关键词： Traveler vaccination   Health economics   Polio eradication   Outbreaks   International Health Regulations  

摘要： Recognizing that infectious agents readily cross international borders, the International Health Regulations Emergency Committee issues Temporary Recommendations (TRs) that include vaccination of travelers from countries affected by public health emergencies, including serotype 1 wild polioviruses (WPV1s). This analysis estimates the costs and benefits of TRs implemented by countries with reported WPV1 during 2014-2016 while accounting for numerous uncertainties. We estimate the TR costs based on programmatic data and prior economic analyses and TR benefits by simulating potential WPV1 outbreaks in the absence of the TRs using the rate and extent of WPV1 importation outbreaks per reported WPV1 case during 2004-2013 and the number of reported WPV1 cases that occurred in countries with active TRs. The benefits of TRs outweigh the costs in 77% of model iterations, resulting in expected incremental net economic benefits of $210 million. Inclusion of indirect costs increases the costs by 13%, the expected savings from prevented outbreaks by 4%, and the expected incremental net benefits by 3%. Despite the considerable costs of implementing TRs, this study provides health and economic justification for these investments in the context of managing a disease in advanced stages of its global eradication. (C) 2017 The Authors. Published by Elsevier Ltd.

关键词： 二价脊髓灰质炎减毒活疫苗   损耗系数   调查分析  

摘要： 目的通过分析北京市丰台区二价脊髓灰质炎减毒活疫苗(bOPV)损耗系数,了解其损耗程度,为科学制定疫苗使用计划,规范疫苗管理提供依据。方法根据统一设计的《丰台区二价脊灰疫苗接种情况日报表》,收集丰台区所有接种单位2016年5月9-27日bOPV接种情况和使用情况。结果丰台区共67家儿童预防接种门诊开展b OPV接种。5月9-27日,b OPV损耗系数为2.10。村属社区站/部队属门诊(2.27)、行业门诊(2.22)和卫生和计划生育委员会直属门诊(1.98)损耗系数之间的差异有统计学意义。达标门诊(2.24)与规范化门诊(2.04)损耗系数之间差异有统计学意义。日均接种量<10人次损耗系数(2.39)高于10~20人次(2.12)和>20人次损耗系数(1.75),差异有统计学意义。损耗系数在每人一个滴管与无污染的情况下不更换滴管之间差异有统计学意义。损耗系数在冷藏保存30 min废弃和当日持续使用之间差异有统计学意义。结论丰台区bOPV损耗率高。为降低损耗,各接种单位应规范使用滴管和剩余疫苗,安排集中接种,减少疫苗开启数量。

关键词： 脊髓灰质炎疫苗   血小板减少性紫癜   药品不良反应  

摘要： 1病例资料 患儿，男，4个月16天，无家族遗传病史和变态反应史，因正常预防接种，于2016年6月1日上午10：45在我院少先社区卫生服务中心预防接种口服Ⅰ型Ⅲ型脊髓灰质炎减毒活疫苗（人二倍体细胞）（北京天坛生物制品股份有限公司，批号：201605073）0．1ml。

关键词： 开水送服   脊髓灰质炎病毒   止咳糖浆类   小儿麻痹症糖丸   咽部黏膜   化学反应   免疫作用   复方制剂  

摘要： 用白开水送服药物是个常识，但有人喜欢用热水服药。殊不知，部分药品遇热后会发生物理或化学反应，进而影响疗效。活疫苗如小儿麻痹症糖丸，是用脊髓灰质炎病毒经特殊处理后制成的一种活疫苗，外裹糖衣，遇热后糖衣溶化，其内病毒将被热水“烫死”而失活，即使吸收后也不能产生抗体，起不了免疫作用。止咳糖浆类此类药为复方制剂，即将止咳药溶解在糖浆中，质地较黏稠。糖浆覆盖在发炎的咽部黏膜表面，形成一层保护性“薄膜”，能减轻黏膜炎症反应，阻断刺激而缓解咳嗽，若用热水冲服，会稀释糖浆，降低黏稠度，使黏附在黏膜上的糖浆减少，不能形成保护性“薄膜”，也就不能减轻刺激，缓解咳嗽，从而使止咳糖浆药效降低。

关键词： POLIOMYELITIS vaccine   IMMUNIZATION   SEROCONVERSION   PHARMACEUTICAL industry   INFECTIOUS disease transmission  

摘要： [...]selecting and then operationally optimising an IPV strategy for a specific context will be challenged by a number of logistical barriers (eg, scalability and costs of vaccine production and storage, availability of trained vaccinators, procurement of immunisation devices) and immunological considerations (eg, scheduling to mitigate interference by maternal antibodies, inducing seroprotection of an appropriate magnitude and duration).8 In preparing the global public health system to withstand shortages in IPV supply moving forward, it is also important to give due consideration to a limitation of all IPVs-namely, that inactivated vaccines appear to have a limited capacity to induce intestinal immunity against polio. Garo/Phanie/Science Photo Library We declare no competing interests. 1 WHO, Weekly epidemiological record, 2 December 2016, 2016, World Health Organization, Geneva, 561-584 2 L Rivera, RS Pedersen, L Peña, Immunogenicity and safety of three aluminium hydroxide adjuvanted vaccines with reduced doses of inactivated polio vaccine (IPV-Al) compared with standard IPV in young infants in the Dominican Republic: a phase 2, non-inferiority, observer-blinded, randomised, and controlled dose investigation trial, Lancet Infect Dis, 2017, published online April 25 3 S Resik, A Tejeda, PM Lago, Randomized controlled clinical trial of fractional doses of inactivated poliovirus vaccine administered intradermally by needle-free device...

关键词： Poliomyelitis   Manufacture   GAPIII   Eradication   Vaccines   Immunoglobulins   Assays  

摘要： When poliomyelitis is totally eradicated from the natural world containment will be vital to prevent its re-emergence. The matter has become pressing as type 2 component of oral polio vaccine was completely withdrawn by May 2016 as wild ty[e 2 was declared eradicated. Work on polioviruses must be contained in accordance with GAPIII (the third version of the Global Action Plan of WHO). Some activities will be essential for years after eradication. Vaccine production and control, surveillance and supportive applied and academic research must all continue. Most laboratories do not currently comply with GAPIII and could not do so in the short term without disruption of essential activities including vaccine supply. The development and use of safer strains is raised in GAPIII and the meeting considered the strains available and the uses to which they could be put to facilitate compliance with the aims of GAPIII. (C) 2017 Published by Elsevier Ltd on behalf of International Alliance for Biological Standardization.

关键词： POLIOMYELITIS vaccine   ALUMINUM hydroxide   INFANTS   POLIOVIRUS  

摘要： Background Cost and supply constraints are key challenges in the use of inactivated polio vaccine (IPV). Dose reduction through adsorption to aluminium hydroxide (Al) is a promising option, and establishing its effectiveness in the target population is a crucial milestone in developing IPV-Al. The aim of this clinical trial was to show the noninferiority of three IPV-Al vaccines to standard IPV. Methods In this phase 2, non-inferiority, observer-blinded, randomised, controlled, single-centre trial in the Dominican Republic, healthy infants aged 6 weeks, not previously polio vaccinated, were allocated after computer-generated randomisation by block-size of four, to receive one of four IPV formulations (three-times reduced dose [1/3 IPV-Al], five-times reduced dose [1/5 IPV-Al], ten-times reduced dose [1/10 IPV-Al], or IPV) intramuscularly in the thigh at 6, 10, and 14 weeks of age. The primary outcome was seroconversion for poliovirus types 1, 2, and 3 with titres more than or equal to four-fold higher than the estimated maternal antibody titre and more than or equal to 8 after three vaccinations. Non-inferiority was concluded if the lower two-sided 90% CI of the seroconversion rate difference between IPV-Al and IPV was greater than -10%. The safety analyses were based on the safety analysis set (randomly assigned participants who received at least one trial vaccination) and the immunogenicity analyses were based on the per-protocol population. This study is registered with *** registration, number NCT02347423. Findings Between Feb 2, 2015, and Sept 26, 2015, we recruited 824 infants. The per-protocol population included 820 infants;205 were randomly assigned to receive 1/3 IPV-Al, 205 to receive 1/5 IPV-Al, 204 to receive 1/10 IPV-Al, and 206 to receive IPV. The proportion of individuals meeting the primary endpoint of seroconversion for poliovirus types 1, 2, and 3 was already high for the three IPV-Al vaccines after two vaccinations, but was higher

关键词： oral poliovirus infection   poliomyelitis   animal model   macaques  

摘要： Despite a great deal of prior research, the early pathogenic events in natural oral poliovirus infection remain poorly defined. To establish a model for study, we infected 39 macaques by feeding them single high doses of the virulent Mahoney strain of wild type 1 poliovirus. Doses ranging from 107 to 109 50% tissue culture infective doses (TCID50) consistently infected all the animals, and many monkeys receiving 108 or 109 TCID50 developed paralysis. There was no apparent difference in the susceptibilities of the three macaque species (rhesus, cynomolgus, and bonnet) used. Virus excretion in stool and nasopharynges was consistently observed, with occasional viremia, and virus was isolated from tonsils, gut mucosa, and draining lymph nodes. Viral replication proteins were detected in both epithelial and lymphoid cell populations expressing CD155 in the tonsil and intestine, as well as in spinal cord neurons. Necrosis was observed in these three cell types, and viral replication in the tonsil/ gut was associated with histopathologic destruction and inflammation. The sustained response of neutralizing antibody correlated temporally with resolution of viremia and termination of virus shedding in oropharynges and feces. For the first time, this model demonstrates that early in the infectious process, poliovirus replication occurs in both epithelial cells (explaining virus shedding in the gastrointestinal tract) and lymphoid/monocytic cells in tonsils and Peyer's patches (explaining viremia), extending previous studies of poliovirus pathogenesis in humans. Because the model recapitulates human poliovirus infection and poliomyelitis, it can be used to study polio pathogenesis and to assess the efficacy of candidate antiviral drugs and new vaccines. IMPORTANCE Early pathogenic events of poliovirus infection remain largely undefined, and there is a lack of animal models mimicking natural oral human infection leading to paralytic poliomyelitis. All 39 macaques fed with single

关键词： Disease   disease prevention   vaccines  

摘要： Vaccine vial monitor (VVM) is now commonly used for vaccines that are included in the National Immunization Schedule in India. It helps to indicate the viability of the vaccine and of the proper functioning of the cold chain. This is useful as it prevents health personnel from administering damaged vaccine. Studies have shown a lack of awareness of health workers regarding the use and interpretation of a VVM. The current study, undertaken among the caregivers of children who were immunized, showed that this lack of information about the VVM also exists among the caregivers. This deficiency in knowledge, both in the health workers and the caregivers, can affect the health of the child and needs urgent attention.

关键词： POLIOVIRUS   POLIO -- Prevention   ORAL vaccines   VACCINES   STANDARDS   POLIO vaccination   WORLD Health Assembly  

摘要： The Global Polio Eradication Initiative (GPEI) continues to make progress toward the eradication target. Only one of the three serotypes, wild poliovirus (WPV) type 1 (WPV1), is still circulating, and the numbers of cases and countries with endemic transmission are at record lows. With the certification of wild poliovirus type 2 (WPV2) eradication in 2015 and the global replacement of trivalent oral poliovirus vaccine (tOPV) containing Sabin poliovirus types 1, 2, and 3 with bivalent OPV containing only Sabin poliovirus types 1 and 3 during April-May 2016, poliovirus type 2 (PV2) is now an eradicated pathogen. However, in eight countries (Cameroon, Chad, Democratic Republic of Congo, Mozambique, Niger, Nigeria, Pakistan, and Syria), monovalent type 2 OPV (mOPV2) was authorized for large-scale outbreak control after tOPV withdrawal (1). Poliovirus containment, an evolving area of work that affects every country, aims to ensure that all PV2 specimens are safely contained to minimize the risk for reintroducing the virus into communities. This report summarizes the current status of poliovirus containment and progress since the last report (2), and outlines remaining challenges. Within 30 countries, 86 facilities have been designated by the relevant national authorities (usually the Ministry of Health) to become poliovirus-essential facilities for the continued storage or handling of PV2 materials; each country is responsible for ensuring that these facilities meet all biorisk management requirements.