Polio and Its Epidemiology

Abstract

AFP Acute flaccid paralysis. AFP surveillance Characterization of enteroviruses in stool samples from all AFP cases especially in individuals under 15 years of age to rule in or rule out etiology by polioviruses. AFR or AFRO The African Health Region of the WHO. AGG A PID with agammaglobulinemia. AMR or AMRO The American Health Region of the WHO. aVDPV A vaccine-derived poliovirus isolate whose evolutionary path is unknown or ambiguous. bOPV Bivalent oral polio vaccine (containing serotypes 1 and 3). BSL Biosafety standard level. CAG Containment Advisory Group. C-antigens Refers to the epitopes after poliovirus interacts with CD155 host cell receptor and transitions into a 135S particle. Capsid The protein shell that surrounds a virus particle. Capsomere One of the individual morphological units that makes up the viral capsid. It contains a single copy of viral capsid proteins VP1, VP| 2, VP3, and VP4. CAV Coxsackie A virus. CCID 50 The cell culture infectious dose of a virus that will cause cell death in 50% of replicate cell cultures. CDC US Centers for Disease Control and Prevention. CD155 or PVr The human encoded cell receptor for poliovirus, a member of the immunoglobulin superfamily. cDNA Complimentary DNA (DNA synthesized from RNA by a reverse transcriptase enzyme). CNS Central nervous system. Codon A sequence of three adjacent nucleotides on a strand of DNA or RNA that specifies which specific amino acid will be incorporated into a protein. Codon bias Unequal usage of synonymous codons (different codons that specify the same amino acid). CPE Cytopathic effect. CRE Cis-acting replication element. CVID Common variable immune deficiencya type of primary immune deficiency cVDPV A circulating vaccine-derived poliovirus, that is, a poliovirus that has evolved from vaccine during person-to-person transmission. D-antigens Refers to epitopes on native 150S virions. Lester M. Shulman has retired.

Epidemiology of Type 3 Poliovirus AFP Cases in Israel between 1973 and 1988: Whole Genome Sequencing of RNA Extracted Directly from Archived Stocks to Avoid Re-Culturing Neurovirulent Wild Poliovirus

“…Between 1957 and 1987, various preparations and schedules of OPV were used in Israel (exception: two of fourteen health districts exclusively used IPV between 1982 and 1987) [3,4]. A supplementary immunization of almost all individuals up to the age of 40 in 1988 with a dose of OPV in response to an outbreak of wild-type 1 poliovirus that had begun in 1987 prevented further infections and AFP caused by any of the three wild poliovirus serotypes [3][4][5].…”

Inferring Numbers of Wild Poliovirus Excretors Using Quantitative Environmental Surveillance

“…Two types of polio vaccines were available, vaccines based on inactivated polio virus (IPV) and vaccines based on attenuated oral polio virus strains (OPV). Both types of vaccines were available in trivalent form, e.g., tIPV and tOPV both contained representative polio vaccine strains for each of the three serotypes of poliovirus, although, in some countries, routine vaccination was based on use of one or more monovalent OPV vaccine strains [ 7 , 8 , 9 ]. The three main methods of polio surveillance that are used to date are AFP surveillance, enterovirus surveillance, and environmental surveillance (EnvS).…”

“…Poliovirus infections are considered to be absent when the incidence of investigated AFP cases is ≥1 per 100,000 children and stool samples from all of the AFP cases are poliovirus-negative. However, the ratio of symptomatic infections to asymptomatic infections decreases significantly when polioviruses circulate in highly vaccinated populations [ 9 , 12 , 13 , 14 ]. In such populations, syndrome-based surveillance becomes much less effective for early warning.…”

“…This was increased to 80% coverage in 2013 at the height of the circulation of wild type 1 poliovirus in that year [ 21 ]. Between 1989 and 2005, routine immunization in Israel employed three doses of IPV at 2, 4, and 12 months plus three doses of tOPV at 4, 6, and 12 months [ 9 , 18 ]. During the interval between 2005 and 2013, EnvS samples in Israel were free from polioviruses that could replicate in cells and cause cytopathic effects (CPE) or produce plaques, except for occasional isolations of highly diverged, vaccine derived polioviruses (VPDVs) from unidentified individuals [ 20 , 22 ] and vaccine-like poliovirus strains in EnvS samples from catchment populations that included Palestinian children vaccinated by the Palestinian Health Authority, which did not discontinue routine immunization with a combination of tIPV and tOPV.…”