Emergence of genetically linked vaccine-originated poliovirus type 2 in the absence of oral polio vaccine, Jerusalem, April to July 2022

Zuckerman, Neta S.; Bar-Or, Itay; Sofer, Danit; Bucris, Efrat; Morad, Hagar; Shulman, Lester M.; Levi, Nofar; Weiss, Leah; Aguvaev, Irina; Kestin, Klil; Vasserman, Rinat; Elul, Michal; Fratty, Ilana S.; Geva, Miranda; Wax, Marina; Erster, Oran; Yishai, Ruth; Hecht-Sagie, Lior; Alroy‐Preis, Sharon; Mendelson, Ella; Weil, Merav

doi:10.2807/1560-7917.es.2022.27.37.2200694

Cited by 26 publications

(14 citation statements)

References 11 publications

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“…In the model, if any OPV2‐related virus reaches high transmission settings, like some areas of India and Bangladesh, very high type 2 case counts would likely follow. Recent importations and transmission of cVDPV2s in high‐income countries, including Israel (Zuckerman et al., 2022), the United Kingdom (United Kingdom Department of Health & Social Care, 2022), and the United States (Link‐Gelles et al., 2022; Ryerson et al., 2022), confirm that cVDPV transmission can occur even in countries with high overall reported IPV immunization coverage in communities with low coverage (Thompson et al., 2012), with paralytic cases possible in these communities. Countries with relatively lower immunization coverage should expect to fair worse with respect to potential case counts, and they should recognize the need for large and high‐quality outbreak responses if they want to keep case counts lower.…”

Section: Discussionmentioning

confidence: 99%

Worst‐case scenarios: Modeling uncontrolled type 2 polio transmission

Kalkowska¹,

Wiesen

Wassilak

et al. 2023

Risk Analysis

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In May 2016, the Global Polio Eradication Initiative (GPEI) coordinated the cessation of all use of type 2 oral poliovirus vaccine (OPV2), except for emergency outbreak response. Since then, paralytic polio cases caused by type 2 vaccine‐derived polioviruses now exceed 3,000 cases reported by 39 countries. In 2022 (as of April 25, 2023), 20 countries reported detection of cases and nine other countries reported environmental surveillance detection, but no reported cases. Recent development of a genetically modified novel type 2 OPV (nOPV2) may help curb the generation of neurovirulent vaccine‐derived strains; its use since 2021 under Emergency Use Listing is limited to outbreak response activities. Prior modeling studies showed that the expected trajectory for global type 2 viruses does not appear headed toward eradication, even with the best possible properties of nOPV2 assuming current outbreak response performance. Continued persistence of type 2 poliovirus transmission exposes the world to the risks of potentially high‐consequence events such as the importation of virus into high‐transmission areas of India or Bangladesh. Building on prior polio endgame modeling and assuming current national and GPEI outbreak response performance, we show no probability of successfully eradicating type 2 polioviruses in the near term regardless of vaccine choice. We also demonstrate the possible worst‐case scenarios could result in rapid expansion of paralytic cases and preclude the goal of permanently ending all cases of poliomyelitis in the foreseeable future. Avoiding such catastrophic scenarios will depend on the development of strategies that raise population immunity to type 2 polioviruses.

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Section: Discussionmentioning

confidence: 99%

Worst‐case scenarios: Modeling uncontrolled type 2 polio transmission

Kalkowska¹,

Wiesen

Wassilak

et al. 2023

Risk Analysis

View full text Add to dashboard Cite

show abstract

“…Even in countries with very high IPV‐only coverage, imported live polioviruses may sustain some transmission in populations and potentially cause paralytic cases in undervaccinated subpopulations (Duintjer Tebbens et al., 2005; Kalkowska, Duintjer Tebbens, Grotto, et al., 2015; Thompson et al., 2012, 2015). Recent detections of polio transmission in the United Kingdom (United Kingdom Department of Health & Social Care, 2022; Israel Zuckerman et al., 2022), and the United States (Link‐Gelles et al., 2022; Ryerson et al., 2022) in un‐ or underimmunized populations provide proof of concept. Thus, in the event that OPV use continues, countries will need to consider their national immunization policies and decide which vaccines and how many doses to deliver as part of RI.…”

Section: Opv Cessation Immunization Options and Prerequisitesmentioning

confidence: 99%

Coordinated global cessation of oral poliovirus vaccine use: Options and potential consequences

Kalkowska¹,

Wassilak

Wiesen

et al. 2023

Risk Analysis

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Due to the very low, but nonzero, paralysis risks associated with the use of oral poliovirus vaccine (OPV), eradicating poliomyelitis requires ending all OPV use globally. The Global Polio Eradication Initiative (GPEI) coordinated cessation of Sabin type 2 OPV (OPV2 cessation) in 2016, except for emergency outbreak response. However, as of early 2023, plans for cessation of bivalent OPV (bOPV, containing types 1 and 3 OPV) remain undefined, and OPV2 use for outbreak response continues due to ongoing transmission of type 2 polioviruses and reported type 2 cases. Recent development and use of a genetically stabilized novel type 2 OPV (nOPV2) leads to additional potential vaccine options and increasing complexity in strategies for the polio endgame. Prior applications of integrated global risk, economic, and poliovirus transmission modeling consistent with GPEI strategic plans that preceded OPV2 cessation explored OPV cessation dynamics and the evaluation of options to support globally coordinated risk management efforts. The 2022–2026 GPEI strategic plan highlighted the need for early bOPV cessation planning. We review the published modeling and explore bOPV cessation immunization options as of 2022, assuming that the GPEI partners will not support restart of the use of any OPV type in routine immunization after a globally coordinated cessation of such use. We model the potential consequences of globally coordinating bOPV cessation in 2027, as anticipated in the 2022–2026 GPEI strategic plan. We do not find any options for bOPV cessation likely to succeed without a strategy of bOPV intensification to increase population immunity prior to cessation.

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“…Wastewater samples from 48 sewersheds in Rockland and surrounding counties were then tested for poliovirus from 9 March to 11 October 2022, with 8.3% of the 1,076 samples (from 10 sewersheds) having detectable concentrations of the virus (Ryerson, 2022). Routine wastewater surveillance (April to July 2022) in Jerusalem, Israel detected and identified an increase of vaccine-originated poliovirus type 2 even in the absence of oral polio vaccine (Zuckerman et al, 2022).…”

Section: Enteric Virusesmentioning

confidence: 99%

Not a waste: Wastewater surveillance to enhance public health

et al. 2023

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Domestic wastewater, when collected and evaluated appropriately, can provide valuable health-related information for a community. As a relatively unbiased and non-invasive approach, wastewater surveillance may complement current practices towards mitigating risks and protecting population health. Spurred by the COVID-19 pandemic, wastewater programs are now widely implemented to monitor viral infection trends in sewersheds and inform public health decision-making. This review summarizes recent developments in wastewater-based epidemiology for detecting and monitoring communicable infectious diseases, dissemination of antimicrobial resistance, and illicit drug consumption. Wastewater surveillance, a quickly advancing Frontier in environmental science, is becoming a new tool to enhance public health, improve disease prevention, and respond to future epidemics and pandemics.

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Emergence of genetically linked vaccine-originated poliovirus type 2 in the absence of oral polio vaccine, Jerusalem, April to July 2022

Cited by 26 publications

References 11 publications

Worst‐case scenarios: Modeling uncontrolled type 2 polio transmission

Worst‐case scenarios: Modeling uncontrolled type 2 polio transmission

Coordinated global cessation of oral poliovirus vaccine use: Options and potential consequences

Not a waste: Wastewater surveillance to enhance public health

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