Poliovirus Excretion Among Persons With Primary Immune Deficiency Disorders: Summary of a Seven-Country Study Series

Li, Li; Ivanova, Olga E.; Driss, Nadia; Tiongco-Recto, Marysia; Silva, Rajiva da; Shahmahmoodi, Shohreh; Sazzad, Hossain M.S.; Mach, Ondrej; Kahn, Anna-Léa; Sutter, Roland W.

doi:10.1093/infdis/jiu065

Cited by 56 publications

(53 citation statements)

References 25 publications

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“…Similar results were reported from Ghana, where 75% of samples (21 of 28) were of type 1 [30]. However, a study in Bangladesh, China, the Islamic Republic of Iran, the Philippines, the Russian Federation, Sri Lanka, and Tunisia showed a predominance of types 2 and 3 vaccine poliovirus [31]. …”

Section: Discussionsupporting

confidence: 77%

Epidemiological Surveillance of Poliomyelitis During the Military and Political Conflict in the Central African Republic, 2013 and 2014

Farra

Gonofio

Manirakiza

et al. 2017

Open Forum Infectious Diseases

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Background.Since December 2012, the Central African Republic (CAR) has been undergoing a severe military and political conflict. This situation has resulted in general insecurity and total disorganization of surveillance activities, including those for acute flaccid paralysis (AFP). In this study, we used laboratory data to evaluate surveillance of AFP in 2013 and 2014, the most critical period of the conflict.Methods.The laboratory data on AFP were analyzed retrospectively for the age, sex, vaccination status (oral poliovirus vaccines), and geographical origin of the samples. The χ2 test was used, with P < .05 as the threshold for significance.Results.Decreased activity of AFP surveillance of 57% was registered in 2013 and 36% in 2014 compared with previous years. Only 37.3% and 49.7% of children with AFP were vaccinated in 2013 and 2014, respectively, but no wild poliovirus or vaccine-derived poliovirus (VDPV) was isolated. Laboratory performance concerning the timeliness of cell culture and intratypic differentiation/VDPV results was only 65.5% and 66.7% of the target in 2013 but reached 95.5% and 100% in 2014.Conclusions.All personnel involved in the monitoring of AFP must be mobilized to improve vaccination coverage and surveillance activities in the CAR.

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Section: Discussionsupporting

confidence: 77%

Epidemiological Surveillance of Poliomyelitis During the Military and Political Conflict in the Central African Republic, 2013 and 2014

Farra

Gonofio

Manirakiza

et al. 2017

Open Forum Infectious Diseases

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“…Further data collection of PID patients in developing countries and further screening for iVDPVs could reduce the uncertainty about: (i) PID survival rates, (ii) the probability that a PID develops a long-term infection, and (iii) the average duration of long-term iVDPV infections. The detection of a relatively high number of long-term iVDPV excretors from countries with high rates of consanguinity [4, 30, 40] may indicate that these countries experience a higher incidence of genetic predisposition to PIDs per birth, a higher risk of long-term iVDPV infections given OPV exposure for PIDs associated with consanguinity than other PIDs, higher OPV exposure rates, better PID survival, or some combination of these factors. Teasing out the possible explanations will require additional studies.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive screening for immunodeficiency-associated vaccine-derived poliovirus: an essential oral poliovirus vaccine cessation risk management strategy

Tebbens¹,

Thompson²

2016

Epidemiol. Infect.

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SUMMARYIf the world can successfully control all outbreaks of circulating vaccine-derived poliovirus that may occur soon after global oral poliovirus vaccine (OPV) cessation, then immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) from rare and mostly asymptomatic long-term excretors (defined as ⩾6 months of excretion) will become the main source of potential poliovirus outbreaks for as long as iVDPV excretion continues. Using existing models of global iVDPV prevalence and global long-term poliovirus risk management, we explore the implications of uncertainties related to iVDPV risks, including the ability to identify asymptomatic iVDPV excretors to treat with polio antiviral drugs (PAVDs) and the transmissibility of iVDPVs. The expected benefits of expanded screening to identify and treat long-term iVDPV excretors with PAVDs range from US$0.7 to 1.5 billion with the identification of 25–90% of asymptomatic long-term iVDPV excretors, respectively. However, these estimates depend strongly on assumptions about the transmissibility of iVDPVs and model inputs affecting the global iVDPV prevalence. For example, the expected benefits may decrease to as low as US$260 million with the identification of 90% of asymptomatic iVDPV excretors if iVDPVs behave and transmit like partially reverted viruses instead of fully reverted viruses. Comprehensive screening for iVDPVs will reduce uncertainties and maximize the expected benefits of PAVD use.

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“…In patients with primary immune disorders (PID), especially those with B-cell system disorders, chronic excretion of polio virus rises and the risk of paralytic poliomyelitis increases (16). The first presentations of VAPP may be neurologic abnormalities in some patients with primary immunodeficiency (17).…”

Section: Vaccine-associated Poliovirus Paralysis (Vapp)mentioning

confidence: 99%

Eradication of Polio in the World; Iran is at Risk for Reemerging of Polio: A Review of the Literature

Razavi

Mardani

Salamati

2016

Arch Clin Infect Dis

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Context: The wild polio virus is disrupted in all countries in the world, except Afghanistan and Pakistan, the two neighboring countries of Iran. Because of illegal migrations and some geographical, socioeconomic and managerial problems, Iran is exposed to reemerging of the disease. The current study aimed to assess the condition of the disease in Iran and propose preventive measures. Evidence Acquisition: Authors extracted and evaluated 33 relevant articles among 189 polio related abstracts. The key words were: polio, poliomyelitis, polio eradication, oral polio vaccine (OPV), inactivated polio vaccine (IPV), acute flaccid paralysis (AFP), vaccination derived paralysis (VDP) and Iran. PubMed was used as an international site and IranMedex as a national motor search to assess the subject. Results: Since 2001, Iran is recognized as a polio free country by world health organization (WHO). Afghanistan and Pakistan, the two neighboring countries of Iran, are still infected with wild poliovirus. About 2.5 million Afghan refugees live in Iran and they communicate with their compatriots. Iran and its neighbors are different regarding vaccination coverage rates, rate of access to safe drinking water, political, security and cultural issues, health system and managerial indicators. Conclusions: Health managers in Iran should continuously monitor the coverage of vaccination with at least three doses of OPV in the level of over 95%, monitor the health of the Helmand River water which comes from Afghanistan to Iran, vaccinate the immigrants and replace bivalent vaccine (bOPV) with trivalent (tOPV) vaccine.

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Poliovirus Excretion Among Persons With Primary Immune Deficiency Disorders: Summary of a Seven-Country Study Series

Abstract: Chronic polioviruses excretion remains a rare event even among individuals with PID. Nevertheless, because these individuals were not paralyzed they would have been missed by current surveillance; therefore, surveillance for polioviruses among PID should be established.

Cited by 56 publications

References 25 publications

Epidemiological Surveillance of Poliomyelitis During the Military and Political Conflict in the Central African Republic, 2013 and 2014

Epidemiological Surveillance of Poliomyelitis During the Military and Political Conflict in the Central African Republic, 2013 and 2014

Comprehensive screening for immunodeficiency-associated vaccine-derived poliovirus: an essential oral poliovirus vaccine cessation risk management strategy

Eradication of Polio in the World; Iran is at Risk for Reemerging of Polio: A Review of the Literature

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