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Introduction Since 1988, when WHO Member States and partners launched the Global Polio Eradication Initiative (GPEI), the number of wild poliovirus (WPV) has decreased from 350 000 cases in 125 [...]

Global eradication of indigenous wild poliovirus type 2 was certified in 2015 and that of type 3 in 2019. Since the launch of the Global Polio Eradication Initiative (GPEI) in [...]

Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) is a novel betacoronavirus associated with a broad spectrum of respiratory illness; infection results in death in ≅35%-40% of cases (1). Since the [...]

Achieving global polio eradication requires that global stakeholders coordinate and cooperate to invest human and financial resources in interventions that prevent virus transmission. Reaching this goal depends on effective tools [...]

Middle East respiratory syndrome coronavirus (MERS-CoV) was initially isolated in September 2012 from a 60-year-old man from Bisha, Saudi Arabia (1). In June 2012, this index case-patient was hospitalized for [...]

Indigenous wild-type poliovirus (WPV) remains endemic to 3 countries: Nigeria, Afghanistan, and Pakistan (1). Poliovirus (PV) circulation has been sustained in several African countries after importation from a PV-endemic country, [...]

A study was conducted to compare the efficacy of a newly developed immunogenic monovalent type 1 oral poliovirus vaccine with the trivalent oral poliovirus vaccine on newborns. Results revealed that the newly developed vaccine was superior to the trivalent oral poliovirus vaccine as it induced humoral antibodies.

Objectives. We assessed the costs, risks, and benefits of possible future major policy decisions on vaccination, surveillance, response plans, and containment following global eradication of wild polioviruses. Methods. We developed a decision analytic model to estimate the incremental cost-effectiveness ratios and net benefits of risk management options for polio for the 20-year period and stratified the world according to income level to capture important variability between nations. Results. For low-, lower-middle-, and upper-middle-income groups currently using oral poliovirus vaccine (OPV), we found that after successful eradication of wild polioviruses, OPV cessation would save both costs and lives when compared with continued use of OPV without supplemental immunization activities. We found cost-effectiveness ratios for switching from OPV to inactivated poliovirus vaccine to be higher (i.e., less desirable) than other health investment opportunities, depending on the actual inactivated poliovirus vaccine costs and assumptions about whether supplemental immunization activities with OPV would continue. Conclusions. Eradication promises billions of dollars of net benefits, although global health policy leaders face difficult choices about future policies. Until successful eradication and coordination of posteradication policies, health authorities should continue routine polio vaccination and supplemental immunization activities.

Some of the complex social challenges encountered by the public health workers in total eradication of polio globally are discussed. The public health initiative has made extraordinary progress since 1988 when World Health Assembly adopted the goal of eradication, a major accomplishment being the establishment of a global integrated virologic surveillance network.

The World Health Organization (WHO) addresses the challenges unprecedented in public health for the global eradication of wild poliovirus and the live attenuated oral poliovirus vaccine (OPV) is used for more than four decades to interrupt poliovirus transmission. A strategy for this is developed for posteradication to minimize the risks of vaccine-derived polioviruses (VDPVs) and its spread has become an urgent WHO priority.

The epidemiology of paralytic poliomyelitis reviewed, and the association between the vaccine schedule changes and vaccine-associated paralytic poliomyelitis (VAPP) in the United States is documented. The change in polio vaccination policy from oral poliovirus vaccine (OPV) to exclusive use of inactivated poliovirus vaccine (IPV) was successful implemented, which led to the elimination of VAPP in the United States.

Objective To estimate the rate of long-term poliovirus excretors in people known to have B-cell immune deficiency disorders. Methods An active search for chronic excretors was conducted among 306 persons known to nave immunoglobulin G (IgG) deficiency in the United Stales, Mexico, Brazil, and the United Kingdom, and 40 people with IgA deficiency in the United States. Written informed consent or assent was obtained from the participants or their legal guardians, and the studies were formally approved. Stool samples were collected from participants and cultured for polioviruses. Calculation of the confidence interval for the 3roportion of participants with persistent poliovirus excretion was based on the binomial distribution. Findings No individuals with long-term excretion of polioviruses were identified. Most participants had received oral poliovirus vaccine (OPV) and almost all had been exposed to household contacts who had received OPV. Polioviruses of recent vaccine origin were transiently found in four individuals in Mexico and Brazil, where OPV is recommended for all children. Conclusion Although chronic poliovirus excretion can occur in immunodeficient persons, it appears to be rare. Keywords Poliovirus/isolation and purification; Carrier state; Poliomyelitis/chemically induced/transmission; Poliovirus vaccine, Oral/adverse effects; IgA deficiency; IgG deficiency; Common variable immunodeficiency; Agammaglobulinemia; United States; Mexico; Brazil; United Kingdom (source: MESH, NLM). Mots cles Poliovirus humain/isolement et Purification; Porteur germes; Poliomyelite anterieure aigue/induite chimiquement/transmission. Vaccin antipoliomyelitique Sabin/effets indesirables; IGA, Deficit" IgG, Deficit; Immunodeficit commun variable; Agammaglobulinemie; Bresil; Etats-Unis; Mexique; Royaume-Uni (source: MESH, INSERM). Palabras clave Poliovirus/aislamiento y purificacion; Portador; Poliomielitis/inducida quimicamente/transmision; Vacuna antipolio oral/efectos adversos, Deficiencia de IgA: Deficiencia de IgG; Immunodeficiencia variable comun: Agammaglobulinemia; Estados Unidos; Mexico; Brasil; Reino Unido (fuente: DeCS, BIREME)., Introduction Susceptible individuals usually excrete polioviruses for 2-6 weeks, and occasionally for up to 137 days after they have been immunized with oral poliovirus vaccine (OPV) (1-5). The shed viruses [...]

Within the past 4 years, poliomyelitis outbreaks associated with circulating vaccine-derived polioviruses (cVDPVs) have occurred in Hispaniola (2000-01), the Philippines (2001), and Madagascar (2001-02). Retrospective studies have also detected the circulation of endemic cVDPV in Egypt (1988-93) and the likely localized spread of oral poliovirus vaccine (OPV)-derived virus in Belarus (1965-66). Gaps in OPV coverage and the previous eradication of the corresponding serotype of indigenous wild poliovirus were the critical risk factors for all cVDPV outbreaks. The cVDPV outbreaks were stopped by mass immunization campaigns using OPV. To increase sensitivity for detecting vaccine-derived polioviruses (VDPVs), in 2001 the Global Polio Laboratory Network implemented additional testing requirements for all poliovirus isolates under investigation. This approach quickly led to the recognition of the Philippines and Madagascar cVDPV outbreaks, but of no other current outbreaks. The potential risk of cVDPV emergence has increased dramatically in recent years as wild poliovirus circulation has ceased in most of the world. The risk appears highest for the type 20PV strain because of its greater tendency to spread to contacts, The emergence of cVDPVs underscores the critical importance of eliminating the last pockets of wild poliovirus circulation, maintaining universally high levels of polio vaccine coverage, stopping OPV use as soon as it is safely possible to do so, and continuing sensitive poliovirus surveillance into the foreseeable future. Particular attention must be given to areas where the risks for wild poliovirus circulation have been highest, and where the highest rates of polio vaccine coverage must be maintained to suppress cVDPV emergence. Keywords Poliovirus/genetics/isolation and purification; Poliovirus vaccine, Oral/adverse effects; Poliomyelitis/etiology/chemically induced/prevention and control; Immunization programs; Disease outbreaks/Review literature (source: MeSH, NLM). Mots cles Poliovirus humain/genetique /croissance et developpement; Vaccin antipoliomyelitique Sabin/effets indesirables; Poliomyelite anterieure aigui/etiologie/induite chimiquement/prevention et controle; Programmes de vaccination; Revue de la litterature (source: MeSH, INSERM). Palabras clave Poliovirus/genetica/crecimiento y desarrollo; Vacuna antipolio oral/efectos adversos; Poliomielitis/etiologia/inducida quimicamente/prevencion y control; Programas de inmunizacion; Literatura de revision (fuente: DeCS, BIREME)., Introduction The oral poliuvirus vaccine (OPV) of Albert Sabin is nearly ideal for use ii, polio eradication (1-3). OPV is easily administered by mouth, facilitating its widespread use; it induces [...]

Several hundred cases of severe atypical pneumonia of unknown etiology were reported in Guangdong Province of the People's Republic of China beginning in late 2002. After similar cases were detected [...], In March 2003, a novel coronavirus (SARS-CoV) was discovered in association with cases of severe acute respiratory syndrome (SARS). The sequence of the complete genome of SARS-CoV was determined, and the initial characterization of the viral genome is presented in this report. The genome of SARS-CoV is 29,727 nucleotides in length and has 11 open reading frames, and its genome organization is similar to that of other coronaviruses. Phylogenetic analyses and sequence comparisons showed that SARS-CoV is not closely related to any of the previously characterized coronaviruses.

An outbreak of paralytic poliomyelitis occurred in the Dominican Republic (13 confirmed cases) and Haiti (8 confirmed cases, including 2 fatal cases) during 2000-2001. All but one of the patients were either unvaccinated or incompletely vaccinated children, and cases occurred in communities with very low (7 to 40%) rates of coverage with oral poliovirus vaccine (OPV). The outbreak was associated with the circulation of a derivative of the type 1 OPV strain, probably originating from a single OPV dose given in 1998-1999. The vaccine-derived poliovirus associated with the outbreak had biological properties indistinguishable from those of wild poliovirus., The last case of poliomyelitis in the Americas associated with circulating indigenous wild poliovirus was reported in Peru in 1991 (1). The last poliomyelitis cases in the Caribbean occurred on [...]

Inactivated-poliovirus vaccine (IPV) enhanced the antibody titer against type 3 poliovirus but the oral poliovirus vaccines (OPV) had no effect. In a study of 785 infants nine months old, 88% were seropositive for poliovirus type 3 and showed no significant change in either the seroprevalence or antibody titer at the thirtieth day upon administration of OPV. In infants who received IPV, both the seroprevalence and the antibody titer increased from 87.8% to 97.1% and from 1:228 to 1:448 respectively.

Many inner-city children appear to be adequately immunized against polio. Researchers measured antibodies to the oral polio vaccine (OPV) in blood samples from 224 inner-city children in Houston and 302 in Detroit. Approximately 80% of the children had antibodies against the three types of poliovirus by the time they were two years old and more than 90% had poliovirus antibodies by the time they were three or four years old. Half of the Detroit children and one-quarter of the Houston children had received three doses of polio vaccine by the time they were two years old. Ninety percent of these children had antibodies against the three types of poliovirus. Almost half of 113 unvaccinated children had antibodies against at least one type of poliovirus. These children acquired their immunity from contact with a vaccinated child. Given the high immunization rates in these children and the fact that OPV can cause paralysis, it seems reasonable to switch to using inactivated poliovaccine (IPV) for the first two doses., Objectives.--To assess susceptibility to poliomyelitis in selected inner-city preschool children in the United States and to estimate the contribution of secondary spread of live attenuated oral poliovirus vaccine virus to type-specific immunity. Design.--Cross-sectional seroprevalence study. Methods.--Serum neutralizing antibody levels against poliovirus types 1, 2, and 3 were analyzed according to vaccination status, age, and other sociodemographic variables. Setting.--Hospital and satellite clinics serving inner-city populations in Houston, Tex, and Detroit, Mich, 1990 to 1991. Participants.--A total of 526 children aged 12 to 47 months seeking medical care were enrolled in the seroprevalence study; 144 children aged 12 to 35 months without a history of previous oral poliovirus vaccination were enrolled in the secondary spread study. Results.--Seropositive rates were similar in children in both cities, ranging from about 80% for types 1 and 3 in 12- to 23-month-old children to more than 90% in those aged 36 to 47 months. The most important predictor of seropositivity was the number of doses of oral poliovirus vaccine received (P

Infection with rotavirus (RV) causes vomiting and severe diarrhea in infants and children, and can lead to severe dehydration, or the excessive loss of body fluids. A tetravalent rhesus rotavirus vaccine (RRV-TV) was developed to protect against rotavirus infection in children, and tested on almost 1,000 infants at 22 medical centers in the United States. The infants received three doses of the RRV-TV by mouth. The RV vaccine is usually given with large amounts of buffer (a substance that maintains the appropriate levels of hydrogen ions in a solution). The buffer was also shown to promote a good immune response to the vaccine. In previous studies, researchers maintained a two-week period between administration of the RRV-TV and immunization with the oral poliovirus vaccine (OPV). The difficulties of giving large doses of buffer and the necessity of extra visits to the doctor for the OPV and RV vaccines could be resolved if the RV vaccine could be given with lower doses of buffer and combined with the OPV vaccine. Similar to OPV, the RV vaccine should also be given before two to three months of age. The effect of reducing the dose of buffer on the ability of RRV-TV to promote an immune response was assessed. In addition, the effects of RRV-TV on the immune response to the OPV vaccine was examined. This study was conducted between January and November 1989 and involved 174 infants, aged 6 to 16 weeks. The ability of RRV-TV to promote an immune response was determined by the production of antibody, or immune protein, against RV. The levels of antibody to RV were similar in children receiving RRV-TV prepared in small and large doses of buffer, but were much lower in children who received RRV-TV without buffer. The RRV-TV did not appear to interfere with the immune response to OPV. (Consumer Summary produced by Reliance Medical Information, Inc.)

Poliovirus-positive sewage samples are characterized by using a new protocol for virus concentration and either RD or L20B cells for primary virus isolation. The studies have shown continuous introduction of Sabin-like polioviruses into the community, but high hygienic standards might prevent the more efficient fecal-oral transmission and prevent only the less efficient oral-oral transmission.

In 1998, an outbreak of enterovirus 71-associated hand, foot, and mouth disease occurred in Taiwan. Pathologic studies of two fatal cases with similar clinical features revealed two different causative agents, [...]

Transmission of infectious diseases within child care centers, transmission from children in day care to adults in their homes and to child care providers, and appropriate preventive measures are well […]

Polio An American Story by David M. Oshinsky Oxford University Press, New York, 2005. 340 pp. $30, 18.99 £. ISBN 0-19515294-8. Splendid Solution Jonas Salk and the Conquest of Polio [...]