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Polio vaccination strategies assessed as eradication nears

Polio is on track to become only the second disease ever eradicated. In two studies in the Dec. 15 issue of The Journal of Infectious Diseases, now available online, scientists are working to ensure that once it is gone, it stays gone. One study reduces concerns that people whose immune systems were weakened by HIV would re-introduce poliovirus into the community. The other study looks at the how switching forms of vaccine from a live, attenuated vaccine to an inactivated version may affect communities.

Oral polio vaccine (OPV), one of the vaccines instrumental in driving the disease to near-eradication, contains weakened live virus strains. The vaccine is highly effective, easy to administer, relatively inexpensive, and has been used for more than 40 years. Those given the vaccine excrete, or "shed," virus in their stool. There is some concern over the use of OPV, however, because vaccine-derived poliovirus (VDPV) can occasionally cause another form of polio.

Furthermore, in rare cases, immunodeficient persons have shown prolonged shedding of VDPV, which may be transmitted to contacts, thus potentially re-introducing polio into the community. Concerns had been raised that this issue would be a particular challenge in countries with high HIV prevalence.

Karen Hennessey, PhD, MSPH, and colleagues in Cote d'Ivoire and at the Centers for Disease Control and Prevention examined the duration of shedding of oral poliomyelitis vaccine by individuals with HIV infection.

Dr. Hennessey and colleagues tested stool specimens at various intervals following vaccination. Out of a total of 419 adults with HIV infection, no poliovirus was isolated from any of the specimens. Because of these results, it is likely that fewer than 1 percent of adults with HIV infection experience prolonged virus shedding when exposed to OPV, "and therefore probably represent minimal risk of re-introducing vaccine virus into the population after poliovirus has been
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Source:Infectious Diseases Society of America


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