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Chapter 28 : The Poliovirus Eradication Initiative

Authors: Konstantin Chumakov1, Olen Kew2
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Affiliations: 1: Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, MD 20852; 2: Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333
Content Type: Monograph
Publication Year: 2010

Category: Viruses and Viral Pathogenesis

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The Poliovirus Eradication Initiative, Page 1 of 2

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Abstract:

Poliomyelitis is a neurological disease characterized by paralysis of the extremities and occasionally other muscles, leading to transient or permanent impairment, and rarely, in the most severe bulbar cases, death. Interest in poliomyelitis and poliovirus increased dramatically at the beginning of the 20th century because a relatively rare sporadic illness changed to an epidemic disease with a clear trend to global spread. Due to the very low paralysis-to-infection ratio, some limited circulation of wild poliovirus (WPV) without overt clinical manifestations cannot be fully excluded as the explanation for orphan isolates. Since the early days of oral poliovirus vaccine (OPV), it has been known that the use of this vaccine can cause vaccine associated paralytic poliomyelitis (VAPP) among vaccine recipients and their immediate contacts. Another category of vaccine-derived poliovirus (VDPV), called immunodeficiency-associated VDPVs (iVDPVs), have been isolated from immunodeficient patients chronically infected with poliovirus. The most serious challenge, however, is to greatly strengthen routine immunization within the Expanded Program on Immunization (EPI), which is clearly inadequate in many low-income countries. The successful reintegration of polio eradication activities into the EPI, by also helping to reinvigorate the EPI, can be one of the enduring legacies of the Global Polio Eradication Initiative (GPEI) and serve as a model for other global infectious disease control and eradication initiatives.

Citation: Chumakov K, Kew O. 2010. The Poliovirus Eradication Initiative, p 449-459. In Ehrenfeld E, Domingo E, Roos R (ed), The Picornaviruses. ASM Press, Washington, DC. doi: 10.1128/9781555816698.ch28
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The Poliovirus Eradication Initiative
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Citation: Chumakov K, Kew O. 2010. The Poliovirus Eradication Initiative, p 449-459. In Ehrenfeld E, Domingo E, Roos R (ed), The Picornaviruses. ASM Press, Washington, DC. doi: 10.1128/9781555816698.ch28
/content/10.1128/9781555816698.ch28.ch28fig01
Figure 1.
Incidence of paralytic polio cases associated with WPV infections worldwide, 1985 to 2009. Estimated cases are shown as striped bars; reported and virologically confirmed cases are shown as solid bars. Case count as of 12 April 2010. Arrows below three-letter codes for WHO regions (AMR, Americas; EUR, Europe; WPR, Western Pacific) indicate the year of last detection of indigenous WPV. (Source: WHO [http://www.polioeradication.org/].)
10.1128/9781555816698/f0451-01_thmb.gif
10.1128/9781555816698/f0451-01.gif
Image of Figure 1.
Figure 1.

Incidence of paralytic polio cases associated with WPV infections worldwide, 1985 to 2009. Estimated cases are shown as striped bars; reported and virologically confirmed cases are shown as solid bars. Case count as of 12 April 2010. Arrows below three-letter codes for WHO regions (AMR, Americas; EUR, Europe; WPR, Western Pacific) indicate the year of last detection of indigenous WPV. (Source: WHO [http://www.polioeradication.org/].)

Citation: Chumakov K, Kew O. 2010. The Poliovirus Eradication Initiative, p 449-459. In Ehrenfeld E, Domingo E, Roos R (ed), The Picornaviruses. ASM Press, Washington, DC. doi: 10.1128/9781555816698.ch28
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/content/10.1128/9781555816698.ch28.ch28fig02
Figure 2.
Radial neighbor-joining trees of VP1 sequence relationships of representatives of WPV genotypes detected since the launch of polio eradication activities in the Americas in 1985. Genotypes believed to be extinct and surviving genotypes are shown by dashed and solid lines, respectively. Sequences representing the extinct genotypes usually are from the last known isolate of that genotype. (Source: WHO GPLN.)
10.1128/9781555816698/f0451-02_thmb.gif
10.1128/9781555816698/f0451-02.gif
Image of Figure 2.
Figure 2.

Radial neighbor-joining trees of VP1 sequence relationships of representatives of WPV genotypes detected since the launch of polio eradication activities in the Americas in 1985. Genotypes believed to be extinct and surviving genotypes are shown by dashed and solid lines, respectively. Sequences representing the extinct genotypes usually are from the last known isolate of that genotype. (Source: WHO GPLN.)

Citation: Chumakov K, Kew O. 2010. The Poliovirus Eradication Initiative, p 449-459. In Ehrenfeld E, Domingo E, Roos R (ed), The Picornaviruses. ASM Press, Washington, DC. doi: 10.1128/9781555816698.ch28
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/content/10.1128/9781555816698.ch28.ch28fig03
Figure 3.
Progressive eradication of WPV genotypes, 1986 to 2009. Countries that have never eradicated indigenous WPV circulation are shown in black; reinfected countries are represented in dark grey. Numbers indicate the location and year of the last detection of an indigenous WPV genotype. (Source: WHO GPLN.)
10.1128/9781555816698/f0453-01_thmb.gif
10.1128/9781555816698/f0453-01.gif
Image of Figure 3.
Figure 3.

Progressive eradication of WPV genotypes, 1986 to 2009. Countries that have never eradicated indigenous WPV circulation are shown in black; reinfected countries are represented in dark grey. Numbers indicate the location and year of the last detection of an indigenous WPV genotype. (Source: WHO GPLN.)

Citation: Chumakov K, Kew O. 2010. The Poliovirus Eradication Initiative, p 449-459. In Ehrenfeld E, Domingo E, Roos R (ed), The Picornaviruses. ASM Press, Washington, DC. doi: 10.1128/9781555816698.ch28
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/content/10.1128/9781555816698.ch28.ch28fig04
Figure 4.
Location of polio outbreaks associated with cVDPVs. Shown are the serotypes of the cVDPV isolates, the year(s) of cVDPV isolation, and the number of reported cases associated with cVDPVs.
10.1128/9781555816698/f0455-01_thmb.gif
10.1128/9781555816698/f0455-01.gif
Image of Figure 4.
Figure 4.

Location of polio outbreaks associated with cVDPVs. Shown are the serotypes of the cVDPV isolates, the year(s) of cVDPV isolation, and the number of reported cases associated with cVDPVs.

Citation: Chumakov K, Kew O. 2010. The Poliovirus Eradication Initiative, p 449-459. In Ehrenfeld E, Domingo E, Roos R (ed), The Picornaviruses. ASM Press, Washington, DC. doi: 10.1128/9781555816698.ch28
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/content/10.1128/9781555816698.ch28.ch28fig05
Figure 5.
Location of paralytic cases and prolonged poliovirus infections associated with iVDPVs, worldwide, 1962 to 2009. Mixed iVDPV infections are indicated by composite symbols.
10.1128/9781555816698/f0456-01_thmb.gif
10.1128/9781555816698/f0456-01.gif
Image of Figure 5.
Figure 5.

Location of paralytic cases and prolonged poliovirus infections associated with iVDPVs, worldwide, 1962 to 2009. Mixed iVDPV infections are indicated by composite symbols.

Citation: Chumakov K, Kew O. 2010. The Poliovirus Eradication Initiative, p 449-459. In Ehrenfeld E, Domingo E, Roos R (ed), The Picornaviruses. ASM Press, Washington, DC. doi: 10.1128/9781555816698.ch28
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