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Epidemiol Infect. 1992 Feb;108(1):1-18.

Poliomyelitis: eradication in sight.

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Division of Molecular Virology, Baylor College of Medicine, Houston, Texas 77030.



Eradication of poliomyelitis most likely will occur. In fact, it is almost gone from the Western Hemisphere. Health workers in Sweden, Finland, and the Netherlands routinely vaccinate almost all children with the inactivated poliovaccines (IPV). Despite good vaccination coverage, polio can still occur. For example, in 1978-1979, polio outbreaks occurred among people of closely knit interconnected religious groups in the Netherlands. The virulent type 1 poliovirus was imported from the Middle East and spread to related religious groups in Canada and U.S. Further, in 1984-1985, Finland experienced 10 polio cases. A wild type 3 variant was responsible. An outbreak in 1988 in Israel occurred among young adults who, although received the oral polio vaccine (OPV) as infants, did not receive booster doses. Thus they had an age related deficit in immunity against the wild virus. 6 countries in the Western Pacific Region were able to control polio by 1980, but wild type polioviruses were ubiquitous in 5 other countries in this region and infections were either asymptomatic or unrecognized. They could not control polio by 1980 and just recently able to exert some control. OPV induces serum antibodies, intestinal resistance, and rapid enduring immunity. Also it is easy to administer and inexpensive. Risk of paralytic polio with OPV is 1/1 million vaccinated infants. WHO advises that newborns should be immunized with OPV at the same time as BCG to protect them from polio and to reduce the transmission of wild polioviruses during infancy and childhood. Further many countries have incorporated OPV into routine immunization schedules, but can be difficult in developing countries with limited cold chain capabilities. While some developing countries host periodic mass OPV immunization campaigns. At proper doses, IPV imparts humoral immunity and can be incorporated into other injectable pediatric vaccines (e.g., DPT). Some countries use both IPV and OPV.

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