关键词： 脊髓灰质炎疫苗   衍生病毒   急性弛缓性麻痹  

摘要： 2011年12月7日，达州市疾病预防控制中心接到四川省疾病预防控制中心电话，告知达州市开江县送检的急性弛缓性麻痹（AFP）病例标本检出脊髓灰质炎疫苗衍生病毒。达州市疾控中心接电话后立即报告市卫生局，同时将情况及时反馈给开江县疾病预防控制中心，并派出专家组赴现场。

关键词： IMMUNODEFICIENCY   POLIOVIRUS   X chromosome abnormalities   SYNDROMES   IMMUNIZATION of children  

摘要： Patients with primary immunodeficiency are prone to persistently excrete Sabin-like virus after administration of live-attenuated oral polio vaccine and have an increased risk for vaccine-derived paralytic polio. We report a case of type 3 immunodeficiency-associated vaccine-derived poliovirus in a child in South Africa who was born with X-linked immunodeficiency syndrome.

关键词： Poliovirus proteome   human proteome   peptide sharing   viral pathogenesis   viral immunity  

摘要： In the present study, we analyze the peptide commonality between poliovirus polyprotein and the human proteins. We report on the following findings: (1) the extent of polio peptide overlap on the human proteome is high, and involves the entire viral polyprotein;(2) viral peptide matching affects human proteins linked to fundamental cellular functions. The data may help to further our understanding of the relationships between poliovirus and the human host.

关键词： Patients   Highly Active Antiretroviral Therapy   CD4 Lymphocyte Count   Health Benefits   At-risk  

摘要： Although the public-health benefit of various strategies probably varies by factors such as CD4 count, CrAg prevalence, and time to initiation of antiretroviral therapy, there is an urgent need to identify the most cost-effective policy to reduce the high burden of cryptococcal disease and death in patients with HIV/AIDS. A combined strategy (pre-emptive treatment of antigen-positive patients and prophylaxis of antigen-negative patients), as suggested by Parkes-Ratanshi and colleagues,1 might be promising in theory, but will probably be less cost effective and more operationally challenging than maximising the effectiveness of a single strategy of targeted screening and treatment of those most at risk.

关键词： POLIOVIRUS   PUBLIC health surveillance   ORAL poliomyelitis vaccine   SEROPREVALENCE  

摘要： The progress of the Global Polio Eradication Initiative is monitored by acute flaccid paralysis (AFP) surveillance supplemented with environmental surveillance in selected areas. To assess the sensitivity of environmental surveillance, stools from (re)vaccinated elderly persons with a low seroprevalence and from wastewater were concurrently collected and analyzed in the Netherlands over a prolonged period of time. A total number of 228 healthy individuals with different levels of immunity were challenged with monovalent oral polio vaccine serotype 1 or 3. Poliovirus concentrations were determined by the titration of fecal suspensions on poliovirus-sensitive L20B cells and of sewage concentrates by L20B monolayer plaque assay. Almost half of the individuals (45%) shed poliovirus on day 3 after challenge, which peaked (57%) on day 8 with an average poliovirus excretion of 1.3 x 10(5) TCID50 per g of feces and gradually decreased to less than 5% on day 42. The virus concentrations in sewage peaked on days 6 to 8 at approximately 100 PFU per liter, remained high until day 14, and subsequently decreased to less than 10 PFU per liter on day 29. The estimated poliovirus concentration in sewage approximated the measured initial virus excretion in feces, within 1 log(10) variation, resulting in a sensitivity of detection of 100 infected but mostly asymptomatic individuals in tens of thousands of individuals. An additional second peak observed in sewage may indicate secondary transmission missed by enterovirus or AFP surveillance in patients. This enables the detection of circulating poliovirus by environmental surveillance, supporting its feasibility as an early warning system.

关键词： Adolescents   Diphtheria   Immunization   Pertussis   Poliomyelitis   Seroprevalence  

摘要： Background: We assessed the seroepidemiology of pertussis, diphtheria and poliovirus antibodies in a cohort of highly immunized children, together with the burden of these diseases in Singapore. Methods: Hospital residual sera collected between August 2008 and July 2010 from 1200 children aged 1-17 years were tested for the prevalence of IgG antibodies against Bordetella pertussis, diphtheria toxoid, and all three poliovirus types by enzyme-linked immunosorbent assays. Results: We found an overall seroprevalence of 99.4% (95% CI 98.8-99.7%) for diphtheria, and 92.3% (95% CI 90.6-93.6%) for poliomyelitis, along with no indigenous cases of these diseases since 1993. However, the seroprevalence for pertussis was 60.8% (95% CI 58.0-63.5%) only. Among the subjects who had completed three doses of pertussis vaccination by the age of 2 years (n = 1092), the pertussis seroprevalence was 85.0% (95% CI 79.7-89.2%) in those who received the last vaccination within a year before the study, and it decreased to 75.0% (95% CI 64.5-83.2%) and 63.1% (95% CI 50.9-73.8%) in those who had the last vaccination 1 year and 2 years before the study, respectively. The seroprevalence remained at about 50% for those whose last pertussis vaccination was administered 4 years and longer before the study. Conclusions: The high seroprevalence for poliomyelitis and diphtheria confer solid herd immunity to eliminate these diseases in Singapore. In contrast, immunity against pertussis waned considerably over time, and routine boosters should be given to adolescents to ensure sustained immunity against pertussis. (C) 2012 Elsevier Ltd. All rights reserved.

关键词： Prophylactic vaccination   Poliovirus Vaccines   Oral Poliovirus Vaccine   excreta   Vaccines   Paralysis flaccid   Mucosal immunity   Confidence intervals   India   infection following vaccination   Poliovirus   Odds Ratio  

摘要： The eradication of wild-type polioviruses in areas with efficient fecal-oral transmission relies on intestinal mucosal immunity induced by oral poliovirus vaccine (OPV). Mucosal immunity is thought to wane over time but the rate of loss of protection has not been examined. We examined the degree and duration of intestinal mucosal immunity in India by measuring the prevalence of vaccine poliovirus in stool samples collected 4-28 days after a "challenge" dose of OPV among 47 574 children with acute flaccid paralysis reported during 2005-2009. Previous vaccination with OPV was protective against excretion of vaccine poliovirus after challenge, but the odds of excretion increased significantly with the time since the child was last exposed to an immunization activity (odds ratio, 1.39 [95% confidence interval .99-1.97], 2.04 [1.28-3.25], and 1.31 [1.00-1.70] comparing >= 6 months with 1 month ago for serotypes 1, 2, and 3, respectively). Vaccine administered during the high season for enterovirus infections (April-September) was significantly less likely to result in excretion, especially in northern states (odds ratio, 0.57 [95% confidence interval, .50-.65], 0.58 [.41-.81], and 0.48 [.40-.57] for serotypes 1, 2, and 3). Infection with OPV (vaccine "take") is highly seasonal in India and results in intestinal mucosal immunity that appears to wane significantly within a year of vaccination.

关键词： disease outbreaks   disease transmission, infectious   models, statistical   poliomyelitis   poliovirus   risk assessment   surveillance   vaccination  

摘要： The Global Polio Laboratory Network maintains active surveillance for circulating live polioviruses by obtaining and testing stool samples from patients with acute flaccid paralysis. However, most poliovirus infections occur with no symptoms, and questions remain about the probability of undetected wild poliovirus (WPV) circulation after the apparent interruption of WPV transmission in different populations. In the context of making decisions about the timing of oral poliovirus vaccine cessation following global eradication of WPV, policy-makers need an understanding of this probability as a function of time. Prior modeling of the probability of undetected circulation relied on relatively simple models and assumptions, which limits extrapolation to current conditions. In this analysis, the authors revisit the topic and highlight important considerations for policy-makers related to the impact of initial conditions and seasonality and emphasize the need to focus on appropriate characterization of conditions in the last likely reservoirs of the virus. The authors conclude that the probability of undetected WPV circulation may vary significantly for different poliovirus serotypes, places, and conditions, which suggests that achieving the same level of confidence about the true interruption of WPV transmission will require different periods of time for different situations.