Abstract
The risk of polio importation and re-emergence persists since epidemic polio still occurs in some countries, and the resurgence of polio occurring almost 20 years after polio eradication was declared in Asia has been reported. We analyzed the results of acute flaccid paralysis (AFP) surveillance in Korea to assess the quality of AFP surveillance and understand the etiology of non-polio enterovirus (NPEV)-associated central nervous system diseases in a polio-free area. We investigated 637 AFP patients under 15 years of age whose cases were confirmed during 2012–2019 by virus isolation, real-time reverse transcription polymerase chain reaction, and VP1 gene sequencing. Among the 637 AFP cases, NPEV was detected in 213 (33.4%) patients, with the majority observed in EV-A71, with 54.9% of NPEV positives. EV-A71 has been shown to play a role as a major causative agent in most neurological diseases except for Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), and meningitis. This study provides information on the AFP surveillance situation in Korea and highlights the polio eradication stage in the monitoring and characterization of NPEV against the outbreak of neurological infectious diseases such as polio.
Highlights
IntroductionSince the polio vaccine was developed in the 1950s, global polio eradication activities such as the Global Polio Eradication Initiative (GPEI), including immunization programs for polio, have reduced the global incidence by over 99% since 1988 from an estimated 350,000 cases to 33 cases in 2018 [1]
A total of 50 nationwide hospitals have participated in the acute flaccid paralysis (AFP) surveillance system, and at the participating hospitals, specimens are collected by the pediatric neurologists from patients with AFP and sent to the KDCA
The incidence of polio globally has decreased and wild poliovirus transmission has been interrupted in many countries, polio epidemics have been and are still being reported in Pakistan and Afghanistan [2]
Summary
Since the polio vaccine was developed in the 1950s, global polio eradication activities such as the Global Polio Eradication Initiative (GPEI), including immunization programs for polio, have reduced the global incidence by over 99% since 1988 from an estimated 350,000 cases to 33 cases in 2018 [1]. In Korea, the inactivated polio vaccine (IPV) and oral poliovirus vaccine (OPV) became available in 1958 and 1962, respectively [3]. The polio vaccine was introduced to the national immunization program (NIP) in 1983, and a four-dose polio vaccine schedule was recommended at 2, 4, and 6 months and at 4–6 years of age [3]. Due to the risk of vaccine-associated paralytic poliomyelitis and vaccine-derived polioviruses, OPV was withdrawn from the NIP in 2004 [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
