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Estimating the Extent of Vaccine-Derived Poliovirus Infection
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Estimating the Extent of Vaccine-Derived Poliovirus Infection
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Estimating the Extent of Vaccine-Derived Poliovirus Infection
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Journal Article
Estimating the Extent of Vaccine-Derived Poliovirus Infection
2008
Overview
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.
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.
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.
Publisher
Public Library of Science,Public Library of Science (PLoS)
Subject
/ Child
/ Disease Outbreaks - statistics & numerical data
/ Dominican Republic - epidemiology
/ Genetic Variation - physiology
/ Humans
/ Hygiene
/ Infant
/ Infectious Diseases/Epidemiology and Control of Infectious Diseases
/ Infectious Diseases/Tropical and Travel-Associated Diseases
/ Infectious Diseases/Viral Infections
/ Poliomyelitis - epidemiology
/ Poliovirus - isolation & purification
/ Poliovirus Vaccines - adverse effects
/ Poliovirus Vaccines - genetics
/ Poliovirus Vaccines - immunology
/ Public Health and Epidemiology
/ Public Health and Epidemiology/Global Health
/ Public Health and Epidemiology/Health Policy
/ Public Health and Epidemiology/Immunization
/ Public Health and Epidemiology/Infectious Diseases
/ Vaccines
/ Viruses
