Abstract
Eradicating polio is perhaps the largest worldwide public health initiative in history, and through extensive vaccination efforts, one of the three poliovirus types (poliovirus type 2) has nearly been exterminated while the incidence of polio has declined to the lowest levels ever. Unfortunately, poliovirus has begun to re-emerge in once polio-free countries and new vaccination and therapeutic strategies are being considered. Challenges are many but critical is maintaining good surveillance and sufficient supplies of Oral polio vaccine (OPV), as well as Inactivated polio vaccine (IPV) which ultimately will replace OPV when wild poliovirus transmission has been interrupted. There is a need to develop enhanced polio vaccine cell lines that can increase vaccine titers and production to provide the means lower the cost of vaccine manufacture, to meet worldwide demand, and to address vaccine efficacy by preventing vaccine losses due to ‘cold chain’ requirements implicit in delivering vaccines to third world nations. In addition, there is a need to develop safe and effective antivirals to address the incidence of OPV ‘shedders’ and in achieving and maintaining global eradication and containment of poliovirus.
Highlights
To control disease, such as polio, there is the dilemma of vaccineinduced disease and the unvaccinated
Largely through the efforts of the Global Polio Eradication Initiative that involves the Centers for Disease Control (CDC), World Health Organization (WHO), the Rotary Club, the Bill and Melinda Gates Foundation and others, there has been a significant reduction in polio in endemic and spill-over countries that suggested worldwide eradication could be eventually achieved through careful surveillance and a robust immunization effort [1,2,3]
The number of people worldwide with poliomyelitis caused by wild-type poliovirus infection has decreased to very low levels due to Oral polio vaccine (OPV) vaccination, using live oral polio vaccine to control transmission is an issue because the vaccine is excreted, and because these vaccine-derived strains can cause pathogenicity [1,4,5]
Summary
To control disease, such as polio, there is the dilemma of vaccineinduced disease and the unvaccinated. Live vaccination against polio has effectively prevented disease in most developed countries and contained polio to only a few countries where outbreaks of poliomyelitis by the wild-type strain still remain. Largely through the efforts of the Global Polio Eradication Initiative that involves the Centers for Disease Control (CDC), World Health Organization (WHO), the Rotary Club, the Bill and Melinda Gates Foundation and others, there has been a significant reduction in polio in endemic and spill-over countries that suggested worldwide eradication could be eventually achieved through careful surveillance and a robust immunization effort [1,2,3].
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