Concurrent outbreaks of circulating vaccine-derived poliovirus types 1 and 2 affecting the Republic of the Philippines and Malaysia, 2019–2021

Snider, Cynthia J.; Boualam, Liliane; Tallis, Graham; Takashima, Yusuke; Abeyasinghe, Rabindra; Lo, Ying-Ru; Grabovac, Varja; Avagyan, Tigran; Aslam, Syeda Kanwal; Eltayeb, Abu Obeida; Aung, Khin Devi; Wang, Xiaojun; Shrestha, Achyut; Ante-Orozco, Carla; Silva, Maria Wilda T; Lapastora-Sucaldito, Nemia; Apostol, L.N.; Jikal, Muhammad Bin Hj; Miraj, Waheed; Lodhi, Faisal; Kim, Hyung Joon; Rusli, Norhayati; Thorley, Bruce R; Kaye, Matthew; Nishimura, Yorihiro; Arita, Minetaro; Sani, Jamiatul Aida Md; Rundi, Christina; Feldon, Keith

doi:10.1016/j.vaccine.2022.02.022

Cited by 17 publications

(12 citation statements)

References 14 publications

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“…In the case of case-patient 1, the community had cross border interactions with residents of Togo while case-patient 2 had family members and other community members travelling to and from Nigeria. Possibility of introducing the infection into the community from these countries could therefore not be ruled out as concurrent cVDPV outbreaks have been reported in countries with continuous population subgroup movement between them [33].…”

Section: Discussionmentioning

confidence: 99%

Response to back-to-back outbreaks of circulating vaccine-derived poliovirus type 2 in two nomadic pastoralist settlements in Oti Region, Ghana-2019

et al. 2023

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Background The global switch from trivalent oral poliovirus vaccine (OPV) to bivalent OPV in April 2016 without corresponding co-administration of inactivated poliovirus vaccine (IPV) until June 2018, created a cohort of poliovirus type 2 naïve children with risk of developing vaccine-derived poliovirus type 2 (VDPV2). In November and December 2019, two cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were confirmed in quick succession through Acute Flaccid Paralysis (AFP) surveillance in two nomadic pastoralist settlements in Oti Region. We investigated to determine the outbreak extent, identify risk factors and implement control and preventive measures. Methods We interviewed case-patients’ families, abstracted immunization records, assessed AFP surveillance and conducted rapid OPV and IPV vaccination coverage surveys. Using AFP case definition of any child less than 15 years in the community with sudden onset of paralysis from July to November 2019 (in case-patient 1’s district) and August to December 2019 (in case-patient 2’s district), we conducted active case search. Stool samples from apparently healthy children and close contacts of the case-patients were collected and tested for poliovirus. We conducted environmental assessment of the community to identify potential risk factors. Results Case-patient 1 was an eight-year-old female who had taken two doses of OPV while case-patient 2 was an eight-month-old male who had taken three out of required four OPV doses in addition to IPV at seven months. Families of both case-patients had either travelled to or received visitors from areas with confirmed cVDPV2. Of all children surveyed, eight (29.6%) of 27 and three (18.8%) of 16 eligible children in communities of case-patient 1 and 2 respectively had received required four doses of OPV. No AFP case was found in both communities and surrounding settlements. Both communities had no source of potable water and toilet facilities. A stool sample from a contact of case-patient 1 tested positive for cVDPV2. Conclusion Outbreaks of cVDPV2 occurred in insanitary, under-vaccinated nomadic pastoralist settlements in Oti Region. Three rounds of monovalent OPV vaccination campaigns for children under 5 years of age in the districts and region as well as countrywide IPV vaccination campaign for poliovirus type 2 naïve cohort were conducted.

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Section: Discussionmentioning

confidence: 99%

Response to back-to-back outbreaks of circulating vaccine-derived poliovirus type 2 in two nomadic pastoralist settlements in Oti Region, Ghana-2019

et al. 2023

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“…In addition, after 2016, some tropical countries introduced all-IPV schedules in RI, the most important being Malaysia which reported high coverage with a three-dose IPV schedule (>98% nationwide). Sabah Province, Malaysia, a relatively low IPV coverage province and close to Mindanao, Philippines, experienced cVDPV1 and cVDPV2 outbreaks in 2019 and early 2020 with cVDPV1 and cVDPV2 introduced from the Philippines [ 29 ]. The outbreaks were controlled rapidly with two rounds of monovalent type 2 OPV (mOPV2) and two rounds of bOPV.…”

Section: Increasing the Scientific Knowledge Base Of Ipvmentioning

confidence: 99%

Inactivated Poliovirus Vaccine: Recent Developments and the Tortuous Path to Global Acceptance

Sutter,

Eisenhawer,

Molodecky

et al. 2024

Pathogens

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Inactivated poliovirus vaccine (IPV), available since 1955, became the first vaccine to be used to protect against poliomyelitis. While the immunogenicity of IPV to prevent paralytic poliomyelitis continues to be irrefutable, its requirement for strong containment (due to large quantities of live virus used in the manufacturing process), perceived lack of ability to induce intestinal mucosal immunity, high cost and increased complexity to administer compared to oral polio vaccine (OPV), have limited its use in the global efforts to eradicate poliomyelitis. In order to harvest the full potential of IPV, a program of work has been carried out by the Global Polio Eradication Initiative (GPEI) over the past two decades that has focused on: (1) increasing the scientific knowledge base of IPV; (2) translating new insights and evidence into programmatic action; (3) expanding the IPV manufacturing infrastructure for global demand; and (4) continuing to pursue an ambitious research program to develop more immunogenic and safer-to-produce vaccines. While the knowledge base of IPV continues to expand, further research and product development are necessary to ensure that the program priorities are met (e.g., non-infectious production through virus-like particles, non-transmissible vaccine inducing humoral and intestinal mucosal immunity and new methods for house-to-house administration through micro-needle patches and jet injectors), the discussions have largely moved from whether to how to use this vaccine most effectively. In this review, we summarize recent developments on expanding the science base of IPV and provide insight into policy development and the expansion of IPV manufacturing and production, and finally we provide an update on the current priorities.

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“…The outbreaks were subsequently declared over in June (Philippines) and September (Malaysia) 2021, with the last cases of cVDPV detected in sewage samples collected in January (Philippines) and March (Malaysia) 2020. [12][13][14][15]…”

Section: Polio Regional Reference Laboratory Activitiesmentioning

confidence: 99%

“…12 Within the Western Pacific Region, cVDPV type 1 (cVDPV1) and cVDPV2 outbreaks were first detected in the Philippines in July 2019 and June 2019 respectively, with genetically-linked cases subsequently detected in both Malaysia and the Philippines; these outbreaks were declared over in June 2021 (Philippines) and September 2021 (Malaysia). [13][14][15] Nevertheless, the WHO continues to list both countries as vulnerable to the emergence of further VDPV outbreaks. Recurrent cVDPV outbreaks highlight both the ongoing risks of transmission posed by wild poliovirus and cVDPV, and the crucial need to maintain high levels of polio vaccine coverage and sensitive polio surveillance systems until the global eradication of poliovirus has been certified.…”

Section: Introductionmentioning

confidence: 99%

Australian National Enterovirus Reference Laboratory annual report, 2021

Kaye¹,

Garcia-Clapes²,

Hobday³

et al. 2022

Commun Dis Intell (2018)

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Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System, and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2021, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.31 non-polio AFP cases per 100,000 children, thereby meeting the WHO’s performance criterion for a sensitive surveillance system. The non-polio enteroviruses coxsackievirus A4, coxsackievirus A10, coxsackievirus A13 and enterovirus A71 were identified from clinical specimens collected from AFP cases. Australia also performs enterovirus and environmental surveillance to complement the clinical system focussed on children. In 2021, there were five cases of wild poliovirus reported from the two remaining endemic countries: Afghanistan and Pakistan. Including Afghanistan and Pakistan, 22 countries also reported cases of AFP due to circulating vaccine-derived poliovirus.

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Concurrent outbreaks of circulating vaccine-derived poliovirus types 1 and 2 affecting the Republic of the Philippines and Malaysia, 2019–2021

Cited by 17 publications

References 14 publications

Response to back-to-back outbreaks of circulating vaccine-derived poliovirus type 2 in two nomadic pastoralist settlements in Oti Region, Ghana-2019

Response to back-to-back outbreaks of circulating vaccine-derived poliovirus type 2 in two nomadic pastoralist settlements in Oti Region, Ghana-2019

Inactivated Poliovirus Vaccine: Recent Developments and the Tortuous Path to Global Acceptance

Australian National Enterovirus Reference Laboratory annual report, 2021

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