Acute Flaccid Paralysis Associated With Circulating Vaccine-Derived Poliovirus—Philippines, 2001

doi:10.1001/jama.287.3.311-jwr0116-2-1

Abstract

Three cases of acute flaccid paralysis (AFP) associated with circulating vaccine-derived poliovirus (cVDPV) isolates were reported in the Philippines during March 15-July 26, 2001. The first case-patient, a child aged 8 years from northern Mindanao island (500 miles south of Manila) who had received 3 doses of oral polio vaccine (OPV), had onset of paralysis on March 15. A second child, aged 3 years from Laguna province on Luzon island (60 miles south of Manila) who had received 3 OPV doses, presented with signs of meningitis but no paralysis on July 23. A third child, aged 14 months from Cavite province (25 miles from Manila and 45 miles north of Laguna province) who had received 2 OPV doses, had onset of paralysis on July 26. No patients had traveled outside of their province of residence since birth. Characterization of isolates from the three patients revealed type 1 polioviruses derived from Sabin vaccine strain type 1, with a 3% genetic sequence difference between Sabin 1 vaccine and vaccine-derived poliovirus (VDPV) isolates. The three polioviruses are not identical but are closely related (>99% sequence homology); they also appear to share an identical recombination site with a nonpolio enterovirus in the noncapsid region of the genome.

Highlights

T OBACCO USE, CIGA rette smoking, is the leading preventable cause of death in the United States, but the health consequences extend beyond smokers to nonsmokers involuntarily exposed to environmental tobacco smoke or secondhand smoke (SHS).[1]
12% and the proportion of nonsmokers exposed to environmental tobacco smoke to 45%
THREE CASES OF ACUTE FLACCID PARALYsis (AFP) associated with circulating vaccine-derived poliovirus isolates were reported in the Philippines during March 15–July 26, 2001

Summary

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T OBACCO USE , CIGA rette smoking, is the leading preventable cause of death in the United States, but the health consequences extend beyond smokers to nonsmokers involuntarily exposed to environmental tobacco smoke or secondhand smoke (SHS).[1]. Downloaded From: https://jamanetwork.com/ on 11/02/2021 assess attitudes about smoke-free policies, respondents were asked, “In the following locations, do you think that smoking should be allowed in all areas, some areas, or not allowed at all?” These locations were restaurants, schools, day care centers, and indoor work areas. North Carolina, Tennessee, New Hampshire, Alabama, Arkansas, and Alaska) differed significantly from the 12 areas with lower prevalence (Utah, Puerto Rico, California, Arizona, Montana, Hawaii, Minnesota, Connecticut, Massachusetts, Colorado, Maryland, and Washington). Current smokers and nonsmokers reported similar attitudes about not allowing smoking at all in schools (median: 89.1% for smokers and 95.6% for nonsmokers) and day care centers (median: 94.2% for smokers and 97.6% for nonsmokers); the proportion who thought smoking should not be allowed at all differed widely between smokers and nonsmokers for restaurants (median: 25.9% for smokers versus 66.2% for nonsmokers) and indoor work areas The national health objective for 2000 of ⱕ15% of adults smoking cigarettes was achieved by Puerto Rico, Utah, and in California for women (objective 3.4).[3]

The low prevalence in Utah and Puerto

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Recommendation for Avoiding Pregnancy

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Findings

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