Poliomyelitis


A disease that still paralyzes and kills children around the world1

  • Human-only, viral disease caused by 3 poliovirus types (PV 1, 2, 3)2
  • Paralytic polio in <1% of infections (0.5/100 for PV1) leading to temporary or permanent paralysis, mainly legs3
  • Children <5 years of age at highest risk of infection/paralysis1
  • Highly infectious: 90-100% transmission among susceptible household contacts 2
  • Fecal-oral transmission linked to poor level of sanitation & hygiene3
  • Children in all countries at risk of contracting polio as long as 1 single child remains infected1
  • Global goal of polio eradication yet to be met (WPV1 circulation & cVDPV1,2,3 outbreaks)4,5
  • World getting prepared for global OPV cessation (to eliminate risk of VAPP & cVDPV)6

cVDPV: circulating vaccine-derived poliovirus; VAPP: vaccine-associated paralytic polio

    1. WHO. Online
    2. ECDC.
    3. WHO. WER, 2016;91(12)
    4. GPEI. Online
    5. GPEI. Online
    6. WHO. Polio Endgame Strategy 2019-23; 2019

Global Polio Eradication Initiative (GPEI)


Tremendous achievements…

WPV: wild-type poliovirus; bOPV: bivalent OPV; tOPV: trivalent OPV

    1. WHO. WER. 2016;91(12)
    2. WHO. Polio Bull.2015;19
    3. WHO. Polio Bull.2016;10
    4. WHO. Polio Bull.2018;1
    5. WHO. Polio Bull.2019;20
    6. WHO. Polio Bull.2019;17

Global Polio Eradication Initiative:


Jeopardized by continuous WPV1 circulation & cVDPV2 outbreaks 1,2

 

- Routine immunization is weak in all affected countries

- International poliovirus spread remains a Public Health Emergency of International Concern3

 

CAR: Central African republic; DRC: Democratic Republic of the Congo cVDPV: circulating vaccine-derived poliovirus

    1. GPEI. Online
    2. GPEI. Online
    3. WHO. Statement of 22nd IHR Emergency Committee Regarding international Spread of Poliovirus

Waning Anti-Polio Immunity


School-entry booster is needed to maintain immunity through primary school1

Immune responses after a DTaP-IPV/Hib toddler booster (n=69) and before/2 months after DTaP-IPV school-entry booster (n=232) at 5-6 years in children primed w/ DTaP-IPV/Hib at 2-3-4/2-4-6 months (3+1 schedule, France, 2000-01)1

    1. Mallet. Vaccine, 2004;22(11-12)

Importance of DTaP-IPV School-Entry Booster


Poliomyelitis

Polio is a disease that still paralyzes and kills children around the world1

Despite tremendous progress, the goal of global eradication remains unmet and may be jeopardized by2,3 : 

  • Continuous circulation of wPV1
  • cVDPV outbreaks associated with OPV use

- The world should get prepared for the eventual shift to full-IPV4 

- Almost all IPV-only using countries currently recommend an IPV school-entry booster5

“Sustained high population immunity to poliovirus transmission represents a key prerequisite to eradication, but poliovirus immunity and transmission remain poorly understood despite decades of studies”6

    1. WHO. Online
    2. GPEI. Online
    3. GPEI. Online
    4. WHO. Polio Endgame Strategy 2019-23; 2019
    5. WHO. Online
    6. Duintjer Tebbens. Risk Anal, 2013;33(4)

Vaccination Recommendations - WHO


School-entry boosters are recommended for long-lived protection1-5

    1. WHO. WER, 2017;92(31)
    2. WHO. WER, 2017;92(6)
    3. WHO. WER, 2015;90(351)
    4. WHO. WER, 2016;91(12)
    5. Martinon-Torres. Expert Rev Vaccines, 2018;17(4)

MAT-AE-2200200-V1-March- 2022