Abstract
BackgroundThe goal of polio eradication is to complete elimination and containment of all wild, vaccine-related and Sabin polioviruses. Vaccine-derived poliovirus (VDPV) surveillance in China from 2001–2013 is summarized in this report, which has important implications for the global polio eradication initiative.MethodsAcute flaccid paralysis (AFP) cases and their contacts with VDPVs isolated from fecal specimens were identified in our AFP surveillance system or by field investigation. Epidemiological and laboratory information for these children were analyzed and the reasons for the VDPV outbreak was explored.ResultsVDPVs were isolated from a total of 49 children in more than two-thirds of Chinese provinces from 2001–2013, including 15 VDPV cases, 15 non-polio AFP cases and 19 contacts of AFP cases or healthy subjects. A total of 3 circulating VDPVs (cVDPVs) outbreaks were reported in China, resulting in 6 cVDPVs cases who had not been vaccinated with oral attenuated poliomyelitis vaccine. Among the 4 immunodeficiency-associated VDPVs (iVDPVs) cases, the longest duration of virus excretion was about 20 months. In addition, one imported VDPV case from Myanmar was detected in Yunnan Province.ConclusionsUntil all wild, vaccine-related and Sabin polioviruses are eradicated in the world, high quality routine immunization and sensitive AFP surveillance should be maintained, focusing efforts on underserved populations in high risk areas.
Highlights
The goal of polio eradication is to complete elimination and containment of all wild, vaccine-related and Sabin polioviruses
Descriptive epidemiology During 2001–2013, vaccine-derived polioviruses (VDPVs) were isolated from a total of 49 children, including 15 VDPV cases, 15 non-polio acute flaccid paralysis (AFP) cases and 19 contacts of AFP cases or healthy subjects (Table 1)
The 15 nonpolio AFP cases were classified by the provincial Polio Expert Committee (PEC) as hypokalemia (n = 4), Guillain-Barré syndrome (n = 3), transverse myelitis (n = 3), transient limb paralysis (n = 2), hand-foot-mouth disease (n = 2) and central nervous dysfunction (n = 1)
Summary
The goal of polio eradication is to complete elimination and containment of all wild, vaccine-related and Sabin polioviruses. Vaccine-derived poliovirus (VDPV) surveillance in China from 2001–2013 is summarized in this report, which has important implications for the global polio eradication initiative. The last polio case infected by indigenous WPV was reported in September 1994 in China, and the Western Pacific Region, which encompasses China, has been certified as being polio free since October 2000 [5]. As it shares border with endemic countries, China has experienced WPV importation for many times before being polio-free: 1995 and 1996 in Yunnan Province [6], 1999
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