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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 -
Bulletin of the World Health... 1994Israel has faced the challenge presented by epidemic poliomyelitis by using different immunization strategies. In the 1950s, inactivated poliovirus vaccine (IPV) helped... (Review)
Review
Israel has faced the challenge presented by epidemic poliomyelitis by using different immunization strategies. In the 1950s, inactivated poliovirus vaccine (IPV) helped to reduce the total burden of the disease, but cases continued to occur. Introduction of oral poliovirus vaccine (OPV) in mid-1961 had a dramatic effect in controlling an extensive epidemic of poliomyelitis; however, poliovirus activity and cases continued during the 1970s, and at a low level in the 1980s. A localized outbreak of 15 cases of poliomyelitis in 1988 occurred in an area using enhanced potency IPV (eIPV) only. This led to a revision of poliomyelitis immunization policy. The successful poliomyelitis control in the West Bank and the Gaza Strip using both OPV and IPV since 1978 shows the advantages of a combined approach. This programme was therefore adopted in modified form in the whole of Israel, the West Bank and Gaza. Since late 1988, no cases of poliomyelitis have occurred in any of these three areas, indicating the success of the combined poliomyelitis immunization programme. These experiences may be helpful to other countries, especially those where there is a danger of importation of wild poliovirus, and to prevent vaccine-associated disease. The combined approach provides an additional immunization model in the international effort to eradicate poliomyelitis.
Topics: Child, Preschool; Ethnicity; Humans; Immunization Schedule; Incidence; Infant; Israel; Middle East; Poliomyelitis; Poliovirus Vaccine, Oral; Preventive Health Services
PubMed: 7955030
DOI: No ID Found -
British Medical Journal (Clinical... Jul 1987
Review
Topics: Disease Outbreaks; Humans; Poliomyelitis; Poliovirus Vaccine, Inactivated; Poliovirus Vaccine, Oral
PubMed: 3115358
DOI: 10.1136/bmj.295.6591.158 -
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 -
Acta Medica Portuguesa 2003On the 21st of June 2002, in Copenhagen, the Regional Commission for the Certification of Poliomyelitis Eradication, declared the European Region of the World Health...
On the 21st of June 2002, in Copenhagen, the Regional Commission for the Certification of Poliomyelitis Eradication, declared the European Region of the World Health Organization (WHO) as polio-free. The last case (not imported) of poliomyelitis in Europe had occurred in November 1998. The health impact is enormous. In Portugal, the last case of poliomyelitis caused by the wild poliovirus, had occurred in December 1986. The path to eradication in Portugal had begun with a vaccination campaign in 1965/1966, with the oral polio vaccine (Sabin). High vaccination coverage has been maintained since then. The Portuguese program to eliminate poliomyelitis follows the strategic recommendations of WHO, with three components: vaccination; surveillance of acute placid paralysis (AFP); laboratory containment of wild polioviruses. Global eradication has not yet been achieved but is likely to happen till 2005. Keeping the high levels of motivation among Portuguese health workers is essential, in order not to loose what has been achieved. High vaccination coverage has to be maintained. Surveillance of AFP has to be improved and the prompt notification of cases by hospital clinicians, sending stool samples to the reference laboratory, is essential for the success of this activity. The laboratory containment programme is important to prevent the accidental reintroduction of poliomyelitis from laboratories.
Topics: Acute Disease; Europe; Humans; Poliomyelitis; Poliovirus; Portugal; Vaccination
PubMed: 12828004
DOI: No ID Found -
MMWR. Morbidity and Mortality Weekly... May 2023Since the World Health Assembly established the Global Polio Eradication Initiative (GPEI) in 1988, two of the three wild poliovirus (WPV) serotypes (types 2 and 3) have...
Since the World Health Assembly established the Global Polio Eradication Initiative (GPEI) in 1988, two of the three wild poliovirus (WPV) serotypes (types 2 and 3) have been eradicated, and global WPV cases have decreased by more than 99.9%. Afghanistan and Pakistan remain the only countries where indigenous WPV type 1 (WPV1) transmission has not been interrupted. This report summarizes progress toward global polio eradication during January 1, 2021-March 31, 2023, and updates previous reports (1,2). In 2022, Afghanistan and Pakistan reported 22 WPV1 cases, compared with five in 2021; as of May 5, 2023, a single WPV1 case was reported in Pakistan in 2023. A WPV1 case was reported on the African continent for the first time since 2016, when officials in Malawi confirmed a WPV1 case in a child with paralysis onset in November 2021; neighboring Mozambique subsequently reported eight genetically linked cases. Outbreaks of polio caused by circulating vaccine-derived polioviruses (cVDPVs) can occur when oral poliovirus vaccine (OPV) strains circulate for a prolonged time in underimmunized populations, allowing reversion to neurovirulence (3). A total of 859 cVDPV cases occurred during 2022, an increase of 23% from 698 cases in 2021. cVDPVs were detected in areas where poliovirus transmission had long been eliminated (including in Canada, Israel, the United Kingdom, and the United States). In addition, cocirculation of multiple poliovirus types occurred in multiple countries globally (including Democratic Republic of the Congo [DRC], Israel, Malawi, Mozambique, Republic of the Congo, and Yemen). The 2022-2026 GPEI strategic plan targeted the goal of detecting the last cases of WPV1 and cVDPV in 2023 (4). The current global epidemiology of poliovirus transmission makes the likelihood of meeting this target date unlikely. The detections of poliovirus (WPV1 and cVDPVs) in areas where it had been previously eliminated underscore the threat of continued poliovirus spread to any area where there is insufficient vaccination to poliovirus (3). Mass vaccination and surveillance should be further enhanced in areas of transmission to interrupt poliovirus transmission and to end the global threat of paralytic polio in children.
Topics: Child; Humans; Disease Eradication; Disease Outbreaks; Global Health; Immunization Programs; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral; Population Surveillance
PubMed: 37167156
DOI: 10.15585/mmwr.mm7219a3 -
Bundesgesundheitsblatt,... Jun 2022In the 1950s, the epidemic occurrence of infantile paralysis (poliomyelitis) posed major challenges to health systems worldwide. Since there was no causal therapy for... (Review)
Review
In the 1950s, the epidemic occurrence of infantile paralysis (poliomyelitis) posed major challenges to health systems worldwide. Since there was no causal therapy for the viral disease, exposure prophylaxis was of particular importance. Ultimately, it was only through the development of vaccines that infantile paralysis could be permanently reduced. In 1960, the Sabin-Tschumakow oral vaccine was administered in the former German Democratic Republic GDR for the first time in Germany. Within one year, this vaccine succeeded in almost completely eradicating polio in the GDR. The article uses unpublished archival material to trace the systematic vaccination campaign using the example of the then district capital Halle (Saale). There alone, 63,328 children and adolescents were immunized within three days in May 1960. With 78,085 vaccinees recorded in advance, this corresponded to a rate within the polio-vulnerable population group of around 81%. The sources show that the GDR's government healthcare system and the principle of outreach vaccination contributed to the success of the vaccination campaign.
Topics: Adolescent; Child; Germany; Humans; Immunization Programs; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral; Vaccination
PubMed: 35575809
DOI: 10.1007/s00103-022-03538-7 -
The Lancet. Global Health Oct 2020On Aug 25 2020, the Africa Regional Commission for the Certification of Poliomyelitis Eradication declared that the WHO African region had interrupted transmission of... (Review)
Review
On Aug 25 2020, the Africa Regional Commission for the Certification of Poliomyelitis Eradication declared that the WHO African region had interrupted transmission of all indigenous wild polioviruses. This declaration marks the African region as the fifth of the six WHO regions to celebrate this extraordinary achievement. Following the Yaoundé Declaration on Polio Eradication in Africa by heads of state and governments in 1996, Nelson Mandela launched the Kick Polio out of Africa campaign. In this Health Policy paper, we describe the long and turbulent journey to the certification of the interruption of wild poliovirus transmission, focusing on 2016-20, lessons learned, and the strategies and analyses that convinced the Regional Commission that the African region is free of wild polioviruses. This certification of the WHO African region shows the feasibility of polio eradication in countries with chronic insecurity, inaccessible and hard-to-reach populations, and weak health systems. Challenges have been daunting and the sacrifices enormous-dozens of health workers and volunteers have lost their lives in the pursuit of a polio-free Africa.
Topics: Africa; Disease Eradication; Global Health; Humans; Poliomyelitis; World Health Organization
PubMed: 32916086
DOI: 10.1016/S2214-109X(20)30382-X -
The Journal of Experimental Medicine Dec 1951The first known epidemic of poliomyelitis in Easton, Pennsylvania, occurred in 1949, and was unusual in the high proportion of paralytic to non-paralytic cases. Both...
The first known epidemic of poliomyelitis in Easton, Pennsylvania, occurred in 1949, and was unusual in the high proportion of paralytic to non-paralytic cases. Both poliomyelitis and Cosxackie, or C, viruses were isolated from more than half the patients studied during the acute stage of the disease. One month later C virus was only occasionally recovered. Classification of the 28 strains of C virus which were isolated revealed that 24 belonged to one antigenic type, Easton-2 (related to Albany type 1 virus). Patients from whom C virus was isolated showed a rise during convalescence to the Easton-2 or homologous type antibody. Two patients with paralytic poliomyelitis were studied for the quantitative development of antibodies to the poliomyelitis virus and to the C virus found in their stools. Using the neutralization test in monkeys and in newborn mice, respectively, a simultaneous rise in antibodies to both agents was observed. The situation at present can be summarized as follows:-Poliomyelitis virus or C virus may produce infection in man, with a specific antibody response. Both agents may be carried, particularly in the intestines, without causing any serious illness and healthy carrier states have been observed for each. Both viruses can be found in nature in flies and in sewage. However there has been no evidence to suggest that these two viruses bear a relationship to each other, even when isolated from the same patient. Thus, when both viruses are found in a patient with paralysis, it is not yet possible to say with any degree of accuracy to what extent each is responsible in the over-all pattern of the disease. How frequently dual infections of this nature may occur remains for future investigations to determine. Certainly all cases of poliomyelitis are not complicated by a superimposed infection with a C virus. However, this will have to be one more item to consider in epidemic poliomyelitis.
Topics: Animals; Antibodies; Convalescence; Enterovirus; Feces; Humans; Male; Mice; Poliomyelitis; Poliovirus
PubMed: 14897994
DOI: 10.1084/jem.94.6.471 -
BMC Research Notes Oct 2014A large poliomyelitis outbreak occurred in 2010 in the Republic of Congo. This paper describes the demographic and clinical characteristics of poliomyelitis cases and...
BACKGROUND
A large poliomyelitis outbreak occurred in 2010 in the Republic of Congo. This paper describes the demographic and clinical characteristics of poliomyelitis cases and their outcomes following physiotherapy.
FINDINGS
Demographic and clinical data were collected on 126 individuals between November 23, 2010 and March 23, 2011. The male/female ratio was 2.5 and the median age was 19 years (IQR: 13.5-23). The most severe forms of the disease were more common in older patients, 81 of the 126 patients (64.3%) had multiple evaluations of muscle strength. Among patients with multiple evaluations, 38.1% had improved strength at final evaluation, 48.3% were stable and 13.6% had decreased strength.
CONCLUSIONS
Most acute poliomyelitis patients receiving physiotherapy had improved or stable muscle strength at their final evaluation. These descriptive results highlight the need for further research into the potential benefits of physiotherapy in polio affected patients.
Topics: Adolescent; Adult; Child; Child, Preschool; Congo; Disease Outbreaks; Female; Humans; Infant; Infant, Newborn; Male; Muscle Strength; Muscle, Skeletal; Physical Therapy Modalities; Poliomyelitis; Recovery of Function; Retrospective Studies; Time Factors; Treatment Outcome; Young Adult
PubMed: 25342647
DOI: 10.1186/1756-0500-7-755