关键词： Live attenuated oral polio vaccine   Flaccid monoplegia   Mild clinical course   Muscle biopsy   Magnetic resonance imaging   Electromyography  

摘要： A pediatric patient, who was given live-attenuated oral polio vaccine twice without distinct gait disturbance during infancy, begun to present limp at 3 years. His gait disturbance became remarkable with aging. At 7 years, he was unable to dorsiflex the left ankle, and presented flaccid monoplegia of the left lower extremity, and the left Achilles tendon reflex was diminished. Magnetic resonance imaging revealed multiple crack-lines in the left anterior tibial muscle, but was unable to detect any distinct lesion at responsible level of L4, L5 and S1 anterior horn cells' degeneration. Electromyography showed continuous fibrillation potentials, but muscle biopsy presented nearly normal in this muscle. The serum levels of polio antibody type 1 and type 2 titers were elevated 64x respectively, while the type 3 antibody titer was not elevated 4x. This patient was diagnosed as live attenuated oral polio vaccine-related flaccid monoplegia, with mild clinical course. (C) 2014 Elsevier Ltd. All rights reserved.

关键词： Inactivated poliovirus vaccine   Sabin strains   Aluminum hydroxide   Adjuvant   Phase I trial   Safety   Immunogenicity  

摘要： Background: To ensure that developing countries have the option to produce inactivated poliovirus vaccine (IPV), the Global Polio Eradication Initiative has promoted the development of an IPV using Sabin poliovirus strains (Sabin IPV). This trial assessed the reactogenicity and immunogenicity of Sabin IPV and adjuvanted Sabin IPV in healthy adults in Cuba. Methods: This is a randomized, controlled phase I trial, enrolling 60 healthy (previously vaccinated) male human volunteers, aged 19-23 years to receive one dose of either Sabin IPV (20:32:64 DU/dose), adjuvanted Sabin IPV (10:16:32 DU/dose), or conventional Salk IPV (40:8:32 DU/dose). The primary endpoint for reactogenicity relied on monitoring of adverse events. The secondary endpoint measured boosting immune responses (i.e. seroconversion or 4-fold rise) of poliovirus antibody, assessed by neutralization assays. Results: Sixty subjects fulfilled the study requirements. No serious adverse events reported were attributed to trial interventions during the 6-month follow-up period. Twenty-eight days after vaccination, boosting immune responses against poliovirus types 1-3 were between 90% and 100% in all vaccination groups. There was a more than 6-fold increase in median antibody titers between pre- and post-vaccination titers in all vaccination groups. Discussion: Both Sabin IPV and adjuvanted Sabin IPV were well tolerated and immunogenic against all poliovirus serotypes. This result suggests that the aluminum adjuvant may allow a 50% (or higher) dose reduction. (C) 2014 Published by Elsevier Ltd.

关键词： Afghanistan/epidemiology   Genotype   Geography   Humans   Molecular Epidemiology   Molecular Epidemiology   Pakistan/epidemiology   Phylogeny   Phylogeny   Poliomyelitis/epidemiology   Poliomyelitis/epidemiology   Poliomyelitis/transmission   Poliomyelitis/transmission   Poliovirus/classification   Poliovirus/genetics   Poliovirus/isolation & purification  

摘要： Pakistan and Afghanistan share a long uncontrolled border with extensive population movement on both sides. Wild poliovirus transmission has never been interrupted in this block due to war against terrorism, poor public health infrastructure, misconceptions about polio vaccines and inadequate immunization activities. All these issues complicate the eradication operations and reinforce the complexity of wiping out poliomyelitis from this region. This study illustrates the origins and routes of cross-border wild poliovirus type 1 (WPV1) transmission during 2010-2012 between Pakistan and Afghanistan. Sequence analyses were conducted based on complete VP1 capsid protein sequences for WPV1 study strains to determine the origin of poliovirus genetic lineages and their evolutionary relationships. Phylogenetic tree was constructed from VP1 gene sequences applying Maximum Likelihood method using Kimura 2-parameter model in MEGA program v 5.0. A total of 72 (14.3%) out of 502 wild-type 1 polioviruses were found circulating in border areas of both countries during 2010-2012. Molecular phylogenetic analysis classified these strains in to two sub-genotypes with four clusters and 18 lineages. Genetic data confirmed that the most of WPV1 lineages (12;66.6%) were transmitted from Pakistan to Afghanistan. However, the genetic diversity was significantly reduced during 2012 as most of the lineages were completely eliminated. In conclusion, Pakistan-Afghanistan block has emerged as a single poliovirus reservoir sharing the multiple poliovirus lineages due to uncontrolled movement of people across the borders between two countries. If it is neglected, it can jeopardize the extensive global efforts done so-far to eradicate the poliovirus infection. Our data will be helpful to devise the preventive strategies for effective control of wild poliovirus transmission in this region.

关键词： diarrhea   enterovirus   immunogenicity   interference   oral poliovirus vaccine  

摘要： Background. The impaired immunogenicity of oral poliovirus vaccine (OPV) in low-income countries has been apparent since the early field trials of this vaccine. Infection with enteropathogens at the time of vaccination may contribute to this phenomenon. However, the relative influence of these infections on OPV performance remains uncertain. Methods. We conducted a systematic review to examine the impact of concurrent enteric infections on OPV response. Using random-effects models, we assessed the effects of nonpolio enteroviruses (NPEVs) and diarrhea on the odds of seroconversion and/or vaccine virus shedding. Results. We identified 25 trials in which OPV outcomes were compared according to the presence or absence of enteric infections, the majority of which (n = 17) reported only on NPEVs. Concurrent NPEVs significantly reduced the odds of per-dose seroconversion for type 1 poliovirus (odds ratio [OR] 0.44, 95% confidence interval 0.23-0.84), but not type 2 (OR 0.53 [0.19-1.46]) or type 3 (OR 0.56 [0.27-1.12]). A similar reduction, significant for type 1 poliovirus (OR 0.50 [0.28-0.89]), was observed in the odds of vaccine virus shedding among NPEV-infected individuals. Concurrent diarrhea significantly inhibited per-dose seroconversion overall (OR 0.61 [0.38-0.87]). Conclusions. Our findings are consistent with an inhibitory effect of concurrent enteric infections on OPV response.

关键词： POLIOVIRUS   IMMUNIZATION of children   PUBLIC health   ORAL poliomyelitis vaccine   SEWAGE disposal plants   ISRAEL  

摘要： In 2013, samples from routine environmental surveillance at a sewage-treatment plant in Israel tested positive for wild-type poliovirus. In response, Israeli health policymakers ramped up environmental surveillance and launched supplementary immunization activities.

关键词： Inactivated polio vaccine   Poliomyelitis   Sabin strain   National reference vaccine  

摘要： As one aspect of its campaign to eradicate poliomyelitis, the World Health Organization (WHO) has encouraged development of the inactivated polio vaccine (IPV) derived from the Sabin strains (sIPV) as an option for an affordable polio vaccine, especially in low-income countries. The Japan Poliomyelitis Research Institute (JPRI) inactivated three serotypes of the Sabin strains and made sIPV preparations, including serotypes 1, 2 and 3 D-antigens in the ratio of 3:100:100. The National Institute of Infectious Diseases, Japan, assessed the immunogenic stability of these sIPV preparations in a rat potency test, according to an evaluation method recommended by the WHO. The immunogenicity of the three serotypes was maintained for at least 4 years when properly stored under -70 degrees C. Based on these data, the sIPV preparations made by JPRI have been approved as national reference vaccines by the Japanese national control authority and used for the quality control of the tetracomponent sIPV-containing diphtheria-tetanus-acellular pertussis combination vaccines that were licensed for a routine polio immunization in Japan. (C) 2014 Elsevier Ltd. All rights reserved.

关键词： POLIOMYELITIS vaccine   CELLULAR immunity   EPIDEMICS   PREVENTION   POLIO vaccination  

摘要： In 2010, a large outbreak of poliomyelitis with unusual 47% lethality occurred in Pointe Noire, Republic of Congo. Vaccine-mediated immunity against the outbreak virus was never investigated. A wild poliovirus 1 (WPV1) isolated from a fatal case (termed PV1-RC2010) showed a previously unknown combination of amino acid exchanges in critical antigenic site 2 (AgS2, VP1 capsid protein positions (221)SAAL ->(221)PADL). These exchanges were also detected in an additional 11 WPV1 strains from fatal cases. PV1-RC2010 escaped neutralization by three different mAbs relevant for AgS2. Virus neutralization was tested in sera from fatal cases, who died before supplementary immunization (n = 24), Gabonese recipients of recent oral polio vaccination (n = 12), routinely vaccinated German medical students (n = 34), and German outpatients tested for anti-poliovirus immunity (n = 17) on Vero, human rhabdomyosarcoma, and human epidermoid carcinoma 2 cells. Fatal poliomyelitis cases gave laboratory evidence of previous trivalent vaccination. Neutralizing antibody titers against PV1-RC2010 were significantly lower than those against the vaccine strain Sabin-1, two genetically distinct WPV1s isolated in 1965 and 2010 and two genetically distinct vaccine-derived PV strains. Of German vaccinees tested according to World Health Organization protocols, 15-29% were unprotected according to their neutralization titers (<1: 8 serum dilution), even though all were protected against Sabin-1. Phylogenetic analysis of the WPV1 outbreak strains suggested a recent introduction of virus progenitors from Asia with formation of separate Angolan and Congolese lineages. Only the latter carried both critical AgS2 mutations. Antigenetically variant PVs may become relevant during the final phase of poliomyelitis eradication in populations with predominantly vaccine-derived immunity. Sustained vaccination coverage and clinical and environmental surveillance will be necessary.

关键词： 脊髓灰质炎病毒   抗体   中和   免疫   阳性率   几何平均滴度  

摘要： 目的 调查2012年北京市常住人口脊髓灰质炎病毒抗体水平。方法 2012年在北京市采用分层随机抽样方法，调查连续居住6个月以上的健康居民1676名。使用调查问卷收集人口学特征、脊髓灰质炎减毒活疫苗（OPV）免疫史等信息，并采集静脉血5ml，使用微量中和试验方法检测脊髓灰质炎病毒中和抗体。对不同组别问抗体阳性率和几何平均滴度（geometric mean titer，GMT）进行比较。结果脊髓灰质炎病毒Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为98．2％（1645／1676）、98．1％（1644／1676）、97．6％（1635／1676），抗体GMT分别为l：130．2、1：113．4、1：79．7。〈15岁年龄组Ⅰ、Ⅱ、Ⅲ型抗体阳性率分别为99．7％（664／666）、99．8％（665／666）、99．5％（663／666），均高于≥15岁各年龄组[分别为97．1％（981／1010）、96．9％（979／1010）、96．2％（972／1010）]，差异有统计学意义（P值均〈0．01）；〈15岁年龄组Ⅰ、Ⅱ、Ⅲ型抗体GMT（1：325．9、1：250．5、1：190．7）均高于≥15岁年龄组（1：71．1、1：67．2、1：44．8），差异有统计学意义（P值均〈0．01）。免疫史信息来自于接种证和接种卡的人群各型抗体阳性率（99．O％～100％）和GMT水平（1：128．8～1：300．7）均较高，当记录中免疫次数达到3次时，Ⅰ、Ⅱ、Ⅲ型抗体阳性率（均为100％）和GMT（1：409．7～1：636．7）均达到较高水平。结论2012年北京市健康人群脊髓灰质炎病毒抗体水平处于较高水平；特别是15岁以下免疫覆盖人群，建立了稳固的免疫屏障，可有效阻断输入性脊髓灰质炎野病毒及疫苗衍生病毒的传播。

关键词： 商用食具消毒柜   载体定量法   大肠杆菌   脊髓灰质炎病毒   杀菌效果  

摘要： 目的观察大型商用食具消毒柜在不同消毒模式下的消毒效果,为实际应用提供科学依据。方法采用载体定量杀菌试验方法,观察不同消毒模式运行下对载体上大肠杆菌和脊髓灰质炎病毒的杀灭效果。结果试验结果显示,在商用食具消毒柜满载的情况下,臭氧消毒模式运行60 min,对载体上大肠杆菌杀灭对数值2.10~2.98,对载体上的脊髓灰质炎病毒灭活对数值1.16~1.33;臭氧消毒60 min＋烘干30 min组合模式（关闭循环风机）运行90 min,对载体上大肠杆菌平均杀灭对数值2.19~5.76,对载体上的脊髓灰质炎病毒灭活对数值2.09~5.67;臭氧消毒60 min＋烘干30 min组合模式（开启循环风机）运行90 min,对载体上大肠杆菌杀灭对数值6.26,对载体上的脊髓灰质炎病毒灭活对数值5.83。结论大型商用食具消毒柜需运行臭氧消毒60 min＋烘干30 min组合模式（开启循环风机）才能达到预期的消毒效果。

关键词： 百日咳   白喉   破伤风   脊髓灰质炎   b型流感嗜血杆菌   联合疫苗   基础免疫   安全性  

摘要： 目的评价吸附无细胞百白破、灭活脊髓灰质炎和b型流感嗜血杆菌（结合）联合疫苗（五联疫苗）在婴儿2、3、4月龄时接种（作为3剂基础免疫）的安全性。方法选择上海市松江区4个社区接种单位,共100名满2月龄（60-74 d）的婴儿,在其2、3、4月龄时,分别经大腿前外侧肌肌肉接种1剂五联疫苗,观察接种后反应的发生情况。结果在为期4个月的接种访视期间,共完成五联疫苗接种297剂次,无即刻反应发生。共发生注射局部反应108人次,全身反应150人次,全身反应发生率（50.51%）明显高于注射局部反应发生率（36.36%）,且差异有统计学意义（P=0.001）。随着接种剂次的增加,局部反应（发红、肿胀）发生率逐渐上升（P值分别为0.004和0.010）;全身反应（呕吐、异常哭闹、嗜睡和易激惹）发生率逐渐下降（P值分别为〈0.001、0.004、〈0.001和0.014）。共收到非征集性反应44人次。共发生两起严重不良事件,均与五联疫苗的接种无关。结论五联疫苗引起不良反应的发生率较低,具有良好的安全性。