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Discusses the crippling virus, providing information on how the virus is spread, the effect of vaccinations, famous people who have battled the disease, and the future outlook for eradication.

•Inherent features of PID contribute to manifestations and outcome of polio infection.•Cytotoxic cellular mechanisms may contribute to the development of vaccine paralysis.•T-cell interactions with poliovirus infected cells play a role in infection clearance.•Paralysis, PID type, and income level independently influence patients’ survival.•We explained the trend of vaccine-derived poliovirus genomic evolution. Widespread administration of oral poliovirus vaccine (OPV) has decreased global incidence of poliomyelitis by ≈99.9%. However, the emergence of vaccine-derived polioviruses (VDPVs) is threatening polio-eradication program. Primary immunodeficiency (PID) patients are at higher risks of vaccine-associated paralytic poliomyelitis (VAPP) and prolonged excretion of immunodeficiency-associated VDPV (iVDPV). We searched Embase, Medline, Science direct, Scopus, Web of Science, and CDC and WHO databases by 30 September 2016, for all reports of iVDPV cases. Patient-level data were extracted form eligible studies. Data on immunization coverage and income-level of countries were extracted from WHO/UNICEF and the WORLD BANK databases, respectively. We assessed bivariate associations between immunological, clinical, and virological parameters, and exploited multivariable modeling to identify independent determinants of poliovirus evolution and patients’ outcomes. Study protocol was registered with PROSPERO (CRD42016052931). 4329 duplicate-removed titles were screened. A total of 107 iVDPV cases were identified from 68 eligible articles. The majority of cases were from higher income countries with high polio-immunization coverage. 74 (69.81%) patients developed VAPP. Combined immunodeficiency patients showed lower rates of VAPP (p < .001) and infection clearance (p = .02), compared to humoral immunodeficiency patients. The rate of poliovirus genomic evolution was higher at early stages of replication, decreasing over time until reaching a steady state. Independent of replication duration, higher extent (p = .04) and rates (p = .03) of genome divergence contributed to a less likelihood of virus clearance. PID type (p < .001), VAPP occurrence (p = .008), and income-level of country (p = .04) independently influenced patients’ survival. With the use of OPV, new iVDPVs will emerge independent of the rate of immunization coverage. Inherent features of PIDs contribute to the clinical course of iVDPV infection and virus evolution. This finding could shed further light on poliomyelitis pathogenesis and iVDPV evolution pattern. It also has implications for public health, the polio eradication effort and the development of effective antiviral interventions.

For many decades, scientists could do little to treat polio, they knew its symptoms but had no idea how it was transmitted, or what caused the illness. Discover how it took hundreds of years, thousands of dollars to ultimately find a way to combat this deadly disease.

Three studies from Guinea-Bissau found conflicting effects of OPV-at-birth (OPV0) on child survival. One study from 2004 suggested excess male mortality among children receiving OPV0 compared with children receiving NoOPV0 during a period of shortage of OPV. However, two subsequent studies showed beneficial effects of OPV0. In 2004, two national OPV-campaigns had been conducted in Guinea-Bissau. In a reanalysis of the 2004-study, in a survival analysis the age-adjusted mortality rate of study participants was 67% (95% CI=42–81%) lower after the OPV-campaigns than before the campaigns. In the OPV0 group only 22% (655/3031 person-years (pyrs)) of follow-up time was “after” the OPV-campaigns whereas 55% (473/859 pyrs) of the time in the NoOPV0 group was post-campaign (p<0.0001, Chi2). Censoring for OPV-campaigns in the original study removed excess male mortality and made the three studies more homogeneous. Overall, there is now considerable evidence that OPV, like other live vaccines, has important beneficial non-specific effects.

Recentemente sono stati pubblicati sul Lancet (doi.org/10.1016/so140-6736(25)01037-2) i risultati del Expanded Programme on Immunization (EPI) sull’impatto sanitario globale delle vaccinazioni negli ultimi 50 anni: i programmi di vaccinazione sono riusciti, dal 1974 al 2024, a salvare la vita di 154 milioni persone, nel 95% di bambini sotto i 5 anni. Inoltre, lo studio ha dimostrato che, nonostante l’enorme spesa sanitaria di 3,9 miliardi di dollari, le vaccinazioni pediatriche sono state una delle strategie di sanità pubblica di maggior successo, che ha portato ad un risparmio sia in termine di vite salvate che di ritorno in investimenti sulla sanità. Non si può escludere che le continue campagne anti vax nel nostro Paese possano essere strumentali, favorite anche dal troppo benessere della popolazione e dal continuo aumento dell’utilizzo di social media. Con disappunto assistiamo a quello che sta succedendo negli USA, dove viene nominato un Ministro della sanità no vax, Robert Kennedy jr, e dove è stata allontanata la direttrice dei Centers for Disease Control, Susan Monarez, perché si è rifiutata di approvare raccomandazioni antiscientifiche sui vaccini. Anche nel nostro Paese abbiamo assistito di recente all’inserimento nel NITAG di 2 medici no vax, le cui nomine però, grazie all’intervento di numerose società scientifiche, tra cui la SIP, sono state bloccate.

It was not long ago that scientists proclaimed victory over polio, the dread disease of the 1950s. More recently polio resurfaced, not conquered at all, spreading across the countries of Africa. As we once again face the specter of this disease, along with other killers like AIDS and SARS, this powerful book reminds us of the personal cost, the cultural implications, and the historical significance of one of modern humanity's deadliest biological enemies. In Polio and Its Aftermath Marc Shell, himself a victim of polio, offers an inspired analysis of the disease. Part memoir, part cultural criticism and history, part meditation on the meaning of disease, Shell's work combines the understanding of a medical researcher with the sensitivity of a literary critic. He deftly draws a detailed yet broad picture of the lived experience of a crippling disease as it makes it way into every facet of human existence. Polio and Its Aftermath conveys the widespread panic that struck as the disease swept the world in the mid-fifties. It captures an atmosphere in which polio vied with the Cold War as the greatest cause of unrest in North America--and in which a strange and often debilitating uncertainty was one of the disease's salient but least treatable symptoms. Polio particularly afflicted the young, and Shell explores what this meant to families and communities. And he reveals why, in spite of the worldwide relief that greeted Jonas Salk's vaccine as a miracle of modern science, we have much more to fear from polio now than we know.

\"By the end of the 1950s Hungary became an unlikely leader in what we now call global health. Only three years after Soviet tanks crushed the revolution of 1956, Hungary became one of the first countries to introduce the Sabin vaccine into its national vaccination programme\"-- Provided by publisher.

Following the global eradication of wild poliovirus, countries using live attenuated oral poliovirus vaccines will transition to exclusive use of inactivated poliovirus vaccine (IPV) or fractional doses of IPV (f-IPV; a f-IPV dose is one-fifth of a normal IPV dose), but IPV supply and cost constraints will necessitate dose-sparing strategies. We compared immunisation schedules of f-IPV and IPV to inform the choice of optimal post-eradication schedule. This randomised open-label, multicentre, phase 3, non-inferiority trial was done at two centres in Panama and one in the Dominican Republic. Eligible participants were healthy 6-week-old infants with no signs of febrile illness or known allergy to vaccine components. Infants were randomly assigned (1:1:1:1, 1:1:1:2, 2:1:1:1), using computer-generated blocks of four or five until the groups were full, to one of four groups and received: two doses of intradermal f-IPV (administered at 14 and 36 weeks; two f-IPV group); or three doses of intradermal f-IPV (administered at 10, 14, and 36 weeks; three f-IPV group); or two doses of intramuscular IPV (administered at 14 and 36 weeks; two IPV group); or three doses of intramuscular IPV (administered at 10, 14, and 36 weeks; three IPV group). The primary outcome was seroconversion rates based on neutralising antibodies for poliovirus type 1 and type 2 at baseline and at 40 weeks (4 weeks after the second or third vaccinations) in the per-protocol population to allow non-inferiority and eventually superiority comparisons between vaccines and regimens. Three co-primary outcomes concerning poliovirus types 1 and 2 were to determine if seroconversion rates at 40 weeks of age after a two-dose regimen (administered at weeks 14 and 36) of intradermally administered f-IPV were non-inferior to a corresponding two-dose regimen of intramuscular IPV; if seroconversion rates at 40 weeks of age after a two-dose IPV regimen (weeks 14 and 36) were non-inferior to those after a three-dose IPV regimen (weeks 10, 14, and 36); and if seroconversion rates after a two-dose f-IPV regimen (weeks 14 and 36) were non-inferior to those after a three-dose f-IPV regimen (weeks 10, 14, and 36). The non-inferiority boundary was set at −10% for the lower bound of the two-sided 95% CI for the seroconversion rate difference.. Safety was assessed as serious adverse events and important medical events. This study is registered on ClinicalTrials.gov, NCT03239496. From Oct 23, 2017, to Nov 13, 2018, we enrolled 773 infants (372 [48%] girls) in Panama and the Dominican Republic (two f-IPV group n=217, three f-IPV group n=178, two IPV group n=178, and three IPV group n=200). 686 infants received all scheduled vaccine doses and were included in the per-protocol analysis. We observed non-inferiority for poliovirus type 1 seroconversion rate at 40 weeks for the two f-IPV dose schedule (95·9% [95% CI 92·0–98·2]) versus the two IPV dose schedule (98·7% [95·4–99·8]), and for the three f-IPV dose schedule (98·8% [95·6–99·8]) versus the three IPV dose schedule (100% [97·9–100]). Similarly, poliovirus type 2 seroconversion rate at 40 weeks for the two f-IPV dose schedule (97·9% [94·8–99·4]) versus the two IPV dose schedule (99·4% [96·4–100]), and for the three f-IPV dose schedule (100% [97·7–100]) versus the three IPV dose schedule (100% [97·9–100]) were non-inferior. Seroconversion rate for the two f-IPV regimen was statistically superior 4 weeks after the last vaccine dose in the 14 and 36 week schedule (95·9% [92·0–98·2]) compared with the 10 and 14 week schedule (83·2% [76·5–88·6]; p=0·0062) for poliovirus type 1. Statistical superiority of the 14 and 36 week schedule was also found for poliovirus type 2 (14 and 36 week schedule 97·9% [94·8–99·4] vs 10 and 14 week schedule 83·9% [77·2–89·2]; p=0·0062), and poliovirus type 3 (14 and 36 week schedule 84·5% [78·7–89·3] vs 10 and 14 week schedule 73·3% [65·8–79·9]; p=0·0062). For IPV, a two dose regimen administered at 14 and 36 weeks (99·4% [96·4–100]) was superior a 10 and 14 week schedule (88·9% [83·4–93·1]; p<0·0001) for poliovirus type 2, but not for type 1 (14 and 36 week schedule 98·7% [95·4–99·8] vs 10 and 14 week schedule 95·6% [91·4–98·1]), or type 3 (14 and 36 week schedule 97·4% [93·5–99·3] vs 10 and 14 week schedule 93·9% [89·3–96·9]). There were no related serious adverse events or important medical events reported in any group showing safety was unaffected by administration route or schedule. Our observations suggest that adequate immunity against poliovirus type 1 and type 2 is provided by two doses of either IPV or f-IPV at 14 and 36 weeks of age, and broad immunity is provided with three doses of f-IPV, enabling substantial savings in cost and supply. These novel clinical data will inform global polio immunisation policy for the post-eradication era. Bill & Melinda Gates Foundation.