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2 : Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001

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Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, Page 1 of 2

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Abstract:

The strategies for polio eradication used in the Americas relied on the achievement and maintenance of high immunization levels in the population at risk and disease surveillance. The basic issue that needed to be addressed at the launch of the polio eradication initiative in the Americas was to determine the optimal strategy for achieving and maintaining high vaccination coverage. The results of vaccination program in Brazil were critical to the development of the approaches to be used in the different countries in the Americas. If the case was acute flaccid paralysis (AFP), it would be classified as probable poliomyelitis, and two stool specimens would be collected 24 h apart and sent to one of the laboratories included in a network of diagnostic laboratories that had been established. After 10 weeks, the case would be classified as confirmed poliomyelitis if the wild poliovirus had been isolated from the stools or if the patient had no adequate stool specimens and died within 60 days of the onset of symptoms or was not available for follow-up. Intensive case-finding activities were initiated to determine the extent and magnitude of the outbreak, to identify foci of disease activity, and to organize areas for vaccination activities. A special call was issued to countries in the Americas and worldwide to remain highly vigilant by maintaining high levels of oral polio vaccine (OPV) coverage and active surveillance throughout each country.

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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Figures

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Figure 1

Polio cases by 4-week period, in Brazil, from 1975 to 1984. Sources: Departamento Nacional de Epidemiologia-Secretaria Nacional de Ações Básicas de Saúde, MS, and PAHO.

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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Image of Figure 2
Figure 2

Poliomyelitis in Cuba, from 1946 to 1992. Source: country reports. NVD, national vaccination days.

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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Image of Figure 3
Figure 3

Confirmed vaccine-derived polio cases in the Dominican (Dom) Republic (DOR) and Haiti (HAI) from 2000 and 2001. Source: country reports (data as of 15 May 2002).

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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Figure 4

Areas with confirmed polio cases on the island of Hispaniola, from 2000 and 2001. Source: Polio Eradication Surveillance System/Division of Vaccines and Immunization (data as of 14 December 2001).

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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Figure 5

Rate of fixation of synonymous substitutions in complete capsid. Source: Centers for Disease Control and Prevention.

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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Image of Figure 6
Figure 6

AFP rate per 100,000 persons under 15 years of age, Dominican Republic (DOR) and Haiti (HAI) from 1988 to 2001. Source: PAHO (data as of 30 June 2001).

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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Figure 7

Polio eradication progress, from 1988 to 2001.

Citation: de Quadros C, Landaverde M, Pedreira C, Laender F, Kew O, Garib Z, André J. 2004. Polio Reemerges in the Americas: a Vaccine-Derived Outbreak in Hispaniola in 2000 and 2001, p 13-23. In Scheld W, Murray B, Hughes J (ed), Emerging Infections 6. ASM Press, Washington, DC. doi: 10.1128/9781555816995.ch2
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References

/content/book/10.1128/9781555816995.chap02
1. Centers for Disease Control and Prevention. 2001. Circulation of a type 2 vaccine-derived poliovirus—Egypt, 1982–1993. Morb. Mortal. Wkly. Rep. 50:4142.
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6. Pan American Health Organization, Division of Vaccines and Immunization. 2001. Update: OPV-derived poliomyelitis outbreak in the Dominican Republic and Haiti. EPI Newsl. 23(1):45.
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8. Pan American Health Organization, Division of Vaccines and Immunization. 2001. Haiti's polio campaign: a success story. EPI Newsl. 23(4):23.
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10. Wood, D. J.,, R. W. Sutter,, and W. R. Dowdle. 2001. Stopping poliovirus vaccination after eradication: issues and challenges. Bull. W. H. O. 78:347363.
11. World Health Organization. 1998. Report of the Meeting on the Scientific Basis for Stopping Polio Immunization. World Health Organization, Geneva, Switzerland.
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13. World Health Organization. 2000. Global Action Plan for Laboratory Containment of Wild Polioviruses. WHO/V&B/99.32. 2000. World Health Organization, Geneva, Switzerland.

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