1
|
Rodríguez R, Juárez E, Estívariz CF, Cajas C, Rey-Benito G, Amézquita MOB, Miles SJ, Orantes O, Freire MC, Chévez AE, Signor LC, Sayyad L, Jarquin C, Cain E, Villalobos Rodríguez AP, Mendoza L, Ovando CA, Mayorga HDJB, Gaitán E, Paredes A, Belgasmi-Allen H, Gobern L, Rondy M. Response to Vaccine-Derived Polioviruses Detected through Environmental Surveillance, Guatemala, 2019. Emerg Infect Dis 2023; 29:1524-1530. [PMID: 37486156 PMCID: PMC10370855 DOI: 10.3201/eid2908.230236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Guatemala implemented wastewater-based poliovirus surveillance in 2018, and three genetically unrelated vaccine-derived polioviruses (VDPVs) were detected in 2019. The Ministry of Health (MoH) response included event investigation through institutional and community retrospective case searches for acute flaccid paralysis (AFP) during 2018-2020 and a bivalent oral polio/measles, mumps, and rubella vaccination campaign in September 2019. This response was reviewed by an international expert team in July 2021. During the campaign, 93% of children 6 months <7 years of age received a polio-containing vaccine dose. No AFP cases were detected in the community search; institutional retrospective searches found 37% of unreported AFP cases in 2018‒2020. No additional VDPV was isolated from wastewater. No evidence of circulating VDPV was found; the 3 isolated VDPVs were classified as ambiguous VDPVs by the international team of experts. These detections highlight risk for poliomyelitis reemergence in countries with low polio vaccine coverage.
Collapse
|
2
|
Ali ASMA, Allzain H, Ahmed OM, Mahgoub E, Bashir MBM, Gorish BMT. Evaluation of acute flaccid paralysis surveillance system in the River Nile State - Northern Sudan, 2021. BMC Public Health 2023; 23:125. [PMID: 36653818 PMCID: PMC9845815 DOI: 10.1186/s12889-023-15019-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND One of the four main elements of the worldwide polio eradication strategy is acute flaccid paralysis surveillance (AFP). This system is based on (acute flaccid paralysis (AFP) cases reported and tested at World Health Organization (WHO) accredited laboratories. To measure and monitor performance, indicators were created. The current study aims to evaluate the system components, performance, and efficiency in River Nile State, Northern Sudan, and their compliance with World Health Organization (WHO) requirements for it to be adopted as a good system; its results can be used to certify whether a country is polio-free or not. MATERIAL AND METHODS A facility-based retrospective descriptive study was conducted in the River Nile State, Northern Sudan, from Jan 2017 to Dec 2020. This study included all reporting sites/units, workers who reported acute flaccid paralysis (AFP) cases, and officers at the locality level. A total of 50 health institutions were visited for surveillance, and interviews with 59 health workers who were part of the AFP surveillance system were undertaken. The data were collected from participants using a pre-tested questionnaire designed and constructed by the World Health Organization (WHO) framework, and the data were analyzed using the SPSS version (22). RESULTS The River Nile State's AFP surveillance system was of high quality in terms of the infrastructure that had been put in place and the effectiveness of the system's operations, as evidenced by the following statistics: from 2017 to 2020, the reported non-polio acute flaccid paralysis (AFP) cases were at a mean rate of 4.02 per 100,000 children under the age of 15; the majority of AFP reported cases were under 10 years; and males made up 73.3% of reported cases; The completeness of reports and surveillance documents exceeded 80%, and active surveillance was applied in 80% of reporting sites. CONCLUSION Despite the fact that the surveillance system is capable of detecting cases, Sudan continues to report cases of imported polio from other countries, highlighting the need to strengthen surveillance systems and eradication efforts in these countries.
Collapse
Affiliation(s)
| | - Haghamad Allzain
- grid.442427.30000 0004 5984 622XDepartment of Biochemistry, Faculty of Medicine, Shendi University, Shendi, Sudan
| | - Omran M. Ahmed
- grid.442427.30000 0004 5984 622XDepartment of Public Health, Faculty of Public Health, Shendi University, Shendi, Sudan
| | - Elsadig Mahgoub
- grid.414827.cAFP Surveillance System, Federal Ministry of Health, Khartoum, Sudan
| | - Mazin Babekir Musa Bashir
- grid.442427.30000 0004 5984 622XDepartment of Microbiology, Faculty of Medical Laboratory Science, Shendi University, Shendi, Sudan
| | - Babbiker Mohammed Tahir Gorish
- grid.442422.60000 0000 8661 5380Department of Microbiology, Faculty of Medical Laboratory Science, Omdurman Islamic University, Omdurman, Sudan
| |
Collapse
|
3
|
Sharma H, Lalwani S, Parekh S, Pujari P, Shewale S, Palkar S, Hanumante N, Gokhale S, Ks J, Kumar R, Sharma I, Gairola S. A phase I, open label, clinical study to assess the safety and immunogenicity of indigenously developed liquid (DTwP-HepB-IPV-Hib) hexavalent combination vaccine in healthy toddlers aged 16-24 months. Hum Vaccin Immunother 2022; 18:2146435. [PMID: 36412272 DOI: 10.1080/21645515.2022.2146435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This first in human study was designed as an open label clinical trial to assess the safety and immunogenicity of SIIPL DTwP-HepB-IPV-Hib (Hexavalent) combination vaccine in healthy toddlers, aged 16-24 months. A total of 24 healthy toddlers were administered a 0.5 ml single dose of SIIPL DTwP-HepB-IPV-Hib vaccine intramuscularly, and followed for 28 days for safety outcomes viz. immediate, solicited, unsolicited and serious adverse events. Blood samples were collected immediately prior to and 28 days after vaccination to assess the immunogenicity. Twenty four completed the study in compliance with the study protocol. None of the participants experienced any immediate or any serious adverse event. In terms of the frequency and intensity, the adverse events were comparable to DTwP-based combination vaccines. The vaccine elicited a strong booster response as demonstrated by a large increase in antibodies against all vaccine antigens. One month post booster vaccination seroprotection for diphtheria, tetanus, Hepatitis B, Haemophilus influenzae type b and polio virus type 1 and 3 was 100%. The percentage sero-response for pertussis was 75%. Four-fold increase in antibody concentration for pertussis was achieved in 87.5% subjects. Indigenously developed DTwP-HepB-IPV-Hib vaccine by Serum Institute of India Pvt. Ltd. was found to be safe, well tolerated and showed a robust immune response in toddlers. It was concluded that this vaccine should be assessed in the next phases of clinical development in the target population.Clinical Trial Registration - CTRI/2018/10/015875.
Collapse
Affiliation(s)
- Hitt Sharma
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Sanjay Lalwani
- Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical college & Hospital, Pune, India
| | - Sameer Parekh
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Pramod Pujari
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Sunil Shewale
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Sonali Palkar
- Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical college & Hospital, Pune, India
| | - Neeta Hanumante
- Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical college & Hospital, Pune, India
| | - Shilpa Gokhale
- Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical college & Hospital, Pune, India
| | - Jaganathan Ks
- Department of Production, Serum Institute of India Pvt. Ltd., Pune, India
| | - Rakesh Kumar
- Department of Production, Serum Institute of India Pvt. Ltd., Pune, India
| | - Inderjit Sharma
- Department of Production, Serum Institute of India Pvt. Ltd., Pune, India
| | - Sunil Gairola
- Department of Quality Control, Serum Institute of India Pvt. Ltd., Pune, India
| |
Collapse
|
4
|
Soofi SB, Martinez M, Farag NH, Hendley WS, Ehrhardt D, Ahmed I, Hussain I, Weldon W, Kassem AM. Poliovirus Immunity among Children Aged 6-11 and 36-48 Months in 14 Polio High-Risk Provinces of Afghanistan: A Health-Facility-Based Study. Vaccines (Basel) 2022; 10:vaccines10101726. [PMID: 36298591 PMCID: PMC9610936 DOI: 10.3390/vaccines10101726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022] Open
Abstract
Afghanistan is one of two countries where wild poliovirus (WPV) type 1 remains endemic. We conducted a facility-based cross-sectional survey of antipoliovirus antibodies in children in 14 provinces of Afghanistan. The provinces were selected based on programmatic priorities for polio eradication. Children aged 6–11 and 36–48 months attending outpatient clinics were enrolled in the study. We collected venous blood, isolated serum, and conducted neutralization assays to detect poliovirus neutralizing antibodies. A total of 2086 children from the 14 provinces were enrolled. Among the enrolled children, 44.3% were girls; the median age in the 6–11-month group was 9.4 months, and in the 36–48-month group, it was 41.8 months. The most common spoken language was Pashtu (70.8%). Eighty-two percent of children were fully immunized against all the diseases in the vaccination schedule of Afghanistan. In the children aged 6–11 months, seroprevalence to poliovirus type 1 (PV1) was 96.5% and seroprevalence to poliovirus type 3 (PV3) was 93%; in children aged 36–48 months, seroprevalence to PV1 was 99.5% and to PV3 was 98%. Antipoliovirus antibody prevalence for poliovirus type 2 (PV2) was 70.5% in the younger group compared with 90.9% in the older children. Children from Herat and Laghman provinces had almost 100% seroprevalence to PV1, and other provinces also had high prevalence, ranging from 92.0% to 99.0%. A similar finding was seen for antibodies against PV3, ranging from 88% to 100% by province. On the contrary, antibodies to PV2 were low, ranging from 53% for children in the Khost province to around 89% in Kunduz. There was a cluster of 18 seronegative children in the Nuristan province. Overall, the polio eradication program of Afghanistan has been successful in achieving high seroprevalence of poliovirus neutralizing antibodies in the parts of the country included in this study.
Collapse
Affiliation(s)
- Sajid Bashir Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Correspondence: ; Tel.: +92-21-3486-4798
| | - Maureen Martinez
- The Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA
| | - Noha H. Farag
- The Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA
| | - William S. Hendley
- The Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA
| | - Derek Ehrhardt
- The Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA
| | - Imran Ahmed
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Imtiaz Hussain
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - William Weldon
- The Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA
| | - Ahmed M. Kassem
- The Centers for Disease Control and Prevention, Atlanta, GA 30329-4027, USA
| |
Collapse
|
5
|
Seinfeld J, Rosales ML, Sobrevilla A, López Yescas JG. Economic assessment of incorporating the hexavalent vaccine as part of the National Immunization Program of Peru. BMC Health Serv Res 2022; 22:651. [PMID: 35570278 PMCID: PMC9109284 DOI: 10.1186/s12913-022-08006-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to estimate the economic impact of replacing the current Peruvian primary immunization scheme for infants under 1 year old with an alternative scheme with similar efficacy, based on a hexavalent vaccine. Methods A cost-minimization analysis compared the costs associated with vaccine administration, adverse reactions medical treatment, logistical activities, and indirect social costs associated with time spent by parents in both schemes. A budgetary impact analysis assessed the financial impact of the alternative scheme on healthcare budget. Results Incorporating the hexavalent vaccine would result in a 15.5% net increase in healthcare budget expenditure ($48,281,706 vs $55,744,653). Vaccination costs would increase by 54.1%, whereas logistical and adverse reaction costs would be reduced by 59.8% and 33.1%, respectively. When including indirect social costs in the analysis, the budgetary impact was reduced to 8.7%. Furthermore, the alternative scheme would enable the liberation of 17.5% of national vaccines storage capacity. Conclusions Despite of the significant reduction of logistical and adverse reaction costs, including the hexavalent vaccine into the National Immunization Program of Peru in place of the current vaccination scheme for infants under 1 year of age would increase the public financial budget of the government as it would represent larger vaccine acquisition costs. Incorporating the indirect costs would reduce the budgetary impact demonstrating the social value of the alternative scheme. This merits consideration by government bodies, and future studies investigating such benefits would be informative. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08006-1.
Collapse
Affiliation(s)
- Janice Seinfeld
- Videnza Consultores, Calle Alberto Alexander 2695, Lince, Lima, Perú.
| | | | | | | |
Collapse
|
6
|
Weintraub RL, Subramanian L, Karlage A, Ahmad I, Rosenberg J. COVID-19 Vaccine To Vaccination: Why Leaders Must Invest In Delivery Strategies Now. Health Aff (Millwood) 2021; 40:33-41. [DOI: 10.1377/hlthaff.2020.01523] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Rebecca L. Weintraub
- Rebecca L. Weintraub is director of Better Evidence, Ariadne Labs, Harvard T. H. Chan School of Public Health and Brigham and Women’s Hospital, and an associate physician at Brigham and Women’s Hospital, all in Boston, Massachusetts
| | | | - Ami Karlage
- Ami Karlage is a writing specialist at Ariadne Labs
| | - Iman Ahmad
- Iman Ahmad is a research assistant at Better Evidence, Ariadne Labs
| | - Julie Rosenberg
- Julie Rosenberg is deputy director of Better Evidence, Ariadne Labs
| |
Collapse
|
7
|
Guan Q, Sadykov M, Mfarrej S, Hala S, Naeem R, Nugmanova R, Al-Omari A, Salih S, Al Mutair A, Carr MJ, Hall WW, Arold ST, Pain A. A genetic barcode of SARS-CoV-2 for monitoring global distribution of different clades during the COVID-19 pandemic. Int J Infect Dis 2020; 100:216-223. [PMID: 32841689 PMCID: PMC7443060 DOI: 10.1016/j.ijid.2020.08.052] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE The SARS-CoV-2 pathogen has established endemicity in humans. This necessitates the development of rapid genetic surveillance methodologies to serve as an adjunct with existing comprehensive, albeit though slower, genome sequencing-driven approaches. METHODS A total of 21,789 complete genomes were downloaded from GISAID on May 28, 2020 for analyses. We have defined the major clades and subclades of circulating SARS-CoV-2 genomes. A rapid sequencing-based genotyping protocol was developed and tested on SARS-CoV-2-positive RNA samples by next-generation sequencing. RESULTS We describe 11 major mutations which defined five major clades (G614, S84, V251, I378 and D392) of globally circulating viral populations. The clades can specifically identify using an 11-nucleotide genetic barcode. An analysis of amino acid variation in SARS-CoV-2 proteins provided evidence of substitution events in the viral proteins involved in both host entry and genome replication. CONCLUSION Globally circulating SARS-CoV-2 genomes could be classified into 5 major clades based on mutational profiles defined by an 11-nucleotide barcode. We have successfully developed a multiplexed sequencing-based, rapid genotyping protocol for high-throughput classification of major clade types of SARS-CoV-2 in clinical samples. This barcoding strategy will be required to monitor decreases in genetic diversity as treatment and vaccine approaches become widely available.
Collapse
Affiliation(s)
- Qingtian Guan
- King Abdullah University of Science and Technology (KAUST), Pathogen Genomics Laboratory, Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia
| | - Mukhtar Sadykov
- King Abdullah University of Science and Technology (KAUST), Pathogen Genomics Laboratory, Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia
| | - Sara Mfarrej
- King Abdullah University of Science and Technology (KAUST), Pathogen Genomics Laboratory, Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia
| | - Sharif Hala
- King Abdullah University of Science and Technology (KAUST), Pathogen Genomics Laboratory, Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia; Clinical Microbiology Department, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Raeece Naeem
- King Abdullah University of Science and Technology (KAUST), Pathogen Genomics Laboratory, Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia
| | - Raushan Nugmanova
- King Abdullah University of Science and Technology (KAUST), Pathogen Genomics Laboratory, Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia
| | - Awad Al-Omari
- School of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Dr.Suliman Al-Habib Medical Group, Riyadh, Saudi Arabia
| | - Samer Salih
- Dr.Suliman Al-Habib Medical Group, Riyadh, Saudi Arabia
| | | | - Michael J Carr
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, D04 V1W8, Dublin, Ireland; Research Center for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, N20 W10 Kita-ku, Sapporo, 001-0020 Japan
| | - William W Hall
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, D04 V1W8, Dublin, Ireland; Research Center for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, N20 W10 Kita-ku, Sapporo, 001-0020 Japan; Global Virus Network (GVN), 801 W. Baltimore St., Baltimore, MD, 21201, USA
| | - Stefan T Arold
- King Abdullah University of Science and Technology (KAUST), Computational Bioscience Research Center (CBRC), Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia; Centre de Biochimie Structurale, CNRS, INSERM, Université de Montpellier, 34090 Montpellier, France
| | - Arnab Pain
- King Abdullah University of Science and Technology (KAUST), Pathogen Genomics Laboratory, Biological and Environmental Science and Engineering (BESE), Thuwal-Jeddah, 23955-6900, Saudi Arabia; Research Center for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, N20 W10 Kita-ku, Sapporo, 001-0020 Japan; Nuffield Division of Clinical Laboratory Sciences (NDCLS), The John Radcliffe Hospital, University of Oxford, Headington, Oxford, OX3 9DU, United Kingdom.
| |
Collapse
|
8
|
Vallejo BM, Ong RAC. Policy responses and government science advice for the COVID 19 pandemic in the Philippines: January to April 2020. PROGRESS IN DISASTER SCIENCE 2020; 7:100115. [PMID: 34173440 PMCID: PMC7299863 DOI: 10.1016/j.pdisas.2020.100115] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 05/05/2023]
Abstract
In this paper we examine two policy questions about the COVID 19 pandemic in the Philippines. These are science informed policy questions that will have to take into consideration a large degree of uncertainties in outcomes. The first question is on when to lift the Enhanced Community Quarantine (ECQ) as informed by epidemiological modelling. The second deals on how the Philippines can respond to a future pandemic crisis. We review the Philippine government's responses and introduce the complicating scientific, social, and political contexts for both questions and address proposals for strengthening the science advisory structures. We propose a permanent science advisory body for emergencies with the widest source of expertise as needed.
Collapse
Affiliation(s)
- Benjamin M Vallejo
- Institute of Environmental Science and Meteorology, University of the Philippines Diliman, Philippines
- Science and Society Program, University of the Philippines Diliman, Philippines
- International Network for Government Science Advice-Asia, Kuala Lumpur, Malaysia
| | - Rodrigo Angelo C Ong
- Institute of Environmental Science and Meteorology, University of the Philippines Diliman, Philippines
- Science and Society Program, University of the Philippines Diliman, Philippines
- College of Medicine, University of the Philippines Manila, Philippines
- International Network for Government Science Advice-Asia, Kuala Lumpur, Malaysia
| |
Collapse
|
9
|
Thompson KM, Kalkowska DA. Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication. Expert Rev Vaccines 2020; 19:661-686. [PMID: 32741232 PMCID: PMC7497282 DOI: 10.1080/14760584.2020.1791093] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/22/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Over the last 20 years (2000-2019) the partners of the Global Polio Eradication Initiative (GPEI) invested in the development and application of mathematical models of poliovirus transmission as well as economics, policy, and risk analyses of polio endgame risk management options, including policies related to poliovirus vaccine use during the polio endgame. AREAS COVERED This review provides a historical record of the polio studies published by the three modeling groups that primarily performed the bulk of this work. This review also systematically evaluates the polio transmission and health economic modeling papers published in English in peer-reviewed journals from 2000 to 2019, highlights differences in approaches and methods, shows the geographic coverage of the transmission modeling performed, identified common themes, and discusses instances of similar or conflicting insights or recommendations. EXPERT OPINION Polio modeling performed during the last 20 years substantially impacted polio vaccine choices, immunization policies, and the polio eradication pathway. As the polio endgame continues, national preferences for polio vaccine formulations and immunization strategies will likely continue to change. Future modeling will likely provide important insights about their cost-effectiveness and their relative benefits with respect to controlling polio and potentially achieving and maintaining eradication.
Collapse
|
10
|
Cheng E, Gambhirrao N, Patel R, Zhowandai A, Rychtář J, Taylor D. A game-theoretical analysis of poliomyelitis vaccination. J Theor Biol 2020; 499:110298. [PMID: 32371008 DOI: 10.1016/j.jtbi.2020.110298] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 12/15/2022]
Abstract
Poliomyelitis is a worldwide disease that has nearly been eradicated thanks to the Global Polio Eradication Initiative. Nevertheless, the disease is currently still endemic in three countries. In this paper, we incorporate the vaccination in a two age-class model of polio dynamics. Our main objective is to see whether mandatory vaccination policy is needed or if polio could be almost eradicated by a voluntary vaccination. We perform game theoretical analysis and compare the herd immunity vaccination levels with the Nash equilibrium vaccination levels. We show that the gap between two vaccination levels is too large. We conclude that the mandatory vaccination policy is therefore needed to achieve a complete eradication.
Collapse
Affiliation(s)
- Emily Cheng
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA 23284-3068, USA.
| | - Neeha Gambhirrao
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA 23284-3068, USA.
| | - Rohani Patel
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA 23284-3068, USA.
| | - Aufia Zhowandai
- Department of Biology, Virginia Commonwealth University, Richmond, VA 23284-2012, USA.
| | - Jan Rychtář
- Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA 23284-2014, USA.
| | - Dewey Taylor
- Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA 23284-2014, USA.
| |
Collapse
|
11
|
Chaudhry A, Javed N, Muhsan Wattoo M. Assessment of risk factors associated with oral polio vaccine refusal in Rahim Yar Khan District, Pakistan (2017). JOURNAL OF BIOSAFETY AND BIOSECURITY 2020. [DOI: 10.1016/j.jobb.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
12
|
Spagnoli L, Comte E, Sheath D, Rosset N, Loutan L, Geissbuhler A, Flahault A. Geneva Health Forum: The Forum of Innovative Practices in Global Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051517. [PMID: 32120869 PMCID: PMC7084837 DOI: 10.3390/ijerph17051517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 06/10/2023]
Abstract
In the past years, Global Health has interfaced with important challenges related to several dynamic changes. Technological progress, the digital revolution and the emergence of new actors in the field of health, increase the possibility of finding solutions to these unprecedented challenges. Starting from these assumptions, the idea of providing an adequate platform for good management of the health system has flowed into the creation of a meeting place that would allow a wide exchange of information, ideas sharing and proposals for new collaborations: the Geneva Health Forum (GHF). The GHF is a global health conference that aims to promote critical reflections and constructive debates on contemporary global health issues, thus influencing and informing policy formulation with experience from the field. The profile and impact of the Geneva Health Forum has grown year on year, establishing itself as a unique forum, ranging from more traditional sessions to innovative events.
Collapse
Affiliation(s)
- Laura Spagnoli
- Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; (E.C.); (D.S.); (A.G.); (A.F.)
| | - Eric Comte
- Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; (E.C.); (D.S.); (A.G.); (A.F.)
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland; (N.R.); (L.L.)
| | - Danny Sheath
- Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; (E.C.); (D.S.); (A.G.); (A.F.)
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland; (N.R.); (L.L.)
| | - Nicole Rosset
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland; (N.R.); (L.L.)
| | - Louis Loutan
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland; (N.R.); (L.L.)
| | - Antoine Geissbuhler
- Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; (E.C.); (D.S.); (A.G.); (A.F.)
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland; (N.R.); (L.L.)
| | - Antoine Flahault
- Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland; (E.C.); (D.S.); (A.G.); (A.F.)
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland; (N.R.); (L.L.)
| |
Collapse
|
13
|
Turner PJ, Abdulla AF, Cole ME, Javan RR, Gould V, O'Driscoll ME, Southern J, Zambon M, Miller E, Andrews NJ, Höschler K, Tregoning JS. Differences in nasal immunoglobulin A responses to influenza vaccine strains after live attenuated influenza vaccine (LAIV) immunization in children. Clin Exp Immunol 2020; 199:109-118. [PMID: 31670841 PMCID: PMC6954673 DOI: 10.1111/cei.13395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 11/28/2022] Open
Abstract
Different vaccine strains included in the live attenuated influenza vaccine (LAIV) have variable efficacy. The reasons for this are not clear and may include differences in immunogenicity. We report a Phase IV open-label study on the immunogenicity of a single dose of quadrivalent LAIV (Fluenz™ Tetra) in children during the 2015/16 season, to investigate the antibody responses to different strains. Eligible children were enrolled to receive LAIV; nasal samples were collected before and approximately 4 weeks after immunization. There was a significant increase in nasal immunoglobulin (Ig)A to the H3N2, B/Victoria lineage (B/Brisbane) and B/Yamagata lineage (B/Phuket) components, but not to the H1N1 component. The fold change in nasal IgA response was inversely proportional to the baseline nasal IgA titre for H1N1, H3N2 and B/Brisbane. We investigated possible associations that may explain baseline nasal IgA, including age and prior vaccination status, but found different patterns for different antigens, suggesting that the response is multi-factorial. Overall, we observed differences in immune responses to different viral strains included in the vaccine; the reasons for this require further investigation.
Collapse
Affiliation(s)
- P. J. Turner
- National Heart and Lung InstituteImperial College LondonLondonUK
- Public Health England (Colindale)LondonUK
| | - A. F. Abdulla
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - M. E. Cole
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - R. R. Javan
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - V. Gould
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| | - M. E. O'Driscoll
- Infectious Diseases EpidemiologySt Mary's CampusImperial College LondonLondonUK
| | | | - M. Zambon
- Public Health England (Colindale)LondonUK
| | - E. Miller
- Public Health England (Colindale)LondonUK
| | | | | | - J. S. Tregoning
- Department of Infectious DiseaseSt Mary's CampusImperial College LondonLondonUK
| |
Collapse
|
14
|
Jaiswal N, Singh S, Agarwal A, Chauhan A, Thumburu KK, Kaur H, Singh M. Equivalent schedules of intradermal fractional dose versus intramuscular full dose of inactivated polio vaccine for prevention of poliomyelitis. Cochrane Database Syst Rev 2019; 12:CD011780. [PMID: 31858595 PMCID: PMC6923520 DOI: 10.1002/14651858.cd011780.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Poliomyelitis is a debilitating and deadly infection. Despite exponential growth in medical science, there is still no cure for the disease, which is caused by three types of wild polioviruses: types 1, 2, and 3. According to the Global Polio Eradication Initiative (GPEI), wild poliovirus is still in circulation in three countries, and fresh cases have been reported even in the year 2018. Due to the administration of live vaccines, the risk for vaccine-derived poliovirus (VDPV) is high in areas that are free from wild polioviruses. This is evident based on the fact that VDPV caused 20 outbreaks between 2000 and 2011. Recent recommendations from the World Health Organization favoured the inclusion of inactivated poliovirus vaccine (IPV) in the global immunisation schedule. IPV can be delivered in two ways: intramuscularly and intradermally. IPV was previously administered intramuscularly, but shortages in vaccine supplies, coupled with the higher costs of the vaccines, led to the innovation of delivering a fractional dose (one-fifth) of IPV intradermally. However, there is uncertainty regarding the efficacy, immunogenicity, and safety of an intradermal, fractional dose of IPV compared to an intramuscular, full dose of IPV. OBJECTIVES To compare the immunogenicity and efficacy of an inactivated poliovirus vaccine (IPV) in equivalent immunisation schedules using fractional-dose IPV given via the intradermal route versus full-dose IPV given via the intramuscular route. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 10 other databases, and two trial registers up to February 2019. We also searched the GPEI website and scanned the bibliographies of key studies and reviews in order to identify any additional published and unpublished trials in this area not captured by our electronic searches. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs of healthy individuals of any age who are eligible for immunisation with IPV, comparing intradermal fractional-dose (one-fifth) IPV to intramuscular full-dose IPV. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 13 RCTs involving a total of 7292 participants, both children (n = 6402) and adults (n = 890). Nine studies were conducted in middle-income countries, three studies in high-income countries, and only one study in a low-income country. Five studies did not report methods of randomisation, and one study failed to conceal the allocations. Eleven studies did not blind participants, and six studies did not blind outcome assessments. Two studies had high attrition rates, and one study selectively reported the results. Three studies were funded by pharmaceutical companies. Paralytic poliomyelitis. No study reported data on this outcome. Seroconversion rates. These were significantly higher for all three types of wild poliovirus for children given intramuscular full-dose IPV after a single primary dose and two primary doses, but only significantly higher for type two wild poliovirus given intramuscularly after three primary doses: • dose one (six studies): poliovirus type 1 (odds ratio (OR) 0.30, 95% confidence interval (CI) 0.22 to 0.41; 2570 children); poliovirus type 2 (OR 0.43, 95% CI 0.31 to 0.60; 2567 children); poliovirus type 3 (OR 0.19, 95% CI 0.12 to 0.30; 2571 children); • dose two (three studies): poliovirus type 1 (OR 0.23, 95% CI 0.16 to 0.33; 981 children); poliovirus type 2 (OR 0.41, 95% CI 0.28 to 0.60; 853 children); and poliovirus type 3 (OR 0.12, 95% CI 0.07 to 0.22; 855 children); and • dose three (three studies): poliovirus type 1 (OR 0.45, 95% CI 0.07 to 3.15; 973 children); poliovirus type 2 (OR 0.34, 95% CI 0.19 to 0.63; 973 children); and poliovirus type 3 (OR 0.18, 95% CI 0.01 to 2.58; 973 children). Using the GRADE approach, we rated the certainty of the evidence as low or very low for seroconversion rate (after a single, two, or three primary doses) for all three poliovirus types due to significant risk of bias, heterogeneity, and indirectness in applicability/generalisability. Geometric mean titres. No study reported mean antibody titres. Median antibody titres were higher for intramuscular full-dose IPV (7 studies with 4887 children); although these studies also reported a rise in antibody titres in the intradermal group, none reported the duration for which the titres remained high. Any vaccine-related adverse event. Five studies (2217 children) reported more adverse events, such as fever and redness, in the intradermal group, whilst two studies (1904 children) reported more adverse events in the intramuscular group. AUTHORS' CONCLUSIONS There is low- and very low-certainty evidence that intramuscular full-dose IPV may result in a slight increase in seroconversion rates for all three types of wild poliovirus, compared with intradermal fractional-dose IPV. We are uncertain whether intradermal fractional-dose (one-fifth) IPV has better protective effects and causes fewer adverse events in children than intramuscular full-dose IPV.
Collapse
Affiliation(s)
- Nishant Jaiswal
- Postgraduate Institute of Medical Education and ResearchICMR Advanced Centre for Evidence‐Based Child HealthSector 12ChandigarhIndia160012
| | - Shreya Singh
- Postgraduate Institute of Medical Education and ResearchDepartment of Medical MicrobiologyResearch Block A, Sector 12ChandigarhChandigarhIndia160012
| | - Amit Agarwal
- Postgraduate Institute of Medical Education and ResearchICMR Advanced Centre for Evidence‐Based Child HealthSector 12ChandigarhIndia160012
| | - Anil Chauhan
- Postgraduate Institute of Medical Education and ResearchICMR Advanced Centre for Evidence‐Based Child HealthSector 12ChandigarhIndia160012
| | - Kiran K Thumburu
- Postgraduate Institute of Medical Education and ResearchICMR Advanced Centre for Evidence‐Based Child HealthSector 12ChandigarhIndia160012
| | - Harpreet Kaur
- Panjab UniversityUniversity Business SchoolSector 14ChandigarhIndia160014
| | - Meenu Singh
- Postgraduate Institute of Medical Education and ResearchDepartment of PediatricsSector 12ChandigarhIndia160012
| | | |
Collapse
|
15
|
Qian Y, Pu X, Yu Y, Yu X, Kong L, Liu L, Wang H, Shen H. Poliovirus serotype 2 and coxsackievirus A promote the natural recombination of poliovirus. J Med Virol 2019; 92:263-270. [PMID: 31674680 DOI: 10.1002/jmv.25620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 10/29/2019] [Indexed: 11/08/2022]
Abstract
Poliovirus (PV) is a member of the species Enterovirus C (EV-C), which may cause irreversible paralysis and death. So, for the purpose of analyzing the evolution of PV2 to help in eradicating PVs globally, a recombination analysis was performed to verify all viral genomes of EV-C, and we found 13 putative recombination events that produced PV1, 14 recombination events that can give rise to PV2, and 9 events that can lead to PV3. By analyzing our findings, we found that PV2 was involved in 25 of 36 PV recombination events, whereas coxsackievirus A (CVA) strains were involved in 12 of 36 PV recombination events, indicating that PV2 and CVAs play major roles in the natural recombination of PV. In addition, we found 11 of 36 breakpoint positions located in 2A region, which is the most active region of the recombination events.
Collapse
Affiliation(s)
| | - Xufeng Pu
- Medical College, Jiangsu University, Zhenjiang, China
| | - Yu Yu
- Medical College, Jiangsu University, Zhenjiang, China
| | - Xintian Yu
- Medical College, Jiangsu University, Zhenjiang, China
| | - Liang Kong
- Medical College, Jiangsu University, Zhenjiang, China
| | - Lu Liu
- Medical College, Jiangsu University, Zhenjiang, China
| | - Hua Wang
- Medical College, Jiangsu University, Zhenjiang, China
| | - Hongxing Shen
- Medical College, Jiangsu University, Zhenjiang, China
| |
Collapse
|
16
|
Kolluru C, Gomaa Y, Prausnitz MR. Development of a thermostable microneedle patch for polio vaccination. Drug Deliv Transl Res 2019; 9:192-203. [PMID: 30542944 PMCID: PMC6328527 DOI: 10.1007/s13346-018-00608-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of this study was to develop a dissolving microneedle (MN) patch for administration of inactivated polio vaccine (IPV) with improved thermal stability when compared with conventional liquid IPV. Excipient screening showed that a combination of maltodextrin and D-sorbitol in histidine buffer best preserved IPV activity during MN patch fabrication and storage. As determined by D-antigen ELISA, all three IPV serotypes maintained > 70% activity after 2 months and > 50% activity after 1-year storage at 5 °C or 25 °C with desiccant. Storage at 40 °C yielded > 40% activity after 2 months and > 20% activity after 1 year. In contrast, commercial liquid IPV types 1 and 2 lost essentially all activity within 1 month at 40 °C and IPV type 3 had < 40% activity. Residual moisture content in MN patches measured by thermogravimetric analysis was 1.2–6.5%, depending on storage conditions. Glass transition temperature measured by differential scanning calorimetry, structural changes measured by X-ray diffraction, and molecular interactions measured by Fourier transform infrared spectroscopy showed changes in MN matrix properties, but they did not correlate with IPV activity changes during storage. We conclude that appropriately formulated MN patches can exhibit thermostability that could enable distribution of IPV with less reliance on cold chain storage.
Collapse
Affiliation(s)
- Chandana Kolluru
- School of Materials Science and Engineering, Georgia Institute of Technology, 771 Ferst Drive, Atlanta, GA, 30332, USA
| | - Yasmine Gomaa
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA.,Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, El-Khartoum Square, Alexandria, 21521, Egypt
| | - Mark R Prausnitz
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA.
| |
Collapse
|
17
|
Church JA, Rukobo S, Govha M, Carmolli MP, Diehl SA, Chasekwa B, Ntozini R, Mutasa K, Humphrey JH, Kirkpatrick BD, Prendergast AJ. Neonatal vitamin A supplementation and immune responses to oral polio vaccine in Zimbabwean infants. Trans R Soc Trop Med Hyg 2019; 113:110-115. [PMID: 30576507 PMCID: PMC6391935 DOI: 10.1093/trstmh/try126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/08/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022] Open
Abstract
Background Micronutrient deficiencies may contribute to reduced oral vaccine immunogenicity in developing countries. We hypothesised that neonatal vitamin A supplementation (NVAS) would improve oral vaccine responses. Methods We performed a cross-sectional study of infants recruited at birth to the Zimbabwe Vitamin A for Mothers and Babies (ZVITAMBO) trial, a randomised controlled trial of single, high-dose NVAS vs placebo conducted in Zimbabwe between 1997–2001. We measured poliovirus-specific IgA to type 1–3 polio strains by semiquantitative capture ELISA in cryopreserved plasma samples collected at 6 months of age. Results A total of 181 infants fulfilled inclusion criteria, of whom 80 were randomised to NVAS and 101 to placebo. There were no significant differences in baseline characteristics between groups. At 6 months of age, median (IQR) vaccine titres for infants randomised to NVAS vs placebo were 932 (421–3001) vs 1774 (711–5431) for Sabin-1 (p=0.04); 1361 (705–3402) vs 2309 (1081–4283) for Sabin-2 (p=0.15); and 1584 (796–4216) vs 2260 (996–5723) for Sabin-3 (p=0.14), respectively. After adjusting for breast feeding status, birth weight, season and infant sex in a linear regression model, there was only weak evidence of difference in log mean titres between vitamin A and placebo groups for Sabin-1 (p=0.08) and no evidence of difference in log mean titres for Sabin-2 and Sabin-3. Conclusions NVAS did not augment oral polio vaccine responses in Zimbabwean infants. Further research is required to understand the impact of NVAS on responses to other oral vaccines. The trial is registered with clinicaltrials.gov identifier: NCT00198718.
Collapse
Affiliation(s)
- James A Church
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe.,Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, Newark Street, London, UK
| | - Sandra Rukobo
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Margaret Govha
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Marya P Carmolli
- Vaccine Testing Center, Larner College of Medicine, University of Vemont, Burlington, VT, USA
| | - Sean A Diehl
- Vaccine Testing Center, Larner College of Medicine, University of Vemont, Burlington, VT, USA
| | - Bernard Chasekwa
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Kuda Mutasa
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe
| | - Jean H Humphrey
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Beth D Kirkpatrick
- Vaccine Testing Center, Larner College of Medicine, University of Vemont, Burlington, VT, USA
| | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health Research, 16 Lauchlan Avenue, Harare, Zimbabwe.,Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, Newark Street, London, UK.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
18
|
Umeh GC, Shuaib F, Musa A, Tegegne SG, Braka F, Mkanda P, Banda R, Adamu U, Nomhwange TI, Arenyeka E, Omoleke SA, Johnson TM, Craig K, Idris I, Iyal H, Sambo IG, Nsubuga P. Acute flaccid paralysis (AFP) surveillance intensification for polio certification in Kaduna state, Nigeria: lessons learnt, 2015-2016. BMC Public Health 2018; 18:1310. [PMID: 30541509 PMCID: PMC6291918 DOI: 10.1186/s12889-018-6186-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Nigeria has made remarkable progress in its current efforts to interrupt wild poliovirus transmission despite the re-emergence of wild poliovirus in 2016. The gains made in Nigeria have been achieved through concerted efforts by governments at all levels, traditional leaders, health workers, caregivers, and development partners. The efforts have involved an elaborate plan, coordination, and effective implementation of routine immunization services, supplemental immunization activities, and acute flaccid paralysis (AFP) surveillance. Methods We conducted the following activities to strengthen AFP surveillance in Kaduna state: a monetary reward for all AFP cases reported by health workers or community informants and verified as “true” AFP by a World Health Organization (WHO) cluster coordinator; training and sensitization of surveillance officers, clinicians, and community informants; recruitment of more personnel and expansion of the surveillance network; and the involvement of special populations (nomadic, hard-to-reach, and border communities) and caregivers in stool sample collection. The paired t test was used to evaluate the impact of the different initiatives implemented in Kaduna state to intensify AFP surveillance in 2016. Results There was increased annualized non-polio AFP rate (ANPAFPR) in 21 out of 23 Local Government Areas (LGAs) of Kaduna state 6 months after implementation of different initiatives to intensify AFP surveillance. The AFP reported by the special population increased in 15 out of 23 LGAs. Statistical analyses of mean scores of ANPAFPR before and after the interventions using the paired t test revealed a significant difference in mean scores: mean = 19.7 (standard deviation (SD) = 16.1) per 100,000 < 15 years old in July–December 2015, compared with 38.0 (SD = 21.6) per 100,000 < 15 years old in January–June 2016 (p < 0.05). Likewise, analysis of silent wards using the paired t test showed a significant difference in mean scores: mean = 4.0 (SD = 2.1) in July–December 2015 compared with 2.4 (SD = 1.8) in January–June 2016 (p < 0.05). Conclusion The different initiatives implemented in 23 LGAs of Kaduna state to intensify AFP surveillance may be responsible for the significant improvement in the AFP surveillance performance indicators in 2016.
Collapse
Affiliation(s)
- Gregory C Umeh
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Audu Musa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Usman Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Terna I Nomhwange
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Eyiotoyo Arenyeka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Semeeh A Omoleke
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ticha M Johnson
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Kehinde Craig
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ibrahim Idris
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Hadiza Iyal
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ishaku G Sambo
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | |
Collapse
|
19
|
Epidemiology of the silent polio outbreak in Rahat, Israel, based on modeling of environmental surveillance data. Proc Natl Acad Sci U S A 2018; 115:E10625-E10633. [PMID: 30337479 DOI: 10.1073/pnas.1808798115] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Israel experienced an outbreak of wild poliovirus type 1 (WPV1) in 2013-2014, detected through environmental surveillance of the sewage system. No cases of acute flaccid paralysis were reported, and the epidemic subsided after a bivalent oral polio vaccination (bOPV) campaign. As we approach global eradication, polio will increasingly be detected only through environmental surveillance. We developed a framework to convert quantitative polymerase chain reaction (qPCR) cycle threshold data into scaled WPV1 and OPV1 concentrations for inference within a deterministic, compartmental infectious disease transmission model. We used this approach to estimate the epidemic curve and transmission dynamics, as well as assess alternate vaccination scenarios. Our analysis estimates the outbreak peaked in late June, much earlier than previous estimates derived from analysis of stool samples, although the exact epidemic trajectory remains uncertain. We estimate the basic reproduction number was 1.62 (95% CI 1.04-2.02). Model estimates indicate that 59% (95% CI 9-77%) of susceptible individuals (primarily children under 10 years old) were infected with WPV1 over a little more than six months, mostly before the vaccination campaign onset, and that the vaccination campaign averted 10% (95% CI 1-24%) of WPV1 infections. As we approach global polio eradication, environmental monitoring with qPCR can be used as a highly sensitive method to enhance disease surveillance. Our analytic approach brings public health relevance to environmental data that, if systematically collected, can guide eradication efforts.
Collapse
|
20
|
Costa-Carvalho BT, Sullivan KE, Fontes PM, Aimé-Nobre F, Gonzales IGS, Lima ES, Granato C, de Moraes-Pinto MI. Low Rates of Poliovirus Antibodies in Primary Immunodeficiency Patients on Regular Intravenous Immunoglobulin Treatment. J Clin Immunol 2018; 38:628-634. [PMID: 30006913 DOI: 10.1007/s10875-018-0531-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/03/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Poliovirus has been nearly eliminated as part of a world-wide effort to immunize and contain circulating wild-type polio. Nevertheless, poliovirus has been detected in water supplies and represents a threat to patients with humoral immunodeficiencies where infection can be fatal. To define the risk, we analyzed antibodies to poliovirus 1, 2, and 3 in serum samples collected over a year from patients with primary immunodeficiency diseases (PID) on regular intravenous immunoglobulin (IVIG) replacement. METHODS Twenty-one patients on regular IVIG replacement therapy were evaluated: Twelve patients with common variable immune deficiency (CVID), six with X-linked agammaglobulinemia (XLA), and three with hyper IgM syndrome (HIGM). Over 1 year, four blood samples were collected from each of these patients immediately before immunoglobulin infusion. One sample of IVIG administered to each patient in the month before blood collection was also evaluated. Poliovirus antibodies were quantified by seroneutralization assay. RESULTS All IVIG samples had detectable antibodies to the three poliovirus serotypes. Despite that, only 52.4, 61.9, and 19.0% of patients showed protective antibody titers for poliovirus 1, 2, and 3, respectively. Only two patients (9.5%) had protective antibodies for the three poliovirus serotypes on all samples. Most patients were therefore susceptible to all three poliovirus serotypes. CONCLUSIONS This study demonstrates the need for ongoing vigilance regarding exposure of patients with PID to poliovirus in the community.
Collapse
Affiliation(s)
- Beatriz T Costa-Carvalho
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Kathleen E Sullivan
- Division of Allergy Immunology, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Patrícia M Fontes
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fernanda Aimé-Nobre
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Isabela G S Gonzales
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elaine S Lima
- Division of Infectious Diseases, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Celso Granato
- Division of Infectious Diseases, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria Isabel de Moraes-Pinto
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil.
- Research Laboratory, Division of Pediatric Infectious Diseases, Federal University of Sao Paulo, Rua Pedro de Toledo, 781/9°andar, São Paulo, SP, 04039-032, Brazil.
| |
Collapse
|
21
|
Deen J, von Seidlein L. The case for ring vaccinations with special consideration of oral cholera vaccines. Hum Vaccin Immunother 2018; 14:2069-2074. [PMID: 29630444 PMCID: PMC6149944 DOI: 10.1080/21645515.2018.1462068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 01/09/2023] Open
Abstract
Ring vaccinations create a zone of immune contacts around a case to prevent further disease transmission and have been successfully employed in the eradication of smallpox and the control of other infections. Millions of oral cholera vaccine (OCV) doses have been effectively deployed through mass vaccination campaigns. But there are situations when the OCV supply, resources, and time are limited and alternative strategies need to be considered. People living in close proximity of cholera cases often share risk factors such as contaminated water supply and poor sanitation. Targeting people within a given radius around a cholera case for intervention including vaccination, improved water supply and sanitation may be a practical and effective approach. A ring oral cholera vaccination strategy could be considered before, after or as an alternative to a mass vaccination approach. We review here the use of the ring vaccinations in general and specifically during cholera outbreaks.
Collapse
Affiliation(s)
- Jacqueline Deen
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Lorenz von Seidlein
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| |
Collapse
|
22
|
Umeh GC, Nomhwange TI, Shamang AF, Zakari F, Musa AI, Dogo PM, Gugong V, Iliyasu N. Attitude and subjective wellbeing of non-compliant mothers to childhood oral polio vaccine supplemental immunization in Northern Nigeria. BMC Public Health 2018; 18:231. [PMID: 29422036 PMCID: PMC5806367 DOI: 10.1186/s12889-018-5126-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 01/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background Attitude and subjective well-being are important factors in mothers accepting or rejecting Oral Polio Vaccine (OPV) supplemental immunization. The purpose of the study was to determine the role of mothers’ attitude and subjective wellbeing on non-compliance to OPV supplemental immunization in Northern Nigeria. Methods The study utilized a cross-sectional design to assess attitude and subjective well-being of mothers using previously validated VACSATC (Vaccine Safety, Attitudes, Training and Communication-10 items) & SUBI (Subjective Well-being Inventory-40 items) measures. A total of 396 participants (equal number of non-compliant and compliant mothers) from 94 non-compliant settlements were interviewed, after informed consent. T-test was run to assess difference in mean scores between the non-compliant and compliant mothers on VACSATC and SUBI measures. Results The research showed a significant difference in mean scores between the non-compliant and compliant groups on VACSATC measure of mothers’ attitude (M = 18.9 non-compliant, compared to 26.5 compliant; p < 0.05). On subjective well-being, the study showed there was no significant difference in the mean scores of the SUBI measure (M = 77.4 non-compliant, compared to 78.0 compliant; p > 0.05). Conclusion The research has shown that negative attitude is more commonly present in non-compliant mothers and may be a factor in vaccine refusal in Northern Nigeria. Electronic supplementary material The online version of this article (10.1186/s12889-018-5126-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Gregory C Umeh
- World Health Organization, Field Office Kaduna, Kaduna, Nigeria.
| | | | | | - Furera Zakari
- World Health Organization, Field Office Kaduna, Kaduna, Nigeria
| | - Audu I Musa
- World Health Organization, Field Office Kaduna, Kaduna, Nigeria
| | - Paul M Dogo
- Kaduna State Ministry of Health, Kaduna, Nigeria
| | | | - Neyu Iliyasu
- Kaduna State Primary Health Care Agency, Kaduna, Nigeria
| |
Collapse
|
23
|
Vos A, Freuling C, Ortmann S, Kretzschmar A, Mayer D, Schliephake A, Müller T. An assessment of shedding with the oral rabies virus vaccine strain SPBN GASGAS in target and non-target species. Vaccine 2018; 36:811-817. [PMID: 29325820 DOI: 10.1016/j.vaccine.2017.12.076] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/20/2017] [Accepted: 12/21/2017] [Indexed: 11/30/2022]
Abstract
A safety requirement for live vaccines is investigating possible shedding in recipients since the presence of replication competent vaccine in secretions could result in direct and indirect horizontal transmission. This is especially relevant for oral rabies vaccine baits that are deliberately distributed into the environment. In the current study, survival of an oral rabies virus vaccine, SPBN GASGAS, was examined in excretions from different target and non-target species; red fox, raccoon dog, small Indian mongoose, raccoon, striped skunk, domestic dog, domestic cat and domestic pig. Saliva - and (pooled) fecal samples collected at different time points after oral administration of the vaccine strain were examined for the presence of viral RNA (rt-PCR). All PCR-positive and a subset of PCR-negative samples were subsequently investigated for the presence of infectious virus by isolation in cell culture (RTCIT). Up to 7 days post vaccine administration viral RNA could be detected in 50 of 758 fecal samples but no infectious virus was detected in any of the examined PCR-positive fecal samples. In contrast, RNA-fragments were detected in 248 of 1053 saliva swabs for an extended period (up to 10 days) after vaccine administration, but viable virus was only present during the first hours post vaccine administration in 38 samples. No infectious vaccine virus was isolated in saliva swabs taken 24 h or more after vaccine administration. Hence, no active shedding of the vaccine virus SPBN GASGAS after oral administration occurred and the virus isolated during the initial hours was material originally administered and not a result of virus replication within the host. Thus, potential horizontal transmission of this vaccine virus is limited to a short period directly after vaccine bait uptake. It can be concluded that the environmental risks associated with shedding after distributing vaccine baits containing SPBN GASGAS are negligible.
Collapse
Affiliation(s)
- Ad Vos
- IDT Biologika GmbH, Am Pharmapark, 06861 Dessau-Rosslau, Germany.
| | - Conrad Freuling
- Friedrich Loeffler Institute, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - Steffen Ortmann
- IDT Biologika GmbH, Am Pharmapark, 06861 Dessau-Rosslau, Germany
| | | | - Dietmar Mayer
- IDT Biologika GmbH, Am Pharmapark, 06861 Dessau-Rosslau, Germany
| | - Annette Schliephake
- Federal State Agency Saxony-Anhalt for Consumer Protection, Haferbreiter Weg 132-135, 39576 Stendal, Germany
| | - Thomas Müller
- Federal State Agency Saxony-Anhalt for Consumer Protection, Haferbreiter Weg 132-135, 39576 Stendal, Germany
| |
Collapse
|
24
|
Noori N, Drake JM, Rohani P. Comparative epidemiology of poliovirus transmission. Sci Rep 2017; 7:17362. [PMID: 29234135 PMCID: PMC5727041 DOI: 10.1038/s41598-017-17749-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/30/2017] [Indexed: 02/01/2023] Open
Abstract
Understanding the determinants of polio transmission and its large-scale epidemiology remains a public health priority. Despite a 99% reduction in annual wild poliovirus (WPV) cases since 1988, tackling the last 1% has proven difficult. We identified key covariates of geographical variation in polio transmission patterns by relating country-specific annual disease incidence to demographic, socio-economic and environmental factors. We assessed the relative contributions of these variables to the performance of computer-generated models for predicting polio transmission. We also examined the effect of spatial coupling on the polio extinction frequency in islands relative to larger land masses. Access to sanitation, population density, forest cover and routine vaccination coverage were the strongest predictors of polio incidence, however their relative effect sizes were inconsistent geographically. The effect of climate variables on polio incidence was negligible, indicating that a climate effect is not identifiable at the annual scale, suggesting a role for climate in shaping the transmission seasonality rather than intensity. We found polio fadeout frequency to depend on both population size and demography, which should therefore be considered in policies aimed at extinction. Our comparative epidemiological approach highlights the heterogeneity among polio transmission determinants. Recognition of this variation is important for the maintenance of population immunity in a post-polio era.
Collapse
Affiliation(s)
- Navideh Noori
- Odum School of Ecology, University of Georgia, Athens, GA, USA.
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA.
| | - John M Drake
- Odum School of Ecology, University of Georgia, Athens, GA, USA
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Pejman Rohani
- Odum School of Ecology, University of Georgia, Athens, GA, USA
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| |
Collapse
|
25
|
Drake JM, Hay SI. Monitoring the Path to the Elimination of Infectious Diseases. Trop Med Infect Dis 2017; 2:E20. [PMID: 30270879 PMCID: PMC6082106 DOI: 10.3390/tropicalmed2030020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/17/2017] [Accepted: 06/21/2017] [Indexed: 12/21/2022] Open
Abstract
During the endgame of elimination programs, parasite populations may exhibit dynamical phenomena not typical of endemic disease. Particularly, monitoring programs for tracking infection prevalence may be hampered by overall rarity, the sporadic and unpredictable timing and location of outbreaks, and under-reporting. A particularly important problem for monitoring is determining the distance that must be covered to achieve the elimination threshold at an effective reproduction number less than one. In this perspective, we suggest that this problem may be overcome by measuring critical slowing down. Critical slowing down is a phenomenon exhibited by nonlinear dynamical systems in the vicinity of a critical threshold. In infectious disease dynamics, critical slowing down is expressed as an increase in the coefficient of variation and other properties of the fluctuations in the number of cases. In simulations, we show the coefficient of variation to be insensitive to under-reporting error and therefore a robust measurement of the approach to elimination. Additionally, we show that there is an inevitable delay between the time at which the effective reproduction number is reduced to below one and complete elimination is achieved. We urge that monitoring programs include dynamical properties such as critical slowing down in their metrics for measuring achievement and avoid withdrawing control activities prematurely.
Collapse
Affiliation(s)
- John M Drake
- Odum School of Ecology, University of Georgia, Athens, GA 30602-2202, USA.
- Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602-2202, USA.
- Department of Zoology, University of Oxford, Oxford OX2, UK.
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121, USA.
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK.
| |
Collapse
|
26
|
Resik S, Tejeda A, Diaz M, Okayasu H, Sein C, Molodecky NA, Fonseca M, Alemany N, Garcia G, Hung LH, Martinez Y, Sutter RW. Boosting Immune Responses Following Fractional-Dose Inactivated Poliovirus Vaccine: A Randomized, Controlled Trial. J Infect Dis 2017; 215:175-182. [PMID: 28073858 DOI: 10.1093/infdis/jiw492] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/01/2016] [Indexed: 11/12/2022] Open
Abstract
Background Fractional-dose administration of inactivated poliovirus vaccine (fIPV) could increase IPV affordability and stretch limited supplies. We assessed immune responses following fIPV administered intradermally, compared with full-dose IPV administered intramuscularly, among adults with a history of oral poliovirus vaccine (OPV) receipt. Methods We conducted a randomized, controlled noninferiority trial in Cuba. fIPV or IPV were administered on days 0 and 28; serum was collected on days 0, 7, 28, and 56 for analysis by a neutralization assay. The primary end point was seroconversion or a ≥4-fold rise in antibody titer. The noninferiority limit was 10%. The secondary end point was safety, assessed by the number and intensity of adverse reactions. Results A total of 503 of 534 enrolled participants (94.2%) completed all study requirements. Twenty-eight days after the first dose, 94.8%, 98.0%, and 98.0% of fIPV recipients had an immune response to poliovirus types 1, 2, and 3, respectively, compared with 98.1% (P = .06), 98.0% (P = 1.00), and 99.2% (P = .45) in the IPV arm. Noninferiority was achieved on days 7, 28, and 56 for all serotypes. No serious adverse events were reported. Conclusion fIPV induced similar boosting immune responses, compared with full-dose IPV. This suggests that fIPV would be an effective strategy to boost population immunity in an outbreak situation. Clinical Trials Registration ACTRN12615000305527.
Collapse
Affiliation(s)
- Sonia Resik
- Pedro Kouri Institute of Tropical Medicine, Havana
| | - Alina Tejeda
- Provincial Center for Hygiene, Epidemiology, and Microbiology, Camaguey, Cuba
| | - Manuel Diaz
- Pedro Kouri Institute of Tropical Medicine, Havana
| | | | | | | | | | - Nilda Alemany
- Provincial Center for Hygiene, Epidemiology, and Microbiology, Camaguey, Cuba
| | - Gloria Garcia
- Provincial Center for Hygiene, Epidemiology, and Microbiology, Camaguey, Cuba
| | | | | | | |
Collapse
|
27
|
Sun M, Li C, Xu W, Liao G, Li R, Zhou J, Li Y, Cai W, Yan D, Che Y, Ying Z, Wang J, Yang H, Ma Y, Ma L, Ji G, Shi L, Jiang S, Li Q. Immune Serum From Sabin Inactivated Poliovirus Vaccine Immunization Neutralizes Multiple Individual Wild and Vaccine-Derived Polioviruses. Clin Infect Dis 2017; 64:1317-1325. [DOI: 10.1093/cid/cix110] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 02/08/2017] [Indexed: 01/08/2023] Open
Affiliation(s)
- Mingbo Sun
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan,
| | - Changgui Li
- Third Division of Viral Vaccines, National Institutes for Food and Drug Control, and
| | - Wenbo Xu
- Ministry of Health Key Laboratory for Medical, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing,
| | - Guoyang Liao
- No. 5 Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan,
| | - Rongcheng Li
- Vaccine Clinical Research Center, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, and
| | - Jian Zhou
- No. 4 Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China
| | - Yanping Li
- Vaccine Clinical Research Center, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, and
| | - Wei Cai
- No. 4 Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China
| | - Dongmei Yan
- Ministry of Health Key Laboratory for Medical, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing,
| | - Yanchun Che
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan,
| | - Zhifang Ying
- Third Division of Viral Vaccines, National Institutes for Food and Drug Control, and
| | - Jianfeng Wang
- Third Division of Viral Vaccines, National Institutes for Food and Drug Control, and
| | - Huijuan Yang
- No. 4 Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China
| | - Yan Ma
- No. 4 Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China
| | - Lei Ma
- No. 5 Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan,
| | - Guang Ji
- No. 4 Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan, China
| | - Li Shi
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan,
| | - Shude Jiang
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan,
| | - Qihan Li
- Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Disease, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan,
| |
Collapse
|
28
|
Berchenko Y, Manor Y, Freedman LS, Kaliner E, Grotto I, Mendelson E, Huppert A. Estimation of polio infection prevalence from environmental surveillance data. Sci Transl Med 2017; 9:9/383/eaaf6786. [DOI: 10.1126/scitranslmed.aaf6786] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 03/17/2016] [Accepted: 12/30/2016] [Indexed: 11/02/2022]
|
29
|
Koopman JS, Henry CJ, Park JH, Eisenberg MC, Ionides EL, Eisenberg JN. Dynamics affecting the risk of silent circulation when oral polio vaccination is stopped. Epidemics 2017; 20:21-36. [PMID: 28283373 PMCID: PMC5608688 DOI: 10.1016/j.epidem.2017.02.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 02/20/2017] [Accepted: 02/20/2017] [Indexed: 12/15/2022] Open
Abstract
Silent circulation (SC) of wild polio viruses (WPV) when oral polio vaccine (OPV) use is stopped, could threaten eradication. We analyzed a model designed to develop theory about mechanisms and factors that lead to SC and how SC risks can be assessed using surveillance data. Prolonged low-level SC emerges as a threshold phenomenon through a mechanism related to balancing contributions of different populations to the effective reproduction number. Factors that promote this mechanism are many years of inadequate vaccination efforts, ongoing waning of immunity against transmission years after last OPV or WPV infection, low transmissibility of OPV, and high transmission conditions. Analyzing acute flaccid paralysis surveillance or environmental surveillance data by themselves cannot assess the risk that an SC threshold has been passed, but new methods to analyze them jointly could do so.
Waning immunity could allow transmission of polioviruses without causing poliomyelitis by promoting silent circulation (SC). Undetected SC when oral polio vaccine (OPV) use is stopped could cause difficult to control epidemics. Little is known about waning. To develop theory about what generates SC, we modeled a range of waning patterns. We varied both OPV and wild polio virus (WPV) transmissibility, the time from beginning vaccination to reaching low polio levels, and the infection to paralysis ratio (IPR). There was longer SC when waning continued over time rather than stopping after a few years, when WPV transmissibility was higher or OPV transmissibility was lower, and when the IPR was higher. These interacted in a way that makes recent emergence of prolonged SC a possibility. As the time to reach low infection levels increased, vaccine rates needed to eliminate polio increased and a threshold was passed where prolonged low-level SC emerged. These phenomena were caused by increased contributions to the force of infection from reinfections. The resulting SC occurs at low levels that would be difficult to detect using environmental surveillance. For all waning patterns, modest levels of vaccination of adults shortened SC. Previous modeling studies may have missed these phenomena because (1) they used models with no or very short duration waning and (2) they fit models to paralytic polio case counts. Our analyses show that polio case counts cannot predict SC because nearly identical polio case count patterns can be generated by a range of waning patterns that generate different patterns of SC. We conclude that the possibility of prolonged SC is real but unquantified, that vaccinating modest fractions of adults could reduce SC risk, and that joint analysis of acute flaccid paralysis and environmental surveillance data can help assess SC risks and ensure low risks before stopping OPV.
Collapse
Affiliation(s)
- J S Koopman
- Department of Epidemiology, University of Michigan School of Public Health, United States.
| | - C J Henry
- Department of Epidemiology, University of Michigan School of Public Health, United States
| | - J H Park
- Department of Statistics, University of Michigan School of Literature, Science, and the Arts, United States
| | - M C Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, United States
| | - E L Ionides
- Department of Statistics, University of Michigan School of Literature, Science, and the Arts, United States
| | - J N Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, United States
| |
Collapse
|
30
|
Impact of mosquito gene drive on malaria elimination in a computational model with explicit spatial and temporal dynamics. Proc Natl Acad Sci U S A 2016; 114:E255-E264. [PMID: 28028208 DOI: 10.1073/pnas.1611064114] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The renewed effort to eliminate malaria and permanently remove its tremendous burden highlights questions of what combination of tools would be sufficient in various settings and what new tools need to be developed. Gene drive mosquitoes constitute a promising set of tools, with multiple different possible approaches including population replacement with introduced genes limiting malaria transmission, driving-Y chromosomes to collapse a mosquito population, and gene drive disrupting a fertility gene and thereby achieving population suppression or collapse. Each of these approaches has had recent success and advances under laboratory conditions, raising the urgency for understanding how each could be deployed in the real world and the potential impacts of each. New analyses are needed as existing models of gene drive primarily focus on nonseasonal or nonspatial dynamics. We use a mechanistic, spatially explicit, stochastic, individual-based mathematical model to simulate each gene drive approach in a variety of sub-Saharan African settings. Each approach exhibits a broad region of gene construct parameter space with successful elimination of malaria transmission due to the targeted vector species. The introduction of realistic seasonality in vector population dynamics facilitates gene drive success compared with nonseasonal analyses. Spatial simulations illustrate constraints on release timing, frequency, and spatial density in the most challenging settings for construct success. Within its parameter space for success, each gene drive approach provides a tool for malaria elimination unlike anything presently available. Provided potential barriers to success are surmounted, each achieves high efficacy at reducing transmission potential and lower delivery requirements in logistically challenged settings.
Collapse
|
31
|
Duintjer Tebbens RJ, Thompson KM. The potential benefits of a new poliovirus vaccine for long-term poliovirus risk management. Future Microbiol 2016; 11:1549-1561. [DOI: 10.2217/fmb-2016-0126] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Aim: To estimate the incremental net benefits (INBs) of a hypothetical ideal vaccine with all of the advantages and no disadvantages of existing oral and inactivated poliovirus vaccines compared with current vaccines available for future outbreak response. Methods: INB estimates based on expected costs and polio cases from an existing global model of long-term poliovirus risk management. Results: Excluding the development costs, an ideal poliovirus vaccine could offer expected INBs of US$1.6 billion. The ideal vaccine yields small benefits in most realizations of long-term risks, but great benefits in low-probability–high-consequence realizations. Conclusion: New poliovirus vaccines may offer valuable insurance against long-term poliovirus risks and new vaccine development efforts should continue as the world gathers more evidence about polio endgame risks.
Collapse
|
32
|
González MM, Sarmiento L, Giraldo AM, Padilla L, Rey-Benito G, Castaño JC. [Seroprevalence of antibodies to measles, rubella, mumps, hepatitis B viruses and all three poliovirus serotypes among children in Quindío, Colombia]. Rev Salud Publica (Bogota) 2016; 18:95-103. [PMID: 28453157 DOI: 10.15446/rsap.v18n1.44514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/09/2015] [Indexed: 12/31/2022] Open
Abstract
Objective The main goal of this research was to assess the seroprevalence of antibodies against measles, rubella, mumps, hepatitis B and all three poliovirus serotypes among children in the Quindío Department, Colombia. Methods Blood samples were obtained from 170 healthy children aged 5-9 years from nine municipalities in Quindío. The presence of serum IgG antibodies against measles, rubella, mumps and Hepatitis B were determined using commercial indirect ELISA kits. Immunity to poliomyelitis was assessed through the presence of neutralizing antibodies following the method recommended by the World Health Organization. Results Among the 170 children enrolled, 169 (99.41%), 170 (100 %), and 167 (98.2 %) were seropositive to poliovirus 1, poliovirus 2, and poliovirus 3, respectively. The average reciprocal antibody titers were 178 for poliovirus type 1, 120 for type 2 and 56 for type 3. Of the 170 children, 96.47 % were protected against mumps and rubella, and 86.47 % against measles. Only 106 (62.35 %) of the studied subjects were proved to be seropositive to hepatitis B. Conclusion The immunization program in Quindío has provided seroprotection against all three poliomyelitis serotypes, rubella and mumps. However, the child population is not fully protected against measles and hepatitis B virus infections.
Collapse
Affiliation(s)
- María M González
- Facultad Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| | - Luis Sarmiento
- Department of Clinical Sciences, Skåne University Hospital, Malmo, Sweden
| | | | - Leonardo Padilla
- Facultad Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| | | | - Jhon C Castaño
- Facultad Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| |
Collapse
|
33
|
Abstract
In the United States during the 1950's, polio was on the forefront of every provider and caregiver's mind. Today, most providers in the United States have never seen a case. The Global Polio Eradication Initiative (GPEI), which began in 1988 has reduced the number of cases by over 99%. The world is closer to achieving global eradication of polio than ever before but as long as poliovirus circulates anywhere in the world, every country is vulnerable. The global community can support the polio eradication effort through continued vaccination, surveillance, enforcing travel regulations and contributing financial support, partnerships and advocacy.
Collapse
Affiliation(s)
- Julie R Garon
- Division of Infectious Diseases, Emory University School of Medicine, 1462 Clifton Road Northeast, Suite 446, Atlanta, GA 30322, USA
| | - Stephen L Cochi
- Global Immunization Division, Center for Global Health Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop A-04, Atlanta, GA 30333, USA
| | - Walter A Orenstein
- Division of Infectious Diseases, Emory University School of Medicine, 1462 Clifton Road Northeast, Suite 446, Atlanta, GA 30322, USA.
| |
Collapse
|
34
|
Musa A, Mkanda P, Manneh F, Korir C, Warigon C, Gali E, Banda R, Umeh G, Nsubuga P, Chevez A, Vaz RG. Youth Group Engagement in Noncompliant Communities During Supplemental Immunization Activities in Kaduna, Nigeria, in 2014. J Infect Dis 2015; 213 Suppl 3:S91-5. [PMID: 26609003 PMCID: PMC4818550 DOI: 10.1093/infdis/jiv510] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION One of the major challenges being faced in the Global Polio Eradication Initiative program is persistent refusal of oral polio vaccine (OPV) and harassment of vaccination team members by youths. The objective of the study was to describe the strategy of collaborating with recognized youth groups to reduce team harassment during vaccination campaigns and improve vaccination coverage in noncompliant communities. METHODS We assessed data from polio vaccination activities in OPV-refusing communities in the Igabi and Zaria local government areas (LGAs) of Kaduna State in Nigeria. We evaluated the following factors to determine trends: enhanced independent monitoring data on the proportion of children missed by vaccination activities (hereafter, "missed children"), lot quality assurance surveys, and vaccination team harassment. RESULTS The proportion of missed children decreased in both LGAs after the intervention. In Igabi LGA and Zaria LGA, the lowest proportions of missed children before and after the intervention decreased from 7% to 2% and from 5% to 1%, respectively. Lot quality assurance survey trends showed an improvement in immunization coverage 1 year after youth groups' engagement in both LGAs. CONCLUSIONS Systematic engagement of youth groups has a great future in polio interruption as we approach the endgame strategy for polio eradication. It promises to be a veritable innovation in reaching chronically missed children in OPV-refusing communities.
Collapse
Affiliation(s)
- Audu Musa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Fadinding Manneh
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Emmanuel Gali
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Gregory Umeh
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Ana Chevez
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
| |
Collapse
|
35
|
Famulare M, Hu H. Extracting transmission networks from phylogeographic data for epidemic and endemic diseases: Ebola virus in Sierra Leone, 2009 H1N1 pandemic influenza and polio in Nigeria. Int Health 2015; 7:130-8. [PMID: 25733563 PMCID: PMC4379986 DOI: 10.1093/inthealth/ihv012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background Phylogeography improves our understanding of spatial epidemiology. However, application to practical problems requires choices among computational tools to balance statistical rigor, computational complexity, sensitivity to sampling strategy and interpretability. Methods We introduce a fast, heuristic algorithm to reconstruct partially-observed transmission networks (POTN) that combines features of phylogenetic and transmission tree approaches. We compare the transmission network generated by POTN with existing algorithms (BEAST and SeqTrack), and discuss the benefits and challenges of phylogeographic analysis on examples of epidemic and endemic diseases: Ebola virus, H1N1 pandemic influenza and polio. Results For the 2014 Sierra Leone Ebola virus outbreak and the 2009 H1N1 outbreak, all three methods provide similarly plausible transmission histories but differ in detail. For polio in northern Nigeria, we discuss performance trade-offs between the POTN and discrete phylogeography in BEAST and conclude that spatial history reconstruction is limited by under-sampling. Conclusions POTN is complementary to available tools on densely-sampled data, fails gracefully on under-sampled data and is scalable to accommodate larger datasets. We provide further evidence for the utility of phylogeography for understanding transmission networks of rapidly evolving epidemics. We propose simple heuristic criteria to identify how sampling rates and disease dynamics interact to determine fundamental limitations of phylogeographic inference.
Collapse
Affiliation(s)
| | - Hao Hu
- Institute for Disease Modeling, Bellevue, WA 98005, USA
| |
Collapse
|
36
|
Applying the Concept of Peptide Uniqueness to Anti-Polio Vaccination. J Immunol Res 2015; 2015:541282. [PMID: 26568962 PMCID: PMC4629041 DOI: 10.1155/2015/541282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/28/2015] [Indexed: 11/21/2022] Open
Abstract
Background. Although rare, adverse events may associate with anti-poliovirus vaccination thus possibly hampering global polio eradication worldwide. Objective. To design peptide-based anti-polio vaccines exempt from potential cross-reactivity risks and possibly able to reduce rare potential adverse events such as the postvaccine paralytic poliomyelitis due to the tendency of the poliovirus genome to mutate. Methods. Proteins from poliovirus type 1, strain Mahoney, were analyzed for amino acid sequence identity to the human proteome at the pentapeptide level, searching for sequences that (1) have zero percent of identity to human proteins, (2) are potentially endowed with an immunologic potential, and (3) are highly conserved among poliovirus strains. Results. Sequence analyses produced a set of consensus epitopic peptides potentially able to generate specific anti-polio immune responses exempt from cross-reactivity with the human host. Conclusion. Peptide sequences unique to poliovirus proteins and conserved among polio strains might help formulate a specific and universal anti-polio vaccine able to react with multiple viral strains and exempt from the burden of possible cross-reactions with human proteins. As an additional advantage, using a peptide-based vaccine instead of current anti-polio DNA vaccines would eliminate the rare post-polio poliomyelitis cases and other disabling symptoms that may appear following vaccination.
Collapse
|
37
|
Jaiswal N, Singh M, Thumburu KK, Agarwal A, Kaur H. Intradermal fractional dose vs intramuscular full dose of inactivated polio vaccine for prevention of poliomyelitis. Hippokratia 2015. [DOI: 10.1002/14651858.cd011780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Nishant Jaiswal
- Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research; ICMR Advanced Centre for Evidence-Based Child Health; Sector 12 Chandigarh India 160012
| | - Meenu Singh
- Post Graduate Institute of Medical Education and Research; Department of Pediatrics; Sector 12 Chandigarh India 160012
| | - Kiran K Thumburu
- Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research; ICMR Advanced Centre for Evidence-Based Child Health; Sector 12 Chandigarh India 160012
| | - Amit Agarwal
- Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research; ICMR Advanced Centre for Evidence-Based Child Health; Sector 12 Chandigarh India 160012
| | - Harpreet Kaur
- Panjab University; University Business School; Sector 14 Chandigarh India 160012
| |
Collapse
|
38
|
Ayukekbong JA. Current goals and prospects of the global polio eradication initiative. J Epidemiol Community Health 2015; 69:1133-4. [DOI: 10.1136/jech-2015-205529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/21/2015] [Indexed: 11/04/2022]
|
39
|
Abstract
The American Academy of Pediatrics strongly supports the Polio Eradication and Endgame Strategic Plan of the Global Polio Eradication Initiative. This plan was endorsed in November 2012 by the Strategic Advisory Group of Experts on Immunization of the World Health Organization and published by the World Health Organization in April 2013. As a key component of the plan, it will be necessary to stop oral polio vaccine (OPV) use globally to achieve eradication, because the attenuated viruses in the vaccine rarely can cause polio. The plan includes procedures for elimination of vaccine-associated paralytic polio and circulating vaccine-derived polioviruses (cVDPVs). cVDPVs can proliferate when vaccine viruses are transmitted among susceptible people, resulting in mutations conferring both the neurovirulence and transmissibility characteristics of wild polioviruses. Although there are 3 different types of wild poliovirus strains, the polio eradication effort has already resulted in the global elimination of type 2 poliovirus for more than a decade. Type 3 poliovirus may be eliminated because the wild type 3 poliovirus was last detected in 2012. Thus, of the 3 wild types, only wild type 1 poliovirus is still known to be circulating and causing disease. OPV remains the key vaccine for eradicating wild polioviruses in polio-infected countries because it induces high levels of systemic immunity to prevent paralysis and intestinal immunity to reduce transmission. However, OPV is a rare cause of paralysis and the substantial decrease in wild-type disease has resulted in estimates that the vaccine is causing more polio-related paralysis annually in recent years than the wild virus. The new endgame strategic plan calls for stepwise removal of the type 2 poliovirus component from trivalent oral vaccines, because type 2 wild poliovirus appears to have been eradicated (since 1999) and yet is the main cause of cVDPV outbreaks and approximately 40% of vaccine-associated paralytic polio cases. The Endgame and Strategic Plan will be accomplished by shifting from trivalent OPV to bivalent OPV (containing types 1 and 3 poliovirus only). It will be necessary to introduce trivalent inactivated poliovirus vaccine (IPV) into routine immunization programs in all countries using OPV to provide population immunity to type 2 before the switch from trivalent OPV to bivalent OPV. The Global Polio Eradication Initiative hopes to achieve global eradication of polio by 2018 with this strategy, after which all OPV use will be stopped. Challenges expected for adding IPV into routine immunization schedules include higher cost of IPV compared with OPV, cold-chain capacity limits, more complex administration of vaccine because IPV requires injections as opposed to oral administration, and inferior intestinal immunity conferred by IPV. The goal of this report is to help pediatricians understand the change in strategy and outline ways that pediatricians can help global polio eradication efforts, including advocating for the resources needed to accomplish polio eradication and for incorporation of IPV into routine immunization programs in all countries.
Collapse
|
40
|
Alam MM, Shaukat S, Sharif S, Angez M, Khurshid A, Malik F, Rehman L, Zaidi SSZ. Detection of multiple cocirculating wild poliovirus type 1 lineages through environmental surveillance: impact and progress during 2011-2013 in Pakistan. J Infect Dis 2014; 210 Suppl 1:S324-32. [PMID: 25316851 DOI: 10.1093/infdis/jiu160] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The environmental surveillance has proven to be a useful tool to identify poliovirus circulation in different countries and was started in Pakistan during July 2009 to support the acute flaccid paralysis (AFP) surveillance system. METHODS Sewage samples were collected from 27 environmental sampling (ENV) sites and processed for poliovirus isolation through 2-phase separation method. Poliovirus isolates were identified as Sabin-like or wild type through real-time polymerase chain reaction (PCR). Wild-type strains were subjected to VP1 gene sequencing and phylogenetic analysis performed using MEGA 5.0. RESULTS During 2011-2013, a total of 668 samples were collected from 4 provinces that resulted in 40% of samples positive for wild poliovirus type-1 (WPV-1). None of the samples were positive for WPV-3. The areas with high frequency of WPV-1 detection were Karachi-Gadap (69%), Peshawar (82%), and Rawalpindi (65%), whereas the samples from Quetta and Sukkur remained negative for WPV during 2013. Phylogenetic analysis revealed 3 major clusters with multiple poliovirus lineages circulating across different country areas as well as in bordering areas of Afghanistan. CONCLUSIONS Environmental surveillance in Pakistan has been proven to be a powerful tool to detect WPV circulation in the absence of poliomyelitis cases in many communities. Our findings emphasize the need to continue and expand such surveillance activities to other high-risk areas in the country.
Collapse
Affiliation(s)
- Muhammad Masroor Alam
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Shahzad Shaukat
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Salmaan Sharif
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Mehar Angez
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Adnan Khurshid
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Farzana Malik
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Lubna Rehman
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Syed Sohail Zahoor Zaidi
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| |
Collapse
|
41
|
Luo M. Single crystal X-ray diffraction analysis of virus structure and its applications in the development of pharmaceutical agents. CRYSTALLOGR REV 2014. [DOI: 10.1080/0889311x.2014.957281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
42
|
Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry applied to virus identification. Sci Rep 2014; 4:6803. [PMID: 25354905 PMCID: PMC4213803 DOI: 10.1038/srep06803] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/15/2014] [Indexed: 11/08/2022] Open
Abstract
Virus detection and/or identification traditionally rely on methods based on cell culture, electron microscopy and antigen or nucleic acid detection. These techniques are good, but often expensive and/or time-consuming; furthermore, they not always lead to virus identification at the species and/or type level. In this study, Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) was tested as an innovative tool to identify human polioviruses and to identify specific viral protein biomarkers in infected cells. The results revealed MALDI-TOF MS to be an effective and inexpensive tool for the identification of the three poliovirus serotypes. The method was firstly applied to Sabin reference strains, and then to isolates from different clinical samples, highlighting its value as a time-saving, sensitive and specific technique when compared to the gold standard neutralization assay and casting new light on its possible application to virus detection and/or identification.
Collapse
|
43
|
Kinuani L, Nzolo DB, Aloni MN, Makolo P, Ntamabyaliro N, Ntamba YL, Kazadi C, Nyembwe M, Ekila MB, Mesia GK. Assessment of attitudes towards adverse events following immunization with oral poliovirus vaccine: a pilot study among high school students of Kinshasa, the Democratic Republic of Congo. Pathog Glob Health 2014; 108:292-7. [PMID: 25237792 DOI: 10.1179/2047773214y.0000000151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the reaction of students to adverse events following immunization in order to offer a baseline for developing a communication and risk management plan. METHOD This is a cross-sectional study conducted in Kinshasa. A survey was conducted between the third and the fourth rounds of Supplementary Immunization Activity. Nine hundred and fifty questionnaires were used and addressed students who attended this university from 1 to 10 June 2011. RESULTS Completed questionnaires were received from 848 students, with 485 females (57·2%), 343 males (40·4%), and 20 unknown (2·4%); 46·9% of students were from the faculty of medicine and 24·7% was from the third graduate degree. From those who completed the questionnaire, 136 (16·4%) reported experiencing an adverse events following immunization. Concerning the attitude of students towards adverse events following immunization, 79 students (58·5%) did nothing; 54 (40·0%) opted for self-medication; 2 (1·5%) went to the hospital. CONCLUSION The main finding of our study is the low rate of people referring to health-care providers for vaccine-related problems, more specially for adverse events following immunization. A risk management plan should be focused in strategies to increase communication between population and health-care providers.
Collapse
|
44
|
Sissoko D, Trottier H, Malvy D, Johri M. The influence of compositional and contextual factors on non-receipt of basic vaccines among children of 12-23-month old in India: a multilevel analysis. PLoS One 2014; 9:e106528. [PMID: 25211356 PMCID: PMC4161331 DOI: 10.1371/journal.pone.0106528] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 08/05/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Children unreached by vaccination are at higher risk of poor health outcomes and India accounts for nearly a quarter of unvaccinated children worldwide. The objective of this study was to investigate compositional and contextual determinants of non-receipt of childhood vaccines in India using multilevel modelling. METHODS AND FINDINGS We studied characteristics of unvaccinated children using the District Level Health and Facility Survey 3, a nationally representative probability sample containing 65 617 children aged 12-23 months from 34 Indian states and territories. We developed four-level Bayesian binomial regression models to examine the determinants of non-vaccination. The analysis considered two outcomes: completely unvaccinated (CUV) children who had not received any of the eight vaccine doses recommended by India's Universal Immunization Programme, and children who had not received any dose from routine immunisation services (no RI). The no RI category includes CUV children and those who received only polio doses administered via mass campaigns. Overall, 4.83% (95% CI: 4.62-5.06) of children were CUV while 12.01% (11.68-12.35) had received no RI. Individual compositional factors strongly associated with CUV were: non-receipt of tetanus immunisation for mothers during pregnancy (OR = 3.65 [95% CrI: 3.30-4.02]), poorest household wealth index (OR = 2.44 [1.81-3.22] no maternal schooling (OR = 2.43 [1.41-4.05]) and no paternal schooling (OR = 1.83 [1.30-2.48]). In rural settings, the influence of maternal illiteracy disappeared whereas the role of household wealth index was reinforced. Factors associated with no RI were similar to those for CUV, but effect sizes for individual compositional factors were generally larger. Low maternal education was the strongest risk factor associated with no RI in all models. All multilevel models found significant variability at community, district, and state levels net of compositional factors. CONCLUSION Non-vaccination in India is strongly related to compositional characteristics and is geographically distinct. Tailored strategies are required to overcome current barriers to immunisation.
Collapse
Affiliation(s)
- Daouda Sissoko
- Department of Social and Preventive Medicine, Faculty of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
- International Health Unit (USI), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- * E-mail:
| | - Helen Trottier
- Department of Social and Preventive Medicine, Faculty of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - Denis Malvy
- Département des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- INSERM 897 & Centre René-Labusquière, Université de Bordeaux, Bordeaux, France
| | - Mira Johri
- International Health Unit (USI), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Quebec, Canada
- Department of Health Administration, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
| |
Collapse
|
45
|
Alternative inactivated poliovirus vaccines adjuvanted with Quillaja brasiliensis or Quil-a saponins are equally effective in inducing specific immune responses. PLoS One 2014; 9:e105374. [PMID: 25148077 PMCID: PMC4141792 DOI: 10.1371/journal.pone.0105374] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/19/2014] [Indexed: 12/04/2022] Open
Abstract
Inactivated polio vaccines (IPV) have an important role at the final stages of poliomyelitis eradication programs, reducing the risks associated with the use of attenuated polio vaccine (OPV). An affordable option to enhance vaccine immunogenicity and reduce costs of IPV may be the use of an effective and renewable adjuvant. In the present study, the adjuvant activity of aqueous extract (AE) and saponin fraction QB-90 from Quillaja brasiliensis using poliovirus antigen as model were analyzed and compared to a preparation adjuvanted with Quil-A, a well-known saponin-based commercial adjuvant. Experimental vaccines were prepared with viral antigen plus saline (control), Quil-A (50 µg), AE (400 µg) or QB-90 (50 µg). Sera from inoculated mice were collected at days 0, 28, 42 and 56 post-inoculation of the first dose of vaccine. Serum levels of specific IgG, IgG1 and IgG2a were significantly enhanced by AE, QB-90 and Quil-A compared to control group on day 56. The magnitude of enhancement was statistically equivalent for QB-90 and Quil-A. The cellular response was evaluated through DTH and analysis of IFN-γ and IL-2 mRNA levels using in vitro reestimulated splenocytes. Results indicated that AE and QB-90 were capable of stimulating the generation of Th1 cells against the administered antigen to the same extent as Quil-A. Mucosal immune response was enhanced by the vaccine adjuvanted with QB-90 as demonstrated by increases of specific IgA titers in bile, feces and vaginal washings, yielding comparable or higher titers than Quil-A. The results obtained indicate that saponins from Q. brasiliensis are potent adjuvants of specific cellular and humoral immune responses and represent a viable option to Quil-A.
Collapse
|
46
|
Upfill-Brown AM, Lyons HM, Pate MA, Shuaib F, Baig S, Hu H, Eckhoff PA, Chabot-Couture G. Predictive spatial risk model of poliovirus to aid prioritization and hasten eradication in Nigeria. BMC Med 2014; 12:92. [PMID: 24894345 PMCID: PMC4066838 DOI: 10.1186/1741-7015-12-92] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 05/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One of the challenges facing the Global Polio Eradication Initiative is efficiently directing limited resources, such as specially trained personnel, community outreach activities, and satellite vaccinator tracking, to the most at-risk areas to maximize the impact of interventions. A validated predictive model of wild poliovirus circulation would greatly inform prioritization efforts by accurately forecasting areas at greatest risk, thus enabling the greatest effect of program interventions. METHODS Using Nigerian acute flaccid paralysis surveillance data from 2004-2013, we developed a spatial hierarchical Poisson hurdle model fitted within a Bayesian framework to study historical polio caseload patterns and forecast future circulation of type 1 and 3 wild poliovirus within districts in Nigeria. A Bayesian temporal smoothing model was applied to address data sparsity underlying estimates of covariates at the district level. RESULTS We find that calculated vaccine-derived population immunity is significantly negatively associated with the probability and number of wild poliovirus case(s) within a district. Recent case information is significantly positively associated with probability of a case, but not the number of cases. We used lagged indicators and coefficients from the fitted models to forecast reported cases in the subsequent six-month periods. Over the past three years, the average predictive ability is 86 ± 2% and 85 ± 4% for wild poliovirus type 1 and 3, respectively. Interestingly, the predictive accuracy of historical transmission patterns alone is equivalent (86 ± 2% and 84 ± 4% for type 1 and 3, respectively). We calculate uncertainty in risk ranking to inform assessments of changes in rank between time periods. CONCLUSIONS The model developed in this study successfully predicts districts at risk for future wild poliovirus cases in Nigeria. The highest predicted district risk was 12.8 WPV1 cases in 2006, while the lowest district risk was 0.001 WPV1 cases in 2013. Model results have been used to direct the allocation of many different interventions, including political and religious advocacy visits. This modeling approach could be applied to other vaccine preventable diseases for use in other control and elimination programs.
Collapse
|
47
|
Tao Z, Zhang Y, Liu Y, Xu A, Lin X, Yoshida H, Xiong P, Zhu S, Wang S, Yan D, Song L, Wang H, Cui N, Xu W. Isolation and characterization of a type 2 vaccine-derived poliovirus from environmental surveillance in China, 2012. PLoS One 2013; 8:e83975. [PMID: 24386319 PMCID: PMC3873410 DOI: 10.1371/journal.pone.0083975] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 11/18/2013] [Indexed: 01/24/2023] Open
Abstract
Environmental surveillance of poliovirus on sewage has been conducted in Shandong Province, China since 2008. A type 2 vaccine-derived poliovirus (VDPV) with 7 mutations in VP1 coding region was isolated from the sewage collected in the city of Jinan in December 2012. The complete genome sequencing analysis of this isolate revealed 25 nucleotide substitutions, 7 of which resulted in amino acid alteration. No evidence of recombination with other poliovirus serotypes was observed. The virus did not lose temperature sensitive phenotype at 40°C. An estimation based on the evolution rate of the P1 coding region suggested that evolution time of this strain might be 160–176 days. VP1 sequence analysis revealed that this VDPV strain is of no close relationship with other local type 2 polioviruses (n = 66) from sewage collected between May 2012 and June 2013, suggesting the lack of its circulation in the local population. The person who excreted the virus was not known and no closely related virus was isolated in local population via acute flaccid paralysis surveillance. By far this is the first report of VDPV isolated from sewage in China, and these results underscore the value of environmental surveillance in the polio surveillance system even in countries with high rates of OPV coverage.
Collapse
Affiliation(s)
- Zexin Tao
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory and State Key Laboratory for Molecular Virology and Genetic Engineering, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Yao Liu
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China
| | - Aiqiang Xu
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China
- School of Public Health, Shandong University, Jinan, People's Republic of China
- * E-mail: (AX); (WX)
| | - Xiaojuan Lin
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China
| | - Hiromu Yoshida
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ping Xiong
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory and State Key Laboratory for Molecular Virology and Genetic Engineering, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Suting Wang
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, People's Republic of China
| | - Dongmei Yan
- WHO WPRO Regional Polio Reference Laboratory and State Key Laboratory for Molecular Virology and Genetic Engineering, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Lizhi Song
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
| | - Haiyan Wang
- Academy of Preventive Medicine, Shandong University, Jinan, People's Republic of China
| | - Ning Cui
- Department of Preventive Medicine, College of Basic Medical Sciences, Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory and State Key Laboratory for Molecular Virology and Genetic Engineering, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
- * E-mail: (AX); (WX)
| |
Collapse
|
48
|
Troy SB, Ferreyra-Reyes L, Huang C, Sarnquist C, Canizales-Quintero S, Nelson C, Báez-Saldaña R, Holubar M, Ferreira-Guerrero E, García-García L, Maldonado YA. Community circulation patterns of oral polio vaccine serotypes 1, 2, and 3 after Mexican national immunization weeks. J Infect Dis 2013; 209:1693-9. [PMID: 24367038 DOI: 10.1093/infdis/jit831] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND With wild poliovirus nearing eradication, preventing circulating vaccine-derived poliovirus (cVDPV) by understanding oral polio vaccine (OPV) community circulation is increasingly important. Mexico, where OPV is given only during biannual national immunization weeks (NIWs) but where children receive inactivated polio vaccine (IPV) as part of their primary regimen, provides a natural setting to study OPV community circulation. METHODS In total, 216 children and household contacts in Veracruz, Mexico, were enrolled, and monthly stool samples and questionnaires collected for 1 year; 2501 stool samples underwent RNA extraction, reverse transcription, and real-time polymerase chain reaction (PCR) to detect OPV serotypes 1, 2, and 3. RESULTS OPV was detected up to 7 months after an NIW, but not at 8 months. In total, 35% of samples collected from children vaccinated the prior month, but only 4% of other samples, contained OPV. Although each serotype was detected in similar proportions among OPV strains shed as a result of direct vaccination, 87% of OPV acquired through community spread was serotype 2 (P < .0001). CONCLUSIONS Serotype 2 circulates longer and is transmitted more readily than serotypes 1 or 3 after NIWs in a Mexican community primarily vaccinated with IPV. This may be part of the reason why most isolated cVDPV has been serotype 2.
Collapse
|
49
|
Saint-Victor DS, Omer SB. Vaccine refusal and the endgame: walking the last mile first. Philos Trans R Soc Lond B Biol Sci 2013; 368:20120148. [PMID: 23798696 PMCID: PMC3720046 DOI: 10.1098/rstb.2012.0148] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
As multiple papers within this special issue illustrate, the dynamics of disease eradication are different from disease control. When it comes to disease eradication, 'the last mile is longest'. For social and ecological reasons such as vaccine refusal, further ending incidence of a disease when it has reached low levels is frequently complex. Issues of non-compliance within a target population often influence the outcome of disease eradication efforts. Past eradication efforts confronted such obstacles towards the tail end of the campaign, when disease incidence was lowest. This article provides a comparison of non-compliance within polio, measles and smallpox campaigns, demonstrating the tendency of vaccine refusal to rise as disease incidence falls. In order to overcome one of the most intractable challenges to eradication, future disease eradication efforts must prioritize vaccine refusal from the start, i.e. 'walk the last mile first'.
Collapse
Affiliation(s)
| | - Saad B. Omer
- Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Room 7017, Atlanta, GA 30322, USA
| |
Collapse
|
50
|
Henderson DA, Klepac P. Lessons from the eradication of smallpox: an interview with D. A. Henderson. Philos Trans R Soc Lond B Biol Sci 2013; 368:20130113. [PMID: 23798700 PMCID: PMC3720050 DOI: 10.1098/rstb.2013.0113] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
It has been more than 35 years since the last naturally occurring case of smallpox. Sufficient time has passed to allow an objective overview of what were the key factors in the success of the eradication effort and what lessons smallpox can offer to other campaigns. Professor D. A. Henderson headed the international effort to eradicate smallpox. Here, we present a summary of D. A. Henderson's perspectives on the eradication of smallpox. This text is based upon the Unither Baruch Blumberg Lecture, delivered by D. A. Henderson at the University of Oxford in November 2012 and upon conversations and correspondence with Professor Henderson.
Collapse
Affiliation(s)
- D A Henderson
- Center for Health Security, University of Pittsburgh Medical Center, Baltimore, MD 21202, USA.
| | | |
Collapse
|