies to address the gaps.
Topics: Humans; Poliomyelitis
PubMed: 23550968
DOI: 10.1111/risa.12031 -
British Medical Journal Aug 1952
Topics: Biometry; Poliomyelitis
PubMed: 14944830
DOI: No ID Found -
MMWR. Morbidity and Mortality Weekly... Apr 2022Since the Global Polio Eradication Initiative (GPEI) was established in 1988, the number of reported poliomyelitis cases worldwide has declined by approximately 99.99%....
Since the Global Polio Eradication Initiative (GPEI) was established in 1988, the number of reported poliomyelitis cases worldwide has declined by approximately 99.99%. By the end of 2021, wild poliovirus (WPV) remained endemic in only two countries (Pakistan and Afghanistan). However, a WPV type 1 (WPV1) case with paralysis onset in 2021, was reported by Malawi a year after the World Health Organization (WHO) African Region (AFR) was certified as WPV-free and circulating vaccine-derived poliovirus (cVDPV) cases were reported from 31 countries during 2020-2021 (1,2). cVDPVs are oral poliovirus vaccine-derived viruses that can emerge after prolonged circulation in populations with low immunity and cause paralysis. The primary means of detecting poliovirus transmission is through surveillance for acute flaccid paralysis (AFP) among persons aged <15 years, with confirmation through stool specimen testing by WHO-accredited laboratories, supplemented by systematic sampling of sewage and testing for the presence of poliovirus (environmental surveillance). The COVID-19 pandemic caused disruptions in polio vaccination and surveillance activities across WHO regions in 2020; during January-September 2020, the number of reported cases of AFP declined and the interval between stool collection and receipt by laboratories increased compared with the same period in 2019 (3). This report summarizes surveillance performance indicators for 2020 and 2021 in 43 priority countries* and updates previous reports (4). In 2021, a total of 32 (74%) priority countries met two key surveillance performance indicator targets nationally, an improvement from 2020 when only 23 (53%) met both targets; however, substantial national and subnational gaps persist. High-performing poliovirus surveillance is critical to tracking poliovirus transmission. Frequent monitoring of surveillance indicators could help identify gaps, guide improvements, and enhance the overall sensitivity and timelines of poliovirus detection to successfully achieve polio eradication.
Topics: Humans; COVID-19; Disease Eradication; Global Health; Immunization Programs; Pandemics; Paralysis; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral; Population Surveillance
PubMed: 35421079
DOI: 10.15585/mmwr.mm7115a2 -
Expert Review of Vaccines Nov 2022Multiple vaccine options are available for polio prevention and risk management. Integrated global risk, economic, and poliovirus transmission modeling provides a tool...
BACKGROUND
Multiple vaccine options are available for polio prevention and risk management. Integrated global risk, economic, and poliovirus transmission modeling provides a tool to explore the dynamics of ending all use of one or more poliovirus vaccines to simplify the polio eradication endgame.
RESEARCH DESIGN AND METHODS
With global reported cases of poliomyelitis trending higher since 2016, we apply an integrated global model to simulate prospective vaccine policies and strategies for OPV-using countries starting with initial conditions that correspond to the epidemiological poliovirus transmission situation at the beginning of 2022.
RESULTS
Abruptly ending all OPV use in 2023 and relying only on IPV to prevent paralysis with current routine immunization coverage would lead to expected reestablished endemic transmission of poliovirus types 1 and 2, and approximately 150,000 expected cases of poliomyelitis per year. Alternatively, if OPV-using countries restart trivalent OPV (tOPV) use for all immunization activities and end IPV use, the model shows the lowest anticipated annual polio cases and lowest costs.
CONCLUSIONS
Poor global risk management and coordination of OPV cessation remain a critical failure mode for the polio endgame, and national and global decision makers face difficult choices due to multiple available polio vaccine options and immunization strategies.
Topics: Humans; Poliovirus Vaccine, Oral; Poliovirus Vaccine, Inactivated; Disease Eradication; Global Health; Poliomyelitis; Poliovirus
PubMed: 36154436
DOI: 10.1080/14760584.2022.2128108 -
Expert Review of Vaccines Jul 2020Over the last 20 years (2000-2019) the partners of the Global Polio Eradication Initiative (GPEI) invested in the development and application of mathematical models of... (Review)
Review
INTRODUCTION
Over the last 20 years (2000-2019) the partners of the Global Polio Eradication Initiative (GPEI) invested in the development and application of mathematical models of poliovirus transmission as well as economics, policy, and risk analyses of polio endgame risk management options, including policies related to poliovirus vaccine use during the polio endgame.
AREAS COVERED
This review provides a historical record of the polio studies published by the three modeling groups that primarily performed the bulk of this work. This review also systematically evaluates the polio transmission and health economic modeling papers published in English in peer-reviewed journals from 2000 to 2019, highlights differences in approaches and methods, shows the geographic coverage of the transmission modeling performed, identified common themes, and discusses instances of similar or conflicting insights or recommendations.
EXPERT OPINION
Polio modeling performed during the last 20 years substantially impacted polio vaccine choices, immunization policies, and the polio eradication pathway. As the polio endgame continues, national preferences for polio vaccine formulations and immunization strategies will likely continue to change. Future modeling will likely provide important insights about their cost-effectiveness and their relative benefits with respect to controlling polio and potentially achieving and maintaining eradication.
Topics: Disease Eradication; Global Health; Humans; Immunization Programs; Models, Economic; Models, Theoretical; Poliomyelitis; Poliovirus Vaccines; Risk Management; Vaccination
PubMed: 32741232
DOI: 10.1080/14760584.2020.1791093 -
Frontiers in Public Health 2022Since "Global Polio Eradication Initiative" was launched by World Health Assembly in 1988, the incidence rate of polio has been reduced by more than 99%, and the whole...
Since "Global Polio Eradication Initiative" was launched by World Health Assembly in 1988, the incidence rate of polio has been reduced by more than 99%, and the whole world has entered a post polio era nowadays. China has been a polio free status recognized by World Health Organization for 22 years and most people believe that no more public health concerns need to be given. How is the population of polio survivors in China? What strategies of health economics and actions of public health for those with polio are ethically appropriate? This article, first of all, deeply summarizes and analyzes the history, current situation and unmet needs of population with polio sequelae and post-polio syndrome in China, and then, puts forward important issues faced by polio survivors who natural infected and who due to vaccine associated paralytic polio and vaccine derived poliovirus. The management of polio survivor is not only a medical and rehabilitation problem involving accessibility, accommodations, but also a public health issue, and most importantly, an ethical concern. Furthermore, from the perspective of ethics such as Justice and Cooperation, the author demonstrates the rationality and necessity of continuing to pay more attention to polio sequela cases at this stage in China. Finally, many valuable suggestions and practical recommendations are given.
Topics: Humans; Poliomyelitis; Global Health; World Health Organization; Public Health; China
PubMed: 36743171
DOI: 10.3389/fpubh.2022.1076970 -
Pneumologie (Stuttgart, Germany) Sep 2013
Topics: Europe; History, 19th Century; History, 20th Century; History, 21st Century; Poliomyelitis; Respiration Disorders; Respiration, Artificial; United States
PubMed: 24006200
DOI: 10.1055/s-0033-1344493 -
JPMA. the Journal of the Pakistan... Jan 2021
Topics: Disease Eradication; Global Health; Humans; Immunization Programs; Poliomyelitis
PubMed: 35157692
DOI: 10.47391/JPMA.890 -
Indian Pediatrics Jun 2020
Topics: COVID-19; Humans; Pandemics; Poliomyelitis; SARS-CoV-2
PubMed: 32393679
DOI: No ID Found -
Rhode Island Medical Journal (2013) Aug 2020
Topics: Allergy and Immunology; History, 20th Century; Humans; Poliomyelitis; Poliovirus Vaccines; United States
PubMed: 32752574
DOI: No ID Found