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ESTIMATING THE EXTENT OF VACCINE-DERIVED POLIOVIRUS

Monday, 20th of August 2012

 

• ESTIMATING THE EXTENT OF VACCINE-DERIVED POLIOVIRUS

PLoS ONE. 2008; 3(10): e3433.

Published online 2008 October 29.

Abstract below; full text is at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570794/?tool=pubmed

Estimating the Extent of Vaccine-Derived Poliovirus Infection

Alison Wringe,1,* Paul E. M. Fine,1 Roland W. Sutter,2 and Olen M. Kew3

1Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, England

2Polio Eradication Department, World Health Organization, Geneva, Switzerland

3Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

* E-mail: alison.wringe@lshtm.ac.uk

Conceived and designed the experiments: PEMF RWS OMK. Analyzed the data: AW PEMF RWS OMK. Wrote the paper: AW. Contributed to drafting and revising the manuscript: PEMF RWS OMK.

Jose Esparza, Editor

Received July 9, 2008; Accepted September 1, 2008.

Copyright This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

This article has been cited by other articles in PMC.

Abstract

Background

Eight outbreaks of paralytic polio attributable to circulating vaccine-derived poliovirus (cVDPV) have highlighted the risks associated with oral poliovirus vaccine (OPV) use in areas of low vaccination coverage and poor hygiene. As the Polio Eradication Initiative enters its final stages, it is important to consider the extent to which these viruses spread under different conditions, so that appropriate strategies can be devised to prevent or respond to future cVDPV outbreaks.

Methods and Findings

This paper examines epidemiological (temporal, geographic, age, vaccine history, social group, ascertainment), and virological (type, genetic diversity, virulence) parameters in order to infer the numbers of individuals likely to have been infected in each of these cVDPV outbreaks, and in association with single acute flaccid paralysis (AFP) cases attributable to VDPVs. Although only 114 virologically-confirmed paralytic cases were identified in the eight cVDPV outbreaks, it is likely that a minimum of hundreds of thousands, and more likely several million individuals were infected during these events, and that many thousands more have been infected by VDPV lineages within outbreaks which have escaped detection.

Conclusions

Our estimates of the extent of cVDPV circulation suggest widespread transmission in some countries, as might be expected from endemic wild poliovirus transmission in these same settings. These methods for inferring extent of infection will be useful in the context of identifying future surveillance needs, planning for OPV cessation and preparing outbreak response plans.