Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Poli...
Paul, Yash; Priya
In 1988, the World Health Assembly passed resolution WHA 41.28, which committed the World Health Organization (WHO) to the global eradication of poliomyelitis by the year 2000. In spite of the combined efforts by UNICEF, National Polio Surveillance Project (NPSP), Indian Academy of Pediatrics (IAP) and Rotary International, Polio Free India is still a distant dream. Though oral polio vaccine has succeeded in polio eradication from many countries but there is high incidence of vaccine failure in India. Oral polio vaccine (OPV) has failed to provide full protection to many children who have developed paralytic polio even after taking 10 or more doses of OPV. In some children, OPV has caused paralysis-vaccine associated paralytic polio (VAPP). Number of children developing polio due to vaccine is high and on increase. Reasons for this could be that even immunocompromised children are being administered OPVbecause IPV is not available. Vaccine failure has exaggerated the problem of VAPP. No efforts have been made to find the causes for high incidence of vaccine failure and VAPP. PMID:15532129
Samad EJ Golzari
Full Text Available Launched in 1988, the Global Polio Eradication Initiative (GPEI never seemed as close to its sole target as by 2012; polio cases decreased by over 99% thanks to the global efforts restricting endemic areas into three countries, i.e. Afghanistan, Pakistan and Nigeria. However, the enchantment did not last long as WPV1 and confirmed new polio cases were reported in Syria (1. Re-emergence of the virus, related to the WPV1 still endemic in Pakistan, had already been identified in some of the Middle Eastern countries and caused an outbreak in China (2. In previous experiences, for instance in Egypt, international outbreak response guidelines issued by the World Health Assembly (WHA in Resolution WHA59 were implemented comprehensively and supplementary immunization activities (SIAs were conducted carefully. Such global measures should immediately be taken in order to halt the risk of transmission and spread of WPV as a public health threat (2.Thanks to the continuing support of WHO and Iranian health ministry, Iran is the only country which has achieved the goal of polio eradication yet neighbouring two of the three polio endemic countries. However, the on-going challenge has become even more daunting as the threat has the potential of exacerbation due to the imported cases or carriers. Although Iran has been successful in eradication of some infectious diseases, imported cases contribute immensely to the failure in realizing the eradication aim for some other infectious diseases (3,4. Bordering Pakistan (909 km (565 mi and Afghanistan (936 km (582 mi to the east is one of the few major obstacles to be perceived as important. In some parts of Pakistan, immunization activities were suspended since June 2012 (2. It is pivotal to the polio eradication goals that immunization is restarted in the halted areas and reinforced in neighboring high-risk areas in order to prevent further spread of this outbreak.Surveillance for cases of acute flaccid
Pradeep Sukla; Karun Dev Sharma; Manish Rana; Syed Hasan Nawaz Zaidi
Abstract: Polio eradication continues to be a priority in the South-East Asia Region. For developing countries, considering that the practice of open defecation and fecal contamination of drinking water easily precipitates virus transmissions, the eradication of polio called for rounds after rounds of campaign. In the districts of western Uttar Pradesh (UP), in India, which continues to be polio endemic, key challenge is the low levels of sanitation and personal hygiene. The residents of poli...
Between 1988 and 2004, the Global Polio Eradication Initiative grew to become the largest international health effort in history, operating in every country of the world. An estimated 10 million health workers and volunteers have been engaged in implementing the necessary polio supplementary immunization activities (SIAs) on a recurring basis, and at least 35,000 well-trained workers have been conducting polio surveillance. A combination of task simplification, technological innovations and a...
Kanwal, Sumaira; Hussain, Abrar; Mannan, Shazia; Perveen, Shazia
Polio is one out of 200 infections results to lasting paralysis, usually in the legs. The year 2014 has been the saddest year for the Pakistan when the World was about to eliminate Polio from all over the World. In year 1994 Pakistan took the initiative to eliminate Polio from the country. The efforts were going well until 2005, when Pakistan was on the wedge to overcome the Disease. The hopes were high that soon Pakistan will become a polio-virus-free country, but the drone strikes in FATA and the rise of different militant groups as a reaction of the drone attacks in FATA made it difficult for the health workers to continue their vaccination campaigns in these areas. However various factors ruined the efforts made to eradicate Polio. In Pakistan, polio is widespread to three sections. These are Karachi, Quetta block (Quetta, Pishin and Killah Abdullah district) and FATA and Peshawar district. Numerous things are accountable for polio flourishing in these regions. These comprise near to the ground socioeconomic rank of the families, not having the knowledge concerning hazard caused by polio and disinformation by limited significant people concerning how polio vaccines fabricate damage. In 2014, only 3 countries in the world remain polio-endemic: Nigeria, Pakistan and Afghanistan. From year 2012-2014 the number of registered Polio cases is on rise contrary to rest of the other two Polio-endemic countries. In spite of the extensive work done by Polio workers the number of Polio cases has broken the 16 year record. The situation is getting worse because it can also be threatening to the rest of the World. PMID:26968287
Full Text Available Abstract: Polio eradication continues to be a priority in the South-East Asia Region. For developing countries, considering that the practice of open defecation and fecal contamination of drinking water easily precipitates virus transmissions, the eradication of polio called for rounds after rounds of campaign. In the districts of western Uttar Pradesh (UP, in India, which continues to be polio endemic, key challenge is the low levels of sanitation and personal hygiene. The residents of polio endemic areas are now reluctant to frequent pulse polio immunization rounds and are using these rounds to raise their voice against chronic apathy to providing the basic amenities such as adequate sanitation facilities. Newer initiatives such as Urban Sanitation and Hygiene Action (USHA Project, in western UP and “107 block” campaign launched in UP and Bihar aiming to improve sanitation, water quality and routine immunizations in the high risk polio endemic administrative blocks have the potential to significantly strengthen eradication efforts, especially in high risk areas for wild poliovirus transmission in North India.
Full Text Available In 1988, the World Health Organization (WHO resolved to eradicate poliomyelitis globally. Since then, the initiative has reported dramatic progress in decreasing the incidence of poliomyelitis and limiting the geographical extent of transmission. 2013 is recorded as the second consecutive year not reporting wild poliovirus (WPV from India. If the country can retain this position for one more year India will be declared as polio eradicated. What should be the future vaccination strategies? We searched and reviewed the full text of the available published literature on polio eradication via PubMed and examined Internet sources and websites of major international health agencies. The oral polio vaccine (OPV has been the main tool in the polio eradication program. Once WPV transmission is interrupted, the poliomyelitis will be caused only by OPV. India could expect 1 vaccine-associated paralytic polio per 4.2-4.6 million doses of OPV. Considering the threat of vaccine-derived viruses to polio eradication, WHO urged to develop a strategy to safely discontinue OPV after certification. The ultimate aim is to stop OPV safely and effectively, and eventually substitute with inactivated polio vaccine (IPV. The argument against the use of IPV is its cost. From India, field based data were available on the efficacy of IPV, which was better than OPV. IPV given intradermally resulted in seroconversion rates similar to full-dose intramuscular vaccine. The incremental cost of adopting IPV to replace OPV is relatively low, about US $1 per child per year, and most countries should be able to afford this additional cost.
Waqas Muhammad; Shad Mushtaq Ahmad; Siddiqui Arif Mahmood; Akram Javed; Ullah Mohsin Zia Sana; Majrooh Muhammad Ashraf; Mushtaq Muhammad Umair; Abdullah Hussain Muhammad; Ahmad Waqar; Shahid Ubeera; Khurshid Usman
Abstract Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. The aim of the study was to establish valid and reliable estimate for: routine oral polio vaccine (OPV) coverage, logistics management and the quality of monitoring systems in health facilities, NIDs OPV coverage, the qu...
Aylward R. Bruce
Full Text Available Between 1988 and 2004, the Global Polio Eradication Initiative grew to become the largest international health effort in history, operating in every country of the world. An estimated 10 million health workers and volunteers have been engaged in implementing the necessary polio supplementary immunization activities (SIAs on a recurring basis, and at least 35 000 well-trained workers have been conducting polio surveillance. A combination of task simplification, technological innovations and adaptation of strategies to fit local circumstances has allowed the Initiative to use a wide range of workers and volunteers, from both inside and outside the health sector, to deliver the polio vaccine during SIAs and to monitor progress in virtually every area of every country, regardless of the health infrastructure, conflict, geography and/or culture. This approach has required sustained political advocacy and mass community mobilization, together with strong management and supervisory processes. Non-monetary incentives, reimbursement of costs and substantial technical assistance have been essential. Given the unique features of eradication programmes in general, and polio eradication in particular, the implications of this approach for the broader health system must continue to be studied if it is to be replicated for the delivery and monitoring of other interventions.
Orenstein, Walter A
The American Academy of Pediatrics strongly supports the Polio Eradication and Endgame Strategic Plan of the Global Polio Eradication Initiative. This plan was endorsed in November 2012 by the Strategic Advisory Group of Experts on Immunization of the World Health Organization and published by the World Health Organization in April 2013. As a key component of the plan, it will be necessary to stop oral polio vaccine (OPV) use globally to achieve eradication, because the attenuated viruses in the vaccine rarely can cause polio. The plan includes procedures for elimination of vaccine-associated paralytic polio and circulating vaccine-derived polioviruses (cVDPVs). cVDPVs can proliferate when vaccine viruses are transmitted among susceptible people, resulting in mutations conferring both the neurovirulence and transmissibility characteristics of wild polioviruses. Although there are 3 different types of wild poliovirus strains, the polio eradication effort has already resulted in the global elimination of type 2 poliovirus for more than a decade. Type 3 poliovirus may be eliminated because the wild type 3 poliovirus was last detected in 2012. Thus, of the 3 wild types, only wild type 1 poliovirus is still known to be circulating and causing disease. OPV remains the key vaccine for eradicating wild polioviruses in polio-infected countries because it induces high levels of systemic immunity to prevent paralysis and intestinal immunity to reduce transmission. However, OPV is a rare cause of paralysis and the substantial decrease in wild-type disease has resulted in estimates that the vaccine is causing more polio-related paralysis annually in recent years than the wild virus. The new endgame strategic plan calls for stepwise removal of the type 2 poliovirus component from trivalent oral vaccines, because type 2 wild poliovirus appears to have been eradicated (since 1999) and yet is the main cause of cVDPV outbreaks and approximately 40% of vaccine-associated paralytic
Yvonne E Thomassen
Full Text Available Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV is scheduled. Moreover, a manufacturing process, using attenuated virus strains instead of wild-type polioviruses, is demanded to enhance worldwide production of IPV, especially in low- and middle income countries. Therefore, development of an IPV from attenuated (Sabin poliovirus strains (sIPV was pursued. Starting from the current IPV production process based on wild type Salk strains, adaptations, such as lower virus cultivation temperature, were implemented. sIPV was produced at industrial scale followed by formulation of both plain and aluminium adjuvanted sIPV. The final products met the quality criteria, were immunogenic in rats, showed no toxicity in rabbits and could be released for testing in the clinic. Concluding, sIPV was developed to manufacturing scale. The technology can be transferred worldwide to support post polio-eradication biosafety goals.
Thomassen, Yvonne E; van 't Oever, Aart G; van Oijen, Monique G C T; Wijffels, René H; van der Pol, Leo A; Bakker, Wilfried A M
Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV) is scheduled. Moreover, a manufacturing process, using attenuated virus strains instead of wild-type polioviruses, is demanded to enhance worldwide production of IPV, especially in low- and middle income countries. Therefore, development of an IPV from attenuated (Sabin) poliovirus strains (sIPV) was pursued. Starting from the current IPV production process based on wild type Salk strains, adaptations, such as lower virus cultivation temperature, were implemented. sIPV was produced at industrial scale followed by formulation of both plain and aluminium adjuvanted sIPV. The final products met the quality criteria, were immunogenic in rats, showed no toxicity in rabbits and could be released for testing in the clinic. Concluding, sIPV was developed to manufacturing scale. The technology can be transferred worldwide to support post polio-eradication biosafety goals. PMID:24349497
Morales, Michelle; Tangermann, Rudolf H; Wassilak, Steven G F
In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Wild poliovirus (WPV) transmission persists in only two countries (Afghanistan and Pakistan) after the removal of Nigeria from the list of countries with endemic polio in September 2015.* Indigenous WPV type 2 has not been detected since 1999 and was declared eradicated by the Global Commission for the Certification of Poliomyelitis Eradication in September 2015.(†) Since November 2012, when the last case of WPV type 3 was detected in Nigeria, WPV type 1 has been the sole circulating type of WPV (1). This report summarizes global progress toward polio eradication during 2015-2016 and updates previous reports (2). In 2015, 74 WPV cases were reported in two countries (Afghanistan and Pakistan), a decrease of 79% from the 359 WPV cases reported in 2014 in nine countries; 12 WPV cases have been reported in 2016 (to date), compared with 23 during the same period in 2015 (3). Paralytic polio caused by circulating vaccine-derived poliovirus (cVDPV) remains a risk in areas with low oral poliovirus vaccine (OPV) coverage. Seven countries, including Pakistan, reported 32 cVDPV cases in 2015 (4). In four of these countries, ≥6 months have passed since the most recent case or isolate. One country (Laos) with VDPV transmission in 2015 has reported three additional cVDPV cases in 2016 to date. Encouraging progress toward polio eradication has been made over the last year; however, interruption of WPV transmission will require focus on reaching and vaccinating every missed child through high quality supplementary immunization activities (SIAs) and cross-border coordination between Afghanistan and Pakistan (5,6). PMID:27171208
Porter, Kimberly A; Diop, Ousmane M; Burns, Cara C; Tangermann, Rudolph H; Wassilak, Steven G F
Global efforts to eradicate polio began in 1988 and have been successful in all but two of the six World Health Organization (WHO) regions. Within these two regions (African and Eastern Mediterranean), three countries (Afghanistan, Nigeria, and Pakistan) have never interrupted transmission of wild poliovirus (WPV). Outbreaks following importation of WPV from these countries occurred in the Horn of Africa, Central Africa, and in the Middle East during 2013-2014. The primary means of tracking polio is surveillance for cases of acute flaccid paralysis (AFP), the main symptom of polio, followed by testing of AFP patients' stool specimens for both WPV and vaccine-derived poliovirus (VDPV) in WHO-accredited laboratories within the Global Polio Laboratory Network (GPLN). This is supplemented with environmental surveillance (testing sewage for WPV and VDPV) (4). Both types of surveillance use genomic sequencing for characterization of poliovirus isolates to map poliovirus transmission and for identifying gaps in AFP surveillance by measuring genetic divergence between isolates. This report presents 2013 and 2014 poliovirus surveillance data, focusing primarily on the two WHO regions with endemic WPV transmission, and the 29 countries (African Region = 23; Eastern Mediterranean Region = six) with at least one case of WPV or circulating VDPV (cVDPV) reported during 2010-2014. In 2013, 20 of these 23 African region countries met both primary surveillance quality indicators; in 2014, the number decreased to 15. In 2013, five of the six Eastern Mediterranean Region countries met the primary indicators, and in 2014, all six did. To complete and certify polio eradication, surveillance gaps must be identified and surveillance activities, including supervision, monitoring, and specimen collection, further strengthened. PMID:25905895
Full Text Available Abstract Background This study is based on EPI (Expanded Program on Immunization immunization surveys and surveillance of polio, its challenges in immunization and the way forward to overcome these challenges. Methods Several Government documents, survey reports and unpublished program documents were studied and online search was made to find information on EPI Pakistan. SPSS 16 and Microsoft Excel 2007 were used for the statistical analysis. Results Immunization against polio is higher in urban areas as compared to rural areas. Marked variation in vaccination has been observed in different provinces of Pakistan in the last decade. Secondly 10-20% of the children who have received their first dose of trivalent polio vaccine were deprived of their 2nd and 3rd dose because of poor performance of EPI and Lack of information about immunization. Conclusion In spite of numerous successes, such as the addition of new vaccines and raising immunization to over 100% in some areas, EPI is still struggling to reach its polio eradication goals. Inadequate service delivery, lack of information about immunization and limited number of vaccinators were found to be the key reason for poor performance of immunization and for large number of cases reported each year due to the deficiency of second and third booster dose.
Blake, Isobel M; Chenoweth, Paul; Okayasu, Hiro; Donnelly, Christl A; Aylward, R Bruce; Grassly, Nicholas C
As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities. PMID:26890053
Bradley G Wagner
Full Text Available A priority of the Global Polio Eradication Initiative (GPEI 2013-2018 strategic plan is to evaluate the potential impact on polio eradication resulting from expanding one or more Supplementary Immunization Activities (SIAs to children beyond age five-years in polio endemic countries. It has been hypothesized that such expanded age group (EAG campaigns could accelerate polio eradication by eliminating immunity gaps in older children that may have resulted from past periods of low vaccination coverage. Using an individual-based mathematical model, we quantified the impact of EAG campaigns in terms of probability of elimination, reduction in polio transmission and age stratified immunity levels. The model was specifically calibrated to seroprevalence data from a polio-endemic region: Zaria, Nigeria. We compared the impact of EAG campaigns, which depend only on age, to more targeted interventions which focus on reaching missed populations. We found that EAG campaigns would not significantly improve prospects for polio eradication; the probability of elimination increased by 8% (from 24% at baseline to 32% when expanding three annual SIAs to 5-14 year old children and by 18% when expanding all six annual SIAs. In contrast, expanding only two of the annual SIAs to target hard-to-reach populations at modest vaccination coverage-representing less than one tenth of additional vaccinations required for the six SIA EAG scenario-increased the probability of elimination by 55%. Implementation of EAG campaigns in polio endemic regions would not improve prospects for eradication. In endemic areas, vaccination campaigns which do not target missed populations will not benefit polio eradication efforts.
Rutter, Paul D; Donaldson, Liam J
The Global Polio Eradication Initiative (GPEI) established its Independent Monitoring Board (IMB) in 2010 to monitor and guide its progress toward stopping polio transmission globally. The concept of an IMB is innovative, with no clear analogue in the history of the GPEI or in any other global health program. The IMB meets with senior program officials every 3-6 months. Its reports provide analysis and recommendations about individual polio-affected countries. The IMB also examines issues affecting the global program as a whole. Its areas of focus have included escalating the level of priority afforded to polio eradication (particularly by recommending a World Health Assembly resolution to declare polio eradication a programmatic emergency, which was enacted in May 2012), placing greater emphasis on people factors in the delivery of the program, encouraging innovation, strengthening focus on the small number of so-called sanctuaries where polio persists, and continuous quality improvement to reach every missed child with vaccination. The IMB's true independence from the agencies and countries delivering the program has enabled it to raise difficult issues that others cannot. Other global health programs might benefit from establishing similar independent monitoring mechanisms. PMID:25316831
Craig, Kehinde TemilolaOluwa; Verma, Harish; Iliyasu, Zubairu; Mkanda, Pascal; Touray, Kebba; Johnson, Ticha; Walla, Abdullahi; Banda, Richard; Tegegne, Sisay G.; Yehualashet, Yared G.; Abba, Bashir; Ahmad-Shehu, Amina; Takane, Marina; Sutter, Roland W.; Nsubuga, Peter; Muhammad, Ado J. G.; Vaz, Rui G.
Background. Nigeria was one of 3 polio-endemic countries before it was de-listed in September 2015 by the World Health Organization, following interruption of transmission of the poliovirus. During 2011–2014, Nigeria conducted serial polio seroprevalence surveys (SPS) in Kano Metropolitan Area, comprising 8 local government areas (LGAs) in Kano that is considered very high risk (VHR) for polio, to monitor performance of the polio eradication program and guide the program in the adoption of innovative strategies. Methods. Study subjects who resided in any of the 8 local government areas of Kano Metropolitan Area and satisfied age criteria were recruited from patients at Murtala Mohammed Specialist Hospital (Kano) for 3 seroprevalence surveys. The same methods were used to conduct each survey. Results. The 2011 study showed seroprevalence values of 81%, 75%, and 73% for poliovirus types 1, 2, and 3, respectively, among infants aged 6–9 months age. Among children aged 36–47 months, seroprevalence values were greater (91%, 87%, and 85% for poliovirus types 1, 2, and 3, respectively). In 2013, the results showed that the seroprevalence was unexpectedly low among infants aged 6–9 months, remained high among children aged 36–47 months, and increased minimally among children aged 5–9 years and those aged 10–14 years. The baseline seroprevalence among infants aged 6–9 months in 2014 was better than that in 2013. Conclusions. The results from the polio seroprevalence surveys conducted in Kano Metropolitan Area in 2011, 2013, and 2014 served to assess the trends in immunity and program performance, as well as to guide the program, leading to various interventions being implemented with good effect, as evidenced by the reduction of poliovirus circulation in Kano. PMID:26908720
Embedded in the study of interactions between global health initiatives and country health systems, this paper analyses the impact of the Polio Eradication Initiative’s (PEI) on the routine immunisation programme in Uttar Pradesh, India. Applying the policy implementation framework and a mixed-method research design to analyse the PEI’s policy to “strengthen routine immunisation,” qualitative analysis demonstrates ambiguous translations of programme policies into operational guidelines. Tr...
Previsani, Nicoletta; Tangermann, Rudolph H; Tallis, Graham; Jafari, Hamid S
In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Among the three wild poliovirus (WPV) types (type 1, type 2, and type 3), WPV type 2 (WPV2) has been eliminated in the wild since 1999, and WPV type 3 (WPV3) has not been reported since 2012. In 2015, only Afghanistan and Pakistan have reported WPV transmission. On May 25, 2015, all WHO Member States endorsed World Health Assembly resolution 68.3 on full implementation of the Polio Eradication and Endgame Strategic Plan 2013-2018 (the Endgame Plan), and with it, the third Global Action Plan to minimize poliovirus facility-associated risk (GAPIII). All WHO Member States have committed to implementing appropriate containment of WPV2 in essential laboratory and vaccine production facilities* by the end of 2015 and of type 2 oral poliovirus vaccine (OPV2) within 3 months of global withdrawal of OPV2, which is planned for April 2016. This report summarizes critical steps for essential laboratory and vaccine production facilities that intend to retain materials confirmed to contain or potentially containing type-specific WPV, vaccine-derived poliovirus (VDPV), or OPV/Sabin viruses, and steps for nonessential facilities† that process specimens that contain or might contain polioviruses. National authorities will need to certify that the essential facilities they host meet the containment requirements described in GAPIII. After certification of WPV eradication, the use of all OPV will cease; final containment of all polioviruses after polio eradication and OPV cessation will minimize the risk for reintroduction of poliovirus into a polio-free world. PMID:26313474
Rashid S Hussain
Full Text Available Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity.A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977.Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India.This study is limited by the manual coding of the
Full Text Available Abstract Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. The aim of the study was to establish valid and reliable estimate for: routine oral polio vaccine (OPV coverage, logistics management and the quality of monitoring systems in health facilities, NIDs OPV coverage, the quality of NIDs service delivery in static centers and mobile teams, and to ultimately provide scientific evidence for tailoring future interventions. Methods A cross-sectional study using lot quality assessment sampling was conducted in the District Nankana Sahib of Pakistan's Punjab province. Twenty primary health centers and their catchment areas were selected randomly as 'lots'. The study involved the evaluation of 1080 children aged 12-23 months for routine OPV coverage, 20 health centers for logistics management and quality of monitoring systems, 420 households for NIDs OPV coverage, 20 static centers and 20 mobile teams for quality of NIDs service delivery. Study instruments were designed according to WHO guidelines. Results Five out of twenty lots were rejected for unacceptably low routine immunization coverage. The validity of coverage was questionable to extent that all lots were rejected. Among the 54.1% who were able to present immunization cards, only 74.0% had valid immunization. Routine coverage was significantly associated with card availability and socioeconomic factors. The main reasons for routine immunization failure were absence of a vaccinator and unawareness of need for immunization. Health workers (96.9% were a major source of information. All of the 20 lots were rejected for poor compliance in logistics management and quality of monitoring systems. Mean compliance score and compliance percentage for logistics management were 5.4 ± 2
Yehualashet, Yared G.; Horton, Janet; Mkanda, Pascal; Vaz, Rui G.; Afolabi, Oluwole; Gashu, Sisay G.; Banda, Richard; O'Malley, Helena; Nsubuga, Peter
Country Office team produced and submitted 102 grant reports and facilitated >20 joint project assessment exercises. Discussion. The polio program in Nigeria has achieved unprecedented gains, despite prevailing security and operational challenges, with no case of wild poliovirus infection since July 2014. Through rigorous, transparent, and accountable funds management practice, the WHO country office in Nigeria gained donors' confidence. The locally mobilized funds have made a remarkable contribution to the successful implementation of the strategies set out in the polio emergency plan. We face the challenges of a narrow donor-base, donor fatigue, and competition among other emerging agencies joining the polio eradication initiative efforts over the last few years. We actively engage the national authorities and partners for effective coordination of the polio eradication initiative program and harmonization of resources, using the existing platforms at national, state, and local levels. We recommend strengthening the local resource mobilization machinery and broadening the donor base, to support the polio endgame strategy. Such efforts should also be adopted to support routine immunization, introduction of new vaccines, and strengthening of health systems in the country as part of polio legacy planning. PMID:26912380
Thompson, Kimberly M; Duintjer Tebbens, Radboud J
Achieving the goal of a world free of poliomyelitis still requires significant effort. Although polio immunization represents a mature area, the polio endgame will require new tools and strategies, particularly as national and global health leaders coordinate the cessation of all three serotypes of oral poliovirus vaccine and increasingly adopt inactivated poliovirus vaccine (IPV). Poliovirus epidemiology and the global options for managing polioviruses continue to evolve, along with our understanding and appreciation of the resources needed and the risks that require management. Based on insights from modeling, we offer some perspective on the current status of plans and opportunities to achieve and maintain a world free of wild polioviruses and to successfully implement oral poliovirus vaccine cessation. IPV costs and potential wastage will represent an important consideration for national policy makers. Innovations may reduce future IPV costs, but the world urgently needs lower-cost IPV options. PMID:24308581
Knowlson, Sarah; Burlison, John; Giles, Elaine; Fox, Helen; Macadam, Andrew J; Minor, Philip D
Poliomyelitis has nearly been eradicated through the efforts of the World Health Organization's Global Eradication Initiative raising questions on containment of the virus after it has been eliminated in the wild. Most manufacture of inactivated polio vaccines currently requires the growth of large amounts of highly virulent poliovirus, and release from a production facility after eradication could be disastrous; WHO have therefore recommended the use of the attenuated Sabin strains for production as a safer option although it is recognised that they can revert to a transmissible paralytic form. We have exploited the understanding of the molecular virology of the Sabin vaccine strains to design viruses that are extremely genetically stable and hyperattenuated. The viruses are based on the type 3 Sabin vaccine strain and have been genetically modified in domain V of the 5' non-coding region by changing base pairs to produce a cassette into which capsid regions of other serotypes have been introduced. The viruses give satisfactory yields of antigenically and immunogenically correct viruses in culture, are without measurable neurovirulence and fail to infect non-human primates under conditions where the Sabin strains will do so. PMID:26720150
Yehualashet, Yared G.; Mkanda, Pascal; Gasasira, Alex; Erbeto, Tesfaye; Onimisi, Anthony; Horton, Janet; Banda, Richard; Tegegn, Sisay G.; Ahmed, Haruna; Afolabi, Oluwole; Wadda, Alieu; Vaz, Rui G.; Nsubuga, Peter
Background. Following the 65th World Health Assembly (WHA) resolution on intensification of the Global Poliomyelitis Eradication Initiative (GPEI), the Nigerian government, with support from the World Health Organization (WHO) and other partners, implemented a number of innovative strategies to curb the transmission of wild poliovirus (WPV) in the country. One of the innovations successfully implemented since mid 2012 is the WHO's engagement of surge capacity personnel. Methods. The WHO reorganized its functional structure, adopted a transparent recruitment and deployment process, provided focused technical and management training, and applied systematic accountability framework to successfully manage the surge capacity project in close collaboration with the national counterparts and partners. The deployment of the surge capacity personnel was guided by operational and technical requirement analysis. Results. Over 2200 personnel were engaged, of whom 92% were strategically deployed in 11 states classified as high risk on the basis of epidemiological risk analysis and compromised security. These additional personnel were directly engaged in efforts aimed at improving the performance of polio surveillance, vaccination campaigns, increased routine immunization outreach sessions, and strengthening partnership with key stakeholders at the operational level, including community-based organizations. Discussion. Programmatic interventions were sustained in states in which security was compromised and the risk of polio was high, partly owing to the presence of the surge capacity personnel, who are engaged from the local community. Since mid-2012, significant programmatic progress was registered in the areas of polio supplementary immunization activities, acute flaccid paralysis surveillance, and routine immunization with the support of the surge capacity personnel. As of 19 June 2015, the last case of WPV was reported on 24 July 2014. The surge infrastructure has
Full Text Available In the year 1988, World Health Organization (WHO claims that polio viruses should be eradicated after year 2000. However, until year 2010 the world have not been free from polio viruses circulation. So many effort had been achieved and it is estimated that the world will be free from polio virus after the year 2013. Control of poliomyelitis in Indonesia has been commenced since 1982 with routine immunization of polio program and the National Immunization Days (NID has been commenced since 1995,1996,2005 and 2006. When the world is free from polio virus, WHO suggests several alternative effort to maintain the world free from polio viruses : I stop the OPV (Oral Polio Vaccine and no polio immunization, 2 stop OPV and stock pile mOPV (monovalent OPV, 3 use OPV and IPV (Inactivated Polio Vaccine in a certain times, 4 use IPV only in a certain times. IPV has been used routinely in develop countries but has not been used in the developing countries. Several studies in development countries has been conducted, but had not been done in the developing countries. Indonesia collaboration with WHO has conducted the study of IPV in Yogyakarta Province since year 2002 until year 2010. The overall aim of the study is to compile the necessary data that will inform global and national decision-making regarding future polio immunization policies for the OPV cessation era. The data generated from the study will be particularly important to make decisions regarding optimal IPV use in developing tropical countries. It is unlikely that this data can be assembled through other means than through this study. The tentative result of the study shows that OPV immunization coverage in the year 2004 is 99% in four district and 93 % in the Yogyakarta city. Environment surveillance shows that there are 65.7% polio virus detected from 137 sewage samples pre IPV swich, and 4.8% polio virus detected from 83 sewage samples post IPV swich. Survey polio antibody serologis shows
With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1) in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3) and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV). Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV) to up-scaled routine immunization (RI), switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs), tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of 'right to say no', on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances. PMID:24963219
Full Text Available With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1 in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3 and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV. Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV to up-scaled routine immunization (RI, switch from trivalent oral polio vaccine (tOPV to bivalent oral polio vaccine (bOPV in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs, tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of ′right to say no′, on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances.
Mushtaq Muhammad Umair
Full Text Available Abstract Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI to ultimately provide evidence for designing future interventions. Methods A qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis. Results The main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs, unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization. Conclusion The study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should
Garon, Julie R; Cochi, Stephen L; Orenstein, Walter A
In the United States during the 1950's, polio was on the forefront of every provider and caregiver's mind. Today, most providers in the United States have never seen a case. The Global Polio Eradication Initiative (GPEI), which began in 1988 has reduced the number of cases by over 99%. The world is closer to achieving global eradication of polio than ever before but as long as poliovirus circulates anywhere in the world, every country is vulnerable. The global community can support the polio eradication effort through continued vaccination, surveillance, enforcing travel regulations and contributing financial support, partnerships and advocacy. PMID:26610419
Yotsu Rie R
Full Text Available Abstract Background Cases of polio in India declined after the implementation of the polio eradication programme especially in these recent years. The programme includes surveillance of acute flaccid paralysis (AFP to detect and diagnose cases of polio at early stage. Under this surveillance, over 40,000 cases of AFP are reported annually since 2007 regardless of the number of actual polio cases. Yet, not much is known about these children. We conducted a qualitative research to explore care and support for children with AFP after their diagnosis. Methods The research was conducted in a district of western Uttar Pradesh classified as high-risk area for polio. In-depth interviews with parents of children with polio (17, with non-polio AFP (9, healthcare providers (40, and key informants from community including international and government officers, religious leaders, community leaders, journalists, and academics (21 were performed. Results Minimal medicine and attention were provided at government hospitals. Therefore, most parents preferred private-practice doctors for their children with AFP. Many were visited at homes to have stool samples collected by authorities. Some were visited repetitively following the sample collection, but had difficulty in understanding the reasons for these visits that pertained no treatment. Financial burden was a common concern among all families. Many parents expressed resentment for their children's disease, notably have been affected despite receiving multiple doses of polio vaccine. Both parents and healthcare providers lacked information and knowledge, furthermore poverty minimised the access to available healthcare services. Medicines, education, and transportation means were identified as foremost needs for children with AFP and residual paralysis. Conclusions Despite the high number of children diagnosed with AFP as part of the global polio eradication programme, we found they were not provided with
Full Text Available Abstract Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Villages or urban areas with a history of wild poliovirus transmission, or hard-to-reach or resistant populations are categorized as high-risk areas within blocks. The Social Mobilization Network (SM Net was formed in Uttar Pradesh in 2003 to support polio eradication efforts through improved planning, implementation and monitoring of social mobilization activities in those high-risk areas. In this paper, we examine the vaccination outcomes in districts of SM Net where the CORE Group works. Methods We carried out a secondary data analysis of routine monitoring information collected by the SM Net and the Government of India. These data include information about vaccination outcomes in SM Net areas and non-SM Net areas within the districts where the CORE Group operates. Statistical analysis was used to compare, between SM Net and non-SM Net areas, vaccination outcomes considered sensitive to social mobilization efforts of the SM Net. We employed Generalized Estimating Equations (GEE statistical method to account for Intra-cluster Correlation (ICC, and used 'Quasi-likelihood under the independence model criterion (QIC' as the model selection method. Results Vaccination outcomes in SM Net areas were as high as or higher than in non-SM Net areas. There was considerable variation in vaccination outcomes between districts. Conclusions While not conclusive, the results suggest that the social mobilization efforts of the SM Net and the CORE Group are helping to increase vaccination levels in high-risk areas of Uttar Pradesh. Vaccination outcomes in CORE Group areas were equal or higher than in non-CORE, non-SM Net areas. This occurred even though SM Net areas are those with
Full Text Available Abstract Background Nurses and midwives are the key providers of nursing and midwifery services; in many countries, they form the major category of frontline workers who provide both preventive and curative services in the community. When the skills and experience of nursing and midwifery personnel are maximized, they can contribute significantly to positive health outcomes. We conducted a survey among nurses and midwives working at district level in Sudan and Zambia to determine their roles and functions in polio eradication and measles elimination programmes. Methods Nurses and midwives practising in four selected districts in Sudan and in Zambia completed a self-administered questionnaire on their roles and responsibilities, their routine activities and their functions during supplementary immunization campaigns for polio and measles. Results Nurses and midwives were found to play significant roles in implementing immunization programme activities. The level of responsibilities of nurses and midwives in their routine work related more to existing opportunities than to their job descriptions. In Zambia, where nurses reported constraints in performing their tasks, the reasons cited were an increase in the burden of disease and the shortage of health personnel. Factors identified as key to improving work performance included written job descriptions, opportunities for staff and career development and opportunities to earn extra income through activities associated with their jobs. Other non-monetary incentives mentioned included reliable transport, resources and logistics to support routine work in the district. However, in both countries, during supplementary immunization activities or mass campaigns for polio eradication and measles control, nurses and midwives took on more management responsibilities. Conclusion This study shows that nurses and midwives play an important role in implementing immunization activities at the district level and
Maekawa, Masaharu; Douangmala, Somthana; Sakisaka, Kayako; Takahashi, Kenzoh; Phathammavong, Outavong; Xeuatvongsa, Anonh; Kuroiwa, Chushi
The global poliomyelitis eradication programme had a great impact on routine immunization coverage in Lao PDR: DPT3 increased 23% in 1992 to 56% in 1999; OPV3 27% to 64%. However, after the achievement of regional eradication, coverage became stagnant in accordance with the withdrawal of various sources of financial supports. In place of the former funds, a public-private global partnership began to support EPI. We aim to explore factors affecting routine immunization coverage. From February to March of 2005, a cross-sectional questionnaire survey was conducted, targeting 341 mothers living in two districts where immunization coverage was the lowest and the middle in Oudomxay province. DPT3 coverage was 72%, higher than the national target of 65%; however, the drop-out rate was 21%. Influential factors on fully immunized child was distance, literacy, possession of livestock; mothers knowledge of immunization target diseases, measles immunization schedule; and mother's willingness to pay for immunization. In total, 98% of all mothers lived within a 30-minute walk of the immunization site. Household visits increased the immunization status among mothers who were illiterate, utilizing an outreach site for immunization, not willing to pay for immunization, receiving home delivery, and without health education attendance. The much higher routine immunization coverage especially in a district of poor EPI activities suggests a well-designed primary health care approach under the district strategy, the zone-zero social mobilization strategy and good lines of communications; it also points to the benefits of the polio eradication initiative. Household visits were found to be effective for people living with difficulties in such as education, living location, and finance. An equally shared funding system for the basic health as well as international policy for respecting the existing system in poor country is important. PMID:20103866
Kraan, Heleen; van der Stel, Wanda; Kersten, Gideon; Amorij, Jean-Pierre
Global polio eradication is closer than ever. Replacement of the live attenuated oral poliovirus vaccine (OPV) by inactivated poliovirus vaccine (IPV) is recommended to achieve complete eradication. Limited global production capacity and relatively high IPV costs compared to OPV spur the need for improved polio vaccines. The target product profile of these vaccines includes not only dose sparing but also high stability, which is important for stockpiling, and easy application important for (emergency) vaccination campaigns. In this review, the current status of alternative polio vaccine delivery strategies is given. Furthermore, we discuss the feasibility of these strategies by highlighting challenges, hurdles to overcome, and formulation issues relevant for optimal vaccine delivery. PMID:26912100
Full Text Available Yaws, one of the 17 neglected tropical diseases (NTDs, is targeted for eradication by 2020 in resolution WHA66.12 of the World Health Assembly (2013 and the WHO roadmap on NTDs (2012. The disease frequently affects children who live in poor socioeconomic conditions. Between 1952 and 1964, WHO and the United Nations Children's Fund (UNICEF led a global eradication campaign using injectable benzathine penicillin. Recent developments using a single dose of oral azithromycin have renewed optimism that eradication can be achieved through a comprehensive large-scale treatment strategy. We review historical efforts to eradicate yaws and argue that this goal is now technically feasible using new tools and with the favorable environment for control of NTDs. We also summarize the work of WHO's Department of Control of Neglected Tropical Diseases in leading the renewed eradication initiative and call on the international community to support efforts to achieve the 2020 eradication goal. The critical factor remains access to azithromycin. Excluding medicines, the financial cost of yaws eradication could be as little as US$ 100 million.The development of new tools has renewed interest in eradication of yaws; with modest support, the WHO eradication target of 2020 can be achieved.
Domingues, Carla Magda Allan S; de Fátima Pereira, Sirlene; Cunha Marreiros, Ana Carolina; Menezes, Nair; Flannery, Brendan
In August 2012, the Brazilian Ministry of Health introduced inactivated polio vaccine (IPV) as part of sequential polio vaccination schedule for all infants beginning their primary vaccination series. The revised childhood immunization schedule included 2 doses of IPV at 2 and 4 months of age followed by 2 doses of oral polio vaccine (OPV) at 6 and 15 months of age. One annual national polio immunization day was maintained to provide OPV to all children aged 6 to 59 months. The decision to introduce IPV was based on preventing rare cases of vaccine-associated paralytic polio, financially sustaining IPV introduction, ensuring equitable access to IPV, and preparing for future OPV cessation following global eradication. Introducing IPV during a national multivaccination campaign led to rapid uptake, despite challenges with local vaccine supply due to high wastage rates. Continuous monitoring is required to achieve high coverage with the sequential polio vaccine schedule. PMID:25316829
Fitzpatrick, Christopher; Asiedu, Kingsley; Jannin, Jean
Introduction A disabling and disfiguring disease that “begins where the road ends”, yaws is targeted by WHO for eradication by the year 2020. The global campaign is not yet financed. To evaluate yaws eradication within the context of the post-2015 development agenda, we perform a somewhat allegorical cost-effectiveness analysis of eradication, comparing it to a counterfactual in which we simply wait for more roads (the end of poverty). Methods We use evidence from four yaws eradication pilot ...
Farag, Noha H; Wadood, Mufti Zubair; Safdar, Rana Muhammad; Ahmed, Nabil; Hamdi, Sabrine; Tangermann, Rudolph H; Ehrhardt, Derek
Since Nigeria reported its last case of wild poliovirus type 1 (WPV1) in July 2014, Pakistan and Afghanistan remain the only two countries where WPV transmission has never been interrupted. This report describes actions taken and progress achieved toward polio eradication in Pakistan during January 2014-September 2015 and updates previous reports. A total of 38 WPV1 cases were reported in Pakistan during January-September 2015, compared with 243 during the same period in 2014 (an 84% decline). Among WPV1 cases reported in 2015, 32 (84%) occurred in children aged FATA) and Khyber Pakhtunkhwa (KPK) Province. During January-September 2015, WPV1 was detected in 20% (64 of 325) of environmental samples collected, compared with 34% (98 of 294) of samples collected during the same period in 2014. The quality and scope of polio eradication activities improved considerably following the establishment of a national Emergency Operations Center, which coordinated polio eradication partners' activities. All activities are following a National Polio Eradication Emergency Action Plan that includes a rigorous action plan for the polio low transmission season (January-April). The presence of WPV1 in environmental samples in areas where no polio cases are detected highlights the need to improve surveillance for acute flaccid paralysis (AFP). Focused efforts to close remaining immunity gaps by locating, tracking, and vaccinating continually missed children and improving coverage with OPV through the routine vaccination program are needed to stop WPV transmission in Pakistan. PMID:26584026
... to its advantages over IPV in providing intestinal immunity and providing secondary spread of the vaccine to unprotected contacts. Who needs this vaccine and when? Side Effects Excerpt from Vaccine Information Statement A Polio-Free ...
Clements, Christopher J; Greenough, Paul; Shull, Diana
Vaccine safety is increasingly a major aspect of immunization programmes. Parents are becoming more aware of safety issues relating to vaccines their babies might receive. As a consequence, public health initiatives have had to take note of pressures brought to bear by individual parents and groups. Now we document a new phase in vaccine safety where it has been used to achieve political objectives. In 1988, the World Health Assembly declared its intention to eradicate poliomyelitis from the globe by the year 2000. This goal had to be postponed to 2005 for a number of reasons. Although the progress has been spectacular in achieving eradication in almost all nations and areas, the goal has been tantalizingly elusive. But arguably the most difficult country from which to eradicate the virus has been Nigeria. Over the past two years, tension has arisen in the north against immunizing against polio using the oral polio vaccine (OPV). Although this vaccine has been used in every other country in the world including other Muslim states, some religious leaders in the north found reason in August 2003 to advise their followers not to have their children vaccinated with OPV. Subsequent to this boycott, which the Kano governor had endorsed for a year and then ended in July 2004, cases of polio occurred in African nations previously free of the virus, and the DNA finger-print of the virus indicated it had come from Nigeria. In other words, Nigeria became a net exporter of polio virus to its African neighbours and beyond. Now the disease has spread to a dozen formerly polio-free countries, including Sudan and Indonesia. We show that, while the outward manifestations of the northern Nigerian intransigence were that of distrust of vaccine, the underlying problem was actually part of a longstanding dispute about political and religious power vis a vis Abuja. It is unlikely that polio transmission will be interrupted by 2005 if this dispute is allowed to run its course. PMID
Katz, Samuel L
The continued progress of the Polio Eradication Program has encountered a number of hurdles in the past 2 years as virus has spread from northern Nigeria across much of central Africa and into the Middle East and as far as Indonesia. India continues to be a source of virus exportation but to a much less degree. WHO is optimistic regarding elimination of circulating virus from all of these countries in 2006 with the exception of Nigeria. Newly recognized obstacles to the eradication are the circulating vaccine-derived polioviruses (cVDPV) and those originating from immune deficient patients (iVDPV). Data are presented on the numbers and locations of cases of paralytic polio in 2004 and 2005 as reported to the WHO in early 2006. Scenarios for the maintenance of freedom from polio when/if the final cases occur are considered. PMID:16679055
... had subtle paralytic polio where there was no obvious deficit. In such cases, prior polio should be ... because other medical conditions can complicate the evaluation. Depression, for example, is associated with fatigue and can ...
Jai P Narain
Full Text Available During the past 60 years, a number of infectious diseases have been targeted for eradication or elimination, with mixed results. While smallpox is the only one successfully eradicated so far, campaigns on yaws and malaria brought about a dramatic reduction in the incidence in the beginning of the campaign but ultimately could not achieve the desired goal. There is again a renewed interest in disease eradication. The World Health assembly in May 2010 passed a resolution calling for eradication of measles by 2015; the target of polio eradication still remains elusive. In view of these developments, it is appropriate time to revisit the concept of disease eradication and elimination, the achievements and failures of past eradication programmes and reasons thereof, and possibly apply these lessons while planning for the future activities. This paper based on the Dr. A.L.Saha Memorial Oration describes various infectious diseases that have been targeted for eradication or elimination since 1950s, the potential direct and indirect benefits from disease eradication, and the issues and opportunities for the future.
Warigon, Charity; Mkanda, Pascal; Banda, Richard; Zakari, Furera; Damisa, Eunice; Idowu, Audu; Bawa, Samuel; Gali, Emmanuel; Tegegne, Sisay G.; Hammanyero, Kulchumi; Nsubuga, Peter; Korir, Charles; Vaz, Rui G.
Background. The polio eradication initiative had major setbacks in 2003 and 2007 due to media campaigns in which renowned scholars and Islamic clerics criticized polio vaccines. The World Health Organization (WHO) partnered with journalists in 2007 to form the Journalists Initiatives on Immunisation Against Polio (JAP), to develop communication initiatives aimed at highlighting polio eradication activities and the importance of immunization in northern Nigeria. Methods. We evaluated the impact of JAP activities in Kaduna State by determining the total number of media materials produced and the number of newspaper clips and bulletins published in support of polio eradication. We also determined the number of households in noncompliant communities that became compliant with vaccination during 2015 supplementary immunization activities (SIAs) after JAP interventions and compared caregivers’ sources of information about SIAs in 2007 before and after the JAP was formed. Results. Since creation of the JAP, >500 reports have been published and aired, with most portraying polio vaccine positively. During June 2015 SIAs in high-risk wards of Kaduna STATE, JAP interventions resulted in vaccination of 5122 of 5991 children (85.5%) from noncompliant households. During early 2007, the number of caregivers who had heard about SIA rounds from the media increased from 26% in January, before the JAP was formed, to 33% in March, after the initiation of JAP activities. Conclusions. The formation of the JAP resulted in measurable improvement in the acceptance of polio vaccine in northern Nigeria. PMID:26721745
Vashisht, Neetu; Puliyel, Jacob
It was hoped that following polio eradication, immunisation could be stopped. However the synthesis of polio virus in 2002, made eradication impossible. It is argued that getting poor countries to expend their scarce resources on an impossible dream over the last 10 years was unethical. Furthermore, while India has been polio-free for a year, there has been a huge increase in non-polio acute flaccid paralysis (NPAFP). In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received. Though this data was collected within the polio surveillance system, it was not investigated. The principle of primum-non-nocere was violated. The authors suggest that the huge bill of US$ 8 billion spent on the programme, is a small sum to pay if the world learns to be wary of such vertical programmes in the future. PMID:22591873
Full Text Available Live vaccination against polio has effectively prevented outbreaks in most developed countries for more than 40 years, and there remain only a few countries where outbreaks of poliomyelitis by the wild strain still threaten the community. It is expected that worldwide eradication will be eventually achieved through careful surveillance and a well-managed immunization program. The present paper argues, however, that based on a simple stochastic model the risk of outbreak by a vaccine-derived strain after the cessation of vaccination is quite high, even if many years have passed since the last confirmed case. As vaccinated hosts are natural reservoirs for virulent poliovirus, the source of the risk is the vaccination itself, employed to prevent the outbreaks. The crisis after stopping vaccination will emerge when the following two conditions are met: the susceptible host density exceeds the threshold for epidemics and the vaccinated host density remains large enough to ensure the occurrence of virulent mutants in the population. Our estimates for transmission, recovery, and mutation rates, show that the probability of an outbreak of vaccine-derived virulent viruses easily exceeds 90%. Moreover, if a small fraction of hosts have a longer infectious period, as observed in individuals with innate immunodeficiency, the risk of an outbreak rises significantly. Under such conditions, successful global eradication of polio is restricted to a certain range of parameters even if inactive polio vaccine (IPV is extensively used after the termination of live vaccination.
Collett, Marc S; Neyts, Johan; Modlin, John F
Polio eradication is within sight. In bringing the world close to this ultimate goal, the Global Polio Eradication Initiative (GPEI) has relied exclusively on the live, attenuated oral poliovirus vaccine (OPV). However, as eradication nears, continued OPV use becomes less tenable due to the incidence of vaccine associated paralytic poliomyelitis (VAPP) in vaccine recipients and disease caused by circulating vaccine-derived polioviruses (cVDPVs) in contacts. Once wild poliovirus transmission has been interrupted globally, OPV use will stop. This will leave the inactivated poliovirus vaccine (IPV) as the only weapon to defend a polio-free world. Outbreaks caused by cVDPVs are expected post-OPV cessation, and accidental or deliberate releases of virus could also occur. There are serious doubts regarding the ability of IPV alone to control outbreaks. Here, we argue that antiviral drugs against poliovirus be added to the arsenal. Anti-poliovirus drugs could be used to treat the infected and protect the exposed, acting rapidly on their own to contain an outbreak and used as a complement to IPV. While there are no polio antiviral drugs today, the technological feasibility of developing such drugs and their probability of clinical success have been established by over three decades of drug development targeting the related rhinoviruses and non-polio enteroviruses (NPEVs). Because of this history, there are known compounds with anti-poliovirus activity in vitro that represent excellent starting points for polio drug development. Stakeholders must come to understand the potential public health benefits of polio drugs, the feasibility of their development, and the relatively modest costs involved. Given the timelines for eradication and those for drug development, the time for action is now. PMID:18513807
Smallpox and polio eradication in India: comparative histories and lessons for contemporary policy Erradicação da varíola e da pólio na Índia: histórias comparativas e lições para políticas contemporâneas
Full Text Available This article argues that a detailed examination of factors contributing to the development of complex structures and strategies for smallpox eradication in South Asia in the 1970s can provide fruitful indications for the reformulation of the national chapters of the global polio eradication programme in this region. There is a magnificent archive in the WHO's Geneva offices, which details how smallpox eradication outbreaks were located and then contained in cities, small towns and remote rural areas in this region, by teams of international workers working closely with local officials. A systematic assessment of the global smallpox eradication efforts indicates parallels between the early stages of the global smallpox eradication programme and the present situation of the polio campaign; as we will see here, it can also provide useful indicators for future action in South Asia and beyond.O artigo argumenta que um exame detalhado dos fatores que contribuíram para o desenvolvimento de estruturas e estratégias complexas para a erradicação da varíola no Sul da Ásia nos anos 70 pode fornecer indicações proveitosas para a reformulação dos capítulos nacionais do programa global de erradicação da pólio nesta região. Existe um impressionante arquivo nos escritórios da OMS em Genebra que detalha como os ataques para a erradicação da varíola foram localizados e então contidos em cidades, pequenas vilas e áreas rurais remotas desta região, por equipes de profissionais internacionais trabalhando em conjunto com as autoridades locais. Uma avaliação sistemática dos esforços globais de erradicação da varíola indicam paralelos entre os estágios iniciais do programa global de erradicação da varíola e a atual situação da campanha contra a pólio. Como veremos aqui, o artigo também pode fornecer indicadores úteis para ações futuras no Sul da Ásia e em outros locais.
Nasir, Usman Nakakana; Bandyopadhyay, Ananda Sankar; Montagnani, Francesca; Akite, Jacqueline Elaine; Mungu, Etaluka Blanche; Uche, Ifeanyi Valentine; Ismaila, Ahmed Mohammed
Nigeria has made tremendous strides towards eliminating polio and has been free of wild polio virus (WPV) for more than a year as of August 2015. However, sustained focus towards getting rid of all types of poliovirus by improving population immunity and enhancing disease surveillance will be needed to ensure it sustains the polio-free status. We reviewed the pertinent literature including published and unpublished, official reports and working documents of the Global Polio Eradication Initiative (GPEI) partners as well as other concerned organizations. The literature were selected based on the following criteria: published in English Language, published after year 2000, relevant content and conformance to the theme of the review and these were sorted accordingly. The challenges facing the Polio Eradication Initiative (PEI) in Nigeria were found to fall into 3 broad categories viz failure to vaccinate, failure of the Oral Polio Vaccine (OPV) and epidemiology of the virus. Failure to vaccinate resulted from insecurity, heterogeneous political support, programmatic limitation in implementation of vaccination campaigns, poor performance of vaccination teams in persistently poor performing Local Government areas and sporadic vaccine refusals in Northern Nigeria. Sub optimal effectiveness of OPV in some settings as well as the rare occurrence of VDPVs associated with OPV type 2 in areas of low immunization coverage were also found to be key issues. Some of the innovations which helped to manage the threats to the PEI include a strong government accountability frame work, change from type 2 containing OPV to bi valent OPVs for supplementary immunization activities (SIA), enhancing environmental surveillance in key states (Sokoto, Kano and Borno) along with an overall improvement in SIA quality. There has been an improvement in coverage of routine immunization and vaccination campaigns, which has resulted in Nigeria being removed from the list of endemic countries
Muyembe-Tamfum, Jean-Jacques; Mulembakani, Prime; Lekie, René Botee; Szczeniowski, Mark; Ježek, Zdeněk; Doshi, Reena; Hoff, Nicole; Rimoin, Anne W
Smallpox eradication is considered to be one of the most remarkable accomplishments of the 20th century. Lessons learned from the campaign during the 1960s and 1970s in the Democratic Republic of Congo (DRC) can provide important information for the development of other eradication programs including polio. The DRC is the third largest country in Africa; the population suffers from extreme poverty, deteriorating infrastructure and health systems, and long periods of civil strife. Despite these challenges, DRC's smallpox eradication campaign was successful, eradicating smallpox only 41 months after initiation. DRC had been polio free since 2001; however, in 2006, imported cases were identified in the country. Polio transmission has since been re-established and DRC now has the second greatest number of reported polio cases in the world. Challenges which existed during the smallpox campaign in DRC are still present today; additionally, the polio vaccine itself poses unique challenges which include requiring multiple doses to confer immunity. In the fight against polio in DRC, it will be important to draw from the smallpox eradication experience. A number of important themes emerged during the campaign that could be beneficial to eradicating polio and future eradication programs that may follow. During the smallpox campaign, a standard vaccination program was implemented, surveillance was intensified, and there were strong collaborative programs with community involvement. These successful elements of the smallpox campaign should be adapted and applied in DRC in polio eradication programs. PMID:22188930
... States), the approximately 10 cases per year of polio seen in this country were traced to OPV. IPV is a vaccine that stimulates the immune system of the body (through production of antibodies) to fight the virus if it ...
Manish Rana, Sanju Gajjar, Rashmi Sharma, Anish Sinha, Brinda Chudasama, Pradeep Kumar
Full Text Available Background: It has been more than 1 year since the last case of wild polio virus occurred in the country and we are at the final phase of polio eradication. It needs to enhance/ sustain all activities of polio eradication. This study was carried out to critically evaluate the various activities undertaken and make the suggestions for improvement during the National Immunization Day (NID of February 2012 under Intensified Pulse Polio Immunization Program (IPPI in urban/ rural areas of Ahmedabad, Kheda and Gandhinagar districts of Central Gujarat. Methodology: External evaluators after a training cum orientation program undertook the evaluation of NID (Feb 2012 in 3 districts of Central Gujarat in identified 20 booths through assessing booth based vaccination and undertaking surveys of house to house activities and at migratory/ transit/ street sites. Results: (a Booth based activities: Most booths were accessible and had supply of logistics (IEC materials, stationeries, vaccines, cold chain equipments, marker pens. Understaffing and last minute replacement with untrained staff and non participation of community or nongovernmental organizations (NGOs were some of the issues. (b House to house visits: External monitors could detect 7 missed sites with 63 unvaccinated children while the in house health supervisors could not detect any site. False P detection rates were also high for external monitors (5.3% than in house supervisors (1.3%. (c Migratory sites: Visit to 118 migratory sites yielded even more children as not vaccinated (16.8%. 21 transit sites showed the inadequacies of program where almost one third of children could not be checked for the vaccination. (d Street surveys: Street surveys done after completion of NID (Based on finger markings alone found 12.7% children as not vaccinated. Conclusions: Present communication aims to explore the problematic issues in achieving vaccination coverage, capacity building of team members and
Beale, J; Horaud, F.
In this paper we consider the main steps in the process of manufacture of oral polio vaccine and assess the probable clearance factor for HIV retrovirus at each step. We conclude that the processes employed would have eliminated retrovirus contamination for all practical purposes.
Full Text Available Background. Although rare, adverse events may associate with anti-poliovirus vaccination thus possibly hampering global polio eradication worldwide. Objective. To design peptide-based anti-polio vaccines exempt from potential cross-reactivity risks and possibly able to reduce rare potential adverse events such as the postvaccine paralytic poliomyelitis due to the tendency of the poliovirus genome to mutate. Methods. Proteins from poliovirus type 1, strain Mahoney, were analyzed for amino acid sequence identity to the human proteome at the pentapeptide level, searching for sequences that (1 have zero percent of identity to human proteins, (2 are potentially endowed with an immunologic potential, and (3 are highly conserved among poliovirus strains. Results. Sequence analyses produced a set of consensus epitopic peptides potentially able to generate specific anti-polio immune responses exempt from cross-reactivity with the human host. Conclusion. Peptide sequences unique to poliovirus proteins and conserved among polio strains might help formulate a specific and universal anti-polio vaccine able to react with multiple viral strains and exempt from the burden of possible cross-reactions with human proteins. As an additional advantage, using a peptide-based vaccine instead of current anti-polio DNA vaccines would eliminate the rare post-polio poliomyelitis cases and other disabling symptoms that may appear following vaccination.
To assess the knowledge, attitude and practice of Polio among people in Khyber PakhtunKhwa and to recommend measures in order to improve the awareness of disease. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was conducted at CMH Nowshera, CMH Mardan and Kohat General Hospital from March to June 2013. Subjects and Methods: Persons presenting for consultation to tertiary care hospitals at medical reception rooms were approached by convenience sampling. Structured questionnaire was developed and data was collected by interviews. Results: The findings of the study revealed that out of 296 persons participated in study 57.4% were males while 42.2% were females. They were residents of Mardan, Nowshera, Kohat and Swabi districts of Khyber Pakhtukhwa. Persons who believed that vaccine is prohibited in religion were 13.9%, 81.1% persons knew about Polio disease and 84.5% persons believed that disease could be prevented by giving vaccines to children. Persons who gave vaccine to their children were 88.9% and 66.9% also knew the schedule of the vaccine. Pressure groups which included tribal elders stopped 19.3% people from giving vaccine to their children and for 11.1% persons the facility of giving vaccine was not available. Persons who believed that Polio can cause infertility were 11.5% and 20.9% believed that Polio vaccine cannot prevent Polio disease. Persons who have seen patient of Polio were 38.9% and 88.5 % persons wanted to eradicate disease from Pakistan. Conclusion: The results of the study revealed that people have adequate knowledge about Polio and wanted to eradicate it from Pakistan by participating in vaccination activities but still there are few people who believe that Polio vaccine cannot prevent disease resulting in failure to adminster vaccine for their children. (author)
In 1988, the World Health Assembly resolved to eradicate poliomyelitis globally by 2000. A plan of action for polio eradication in the Western Pacific Region (WPR) by 1995 was adopted in 1990. The plan was based on routine and supplemental vaccination activities with oral poliovirus vaccine (OPV) and acute flaccid paralysis (AFP) surveillance in the eight countries where polio was endemic (Cambodia, China, Laos, Malaysia, Mongolia, Papua New Guinea, Philippines, and Vietnam). Regionwide, the number of reported polio cases decreased from approximately 6000 in 1990 to zero in 1998. This report describes the extensive efforts to eliminate the last chains of poliovirus transmission in the Mekong River area. PMID:9933126
Full Text Available Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan.
Ghafoor, Shazia; Sheikh, Nadeem
Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan. PMID:27517055
Since the 1988 World Health Assembly resolution to eradicate poliomyelitis, three World Health Organization (WHO) regions (Americas, Western Pacific, and European) have been certified polio-free, and the number of countries where polio is endemic has decreased from 125 in 1988 to six in 2003 (Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan). In 2003, Nigeria, the most populous country of the African continent (2003 population projected from 1991 census report: 125 million), reported 355 wild poliovirus (WPV) cases, accounting for 45% of cases reported globally and >80% of cases reported from the African Region (AFR). This report summarizes progress toward polio eradication in Nigeria during January 2003-March 2004. The findings indicate the urgent need to implement high-quality supplementary immunization activities (SIAs) in Nigeria to interrupt ongoing WPV transmission. PMID:15123987
Thomassen, Yvonne E; van 't Oever, Aart G; Vinke, Marian; Spiekstra, Arjen; Wijffels, René H; van der Pol, Leo A; Bakker, Wilfried A M
The anticipated increase in the demand for inactivated polio vaccines resulting from the success in the polio eradication program requires an increase in production capacity and cost price reduction of the current inactivated polio vaccine production processes. Improvement of existing production processes is necessary as the initial process development has been done decades ago. An up-to-date lab-scale version encompassing the legacy inactivated polio vaccine production process was set-up. This lab-scale version should be representative of the large scale, meaning a scale-down model, to allow experiments for process optimization that can be readily applied. Initially the separate unit operations were scaled-down at setpoint. Subsequently, the unit operations were applied successively in a comparative manner to large-scale manufacturing. This allows the assessment of the effects of changes in one unit operation to the consecutive units at small-scale. Challenges in translating large-scale operations to lab-scale are discussed, and the concessions that needed to be made are described. The current scale-down model for cell and virus culture (2.3-L) presents a feasible model with its production scale counterpart (750-L) when operated at setpoint. Also, the current scale-down models for the DSP unit operations clarification, concentration, size exclusion chromatography, ion exchange chromatography, and inactivation are in agreement with the manufacturing scale. The small-scale units can be used separately, as well as sequentially, to study variations and critical product quality attributes in the production process. Finally, it is shown that the scale-down unit operations can be used consecutively to prepare trivalent vaccine at lab-scale with comparable characteristics to the product produced at manufacturing scale. PMID:23192424
Edens, Chris; Dybdahl-Sissoko, Naomi C; Weldon, William C; Oberste, M Steven; Prausnitz, Mark R
The phased replacement of oral polio vaccine (OPV) with inactivated polio vaccine (IPV) is expected to significantly complicate mass vaccination campaigns, which are an important component of the global polio eradication endgame strategy. To simplify mass vaccination with IPV, we developed microneedle patches that are easy to administer, have a small package size, generate no sharps waste and are inexpensive to manufacture. When administered to rhesus macaques, neutralizing antibody titers were equivalent among monkeys vaccinated using microneedle patches and conventional intramuscular injection for IPV types 1 and 2. Serologic response to IPV type 3 vaccination was weaker after microneedle patch vaccination compared to intramuscular injection; however, we suspect the administered type 3 dose was lower due to a flawed pre-production IPV type 3 analytical method. IPV vaccination using microneedle patches was well tolerated by the monkeys. We conclude that IPV vaccination using a microneedle patch is immunogenic in rhesus macaques and may offer a simpler method of IPV vaccination of people to facilitate polio eradication. PMID:25749246
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Full Text Available BackgroundThe government of India launched the pulse polioimmunization (PPI programme in 1995 with the aim oferadicating poliomyelitis by the end of 2000. Despite this,733 children with polio were reported in 2009 alone.Therefore, there is a need to understand the reasonunderlying such high numbers of cases after so many yearsof programme implementation. This study was performedto assess the knowledge of the general population aboutpoliomyelitis and PPI and their attitude and practicetowards PPI.MethodThis cross-sectional study was undertaken in two semiurbanareas of Mangalore city. Only houses in whichchildren under five lived were included in the study. Datawas collected by interviewing any adult member of thehousehold using a pretested questionnaire.ResultsThe literacy rate of study participants was 99%. Only35(10.9% participants knew the correct mode oftransmission of polio. More than one quarter of the studypopulation were under the misconception that polio is acurable disease. The primary source of information aboutPPI in majority of participants was the television (n = 192;60%. Two-hundred and eighty eight (90% participantsknew that the purpose of PPI was to eradicate polio. Only128 (40% participants knew that polio drops can be givento children with mild illnesses and an identical number ofparticipants knew that hot food stuff should not be givenfor at least half an hour following vaccinationadministration. Misconceptions such as PPI causing vaccineoverdose was identified among 7 (2.2% participants, it is asubstitute for routine immunization was believed among 30(9.4% participants and that oral polio vaccine preventsother diseases was seen among 76 (23.7% participants. Theeducational status of the participants was significantlyassociated with their awareness level (χ2 =13.668, DF=6,P=0.033.ConclusionThis study identified a few important misconceptionsassociated with polio and PPI which need to be addressedby large scale awareness
In 1988, the Western Pacific Region (WPR) of the World Health Organization (WHO) adopted a resolution to eradicate poliomyelitis from the region by the end of 1995. In 1993, the Socialist Republic of Vietnam (1993 population: 70.9 million) accounted for 452 (40%) of the 1147 cases of confirmed polio reported to WPR-WHO. Efforts to eradicate polio in Vietnam were initiated in 1991 using supplementary vaccination activities with oral poliovirus vaccine (OPV). National Immunization Days (NIDs) were first conducted during November-December 1993. This report updates these efforts and describes the impact of the first NIDs in 1993 (1). PMID:7753014
Gomber, S; Taneja, D K; Mohan, K
Mass polio immunisation campaign was launched in the national capital territory of Delhi with 2 doses of polio vaccine to be administered to children upto 3 years of age on October and December 4, 1994 respectively. Massive information, education & communication (IEC) efforts through mass media and interpersonal communication preceded the dates of the campaign. A study to assess the awareness of general population was carried out by interviewing 225 adult residents of Delhi using a structured questionnaire. These were drawn by two stage stratified random sampling. Zonewise assembly segments in the first stage and census enumeration blocks in the second stage formed the sampling frame. The study, carried out 3 days prior to date of administration of first dose of oral polio, revealed that 60.4% of population was aware of the programme being launched and 31.6% about aim of the programme. None of the respondents were aware of all the specific parameters put together correctly viz., objective, immunisation days, age group & immunisation status of children. The higher level of awareness was directly proportional to the level of education. The overwhelming success of the programme was indicated by immunisation of > 90% children upto 3 years of age all over Delhi in the first phase of the programme. The key to success of the programme despite low awareness is explained on the basis of unflinching efforts put in by vaccine centre level committees, integrated child development scheme (ICDS) and urban basic service (UBS) functionaries in mobilising people to reach various vaccination centres. Other states planning to launch such mass campaigns should pay attention to social mobilisation in addition to IEC efforts for successful completion of the programme. PMID:10829972
Full Text Available This prospective study was to assess the efficacy of nonbismuth containing quadruple therapy as first-line H. pylori treatment and to determine the clinical factors influencing patient outcome. We enrolled 200 H. pylori-infected naïve patients. They were prescribed either a 7-day nonbismuth containing quadruple therapy group (EACM, esomeprazole 40 mg twice daily, amoxicillin 1 g twice daily, metronidazole 500 mg twice daily, and clarithromycin 500 mg twice daily or a 7-day standard triple therapy group (EAC, esomeprazole 40 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily. Follow-up studies to assess treatment responses were carried out 8 weeks later. The eradication rates attained by EACM and EAC groups were 95.6% (95% confidence interval [CI] = 89.4%–98.3% and 79.3% (95% CI = 70%–86.4% in the per-protocol analysis (P < 0.001 and 88% (95% CI = 80.2%–93.0% and 73% (95% I = 63.6%–80.3% in the intention-to-treat analysis (P = 0.007. Clarithromycin resistance, metronidazole resistance, and dual clarithromycin and metronidazole resistances were the clinical factors influencing H. pylori eradication in EACM group. Clarithromycin resistance and dual clarithromycin and metronidazole resistances were the influential factor for EAC treatment. In conclusion, the results suggest that 7-day nonbismuth containing quadruple therapy could achieve a grade “A” report card for first-line H. pylori treatment.
Rina R., Oke; Ritarwan, Kiking
Poliomyelitis is an acute infectious disease involve motor neuron of the spinal cord and brain and results in an asymmetric flaccid paralysis of the voluntary muscles. Although poliomyelitis caused by wild virus has been eradicated from the western since 1994, its remains a problem in developing countries.With widespread immunization, poliomyelitis has become preventable, and recurrent major epidemics are no longer encountered. Wisdom background and eradicate poliomyelitis strategy ...
N. I. Romanenkova
Full Text Available The article describes the frequency of isolation of polioviruses and non polio enteroviruses from different categories of the investigated children. The percentage of detection of polioviruses from the patients with acute flaccid paralysis was lower than that from the children from groups at risk. Among the patients with the enterovirus infection the polioviruses were rarely revealed. The frequency of isolation of non polio enteroviruses from these patients was significantly higher than that from the other categories of investigated persons. The improvement of poliomyelitis surveillance and the reinforcement of virological surveillance of children from groups at risk and those with enterovirus infection will provide the important data for Global Polio Eradication Initiative and the maintenance of polio free status of the Russian Federation.
... is a medical emergency that may result in paralysis or death (usually from respiratory problems). Disability is more common than death. Infection that is located high in the spinal cord or in the brain increases the risk of breathing problems.
In 1988, the World Health Assembly adopted the goal of global poliomyelitis eradication by 2000, which was endorsed in each of the six regions of the World Health Organization (WHO). In the Western Pacific Region (WPR), where the last known case of polio associated with isolation of wild poliovirus occurred in March 1997, the reported number of cases decreased from 5963 in 1990 to 197 in 1996. This report documents progress toward polio eradication in WPR from January 1, 1996, through September 27, 1997, in countries where polio is endemic (Cambodia, China, Laos, Papua New Guinea, Philippines, and Vietnam) or recently was endemic (Malaysia and Mongolia) and describes the routine and supplemental vaccination activities necessary to interrupt wild poliovirus transmission in the region. PMID:9393657
Ghinai, Isaac; Willott, Chris; Dadari, Ibrahim; Larson, Heidi J
In 2003 five northern Nigerian states boycotted the oral polio vaccine due to fears that it was unsafe. Though the international responses have been scrutinised in the literature, this paper argues that lessons still need to be learnt from the boycott: that the origins and continuation of the boycott were due to specific local factors. We focus mainly on Kano state, which initiated the boycotts and continued to reject immunisations for the longest period, to provide a focused analysis of the internal dynamics and complex multifaceted causes of the boycott. We argue that the delay in resolving the year-long boycott was largely due to the spread of rumours at local levels, which were intensified by the outspoken involvement of high-profile individuals whose views were misunderstood or underestimated. We use sociological concepts to analyse why these men gained influence amongst northern Nigerian communities. This study has implications on contemporary policy: refusals still challenge the Global Polio Eradication Initiative; and polio remains endemic to Nigeria (Nigeria accounted for over half of global cases in 2012). This paper sheds light on how this problem may be tackled with the ultimate aim of vaccinating more children and eradicating polio. PMID:24294986
Sheikh, Asfandyar; Iqbal, Bushra; Ehtamam, Anabia; Rahim, Maria; Shaikh, Hiba Arshad; Usmani, Hina Azhar; Nasir, Javeria; Ali, Sheharbano; Zaki, Muniba; Wahab, Tooba Abdul; Wasim, Warda; Aftab, Ali Akber
Background The Expanded Program on Immunization (EPI) was initiated by World Health Organization (WHO) in 1974 in order to save children from life threatening, disabling vaccine-preventable diseases (VPDs). In Pakistan, this program was launched in 1978 with the main objectives of eradicating polio by 2012, eliminating measles and neonatal tetanus by 2015, and minimizing the incidence of other VPDs. However, despite the efforts of government and WHO, this program has not received the amount o...
Vaz, Rui G.; Mkanda, Pascal; Banda, Richard; Komkech, William; Ekundare-Famiyesin, Olubowale O.; Onyibe, Rosemary; Abidoye, Sunday; Nsubuga, Peter; Maleghemi, Sylvester; Hannah-Murele, Bolatito; Tegegne, Sisay G.
Background. The current West African outbreak of the Ebola virus disease (EVD) began in Guinea in December 2013 and rapidly spread to Liberia and Sierra Leone. On 20 July 2014, a sick individual flew into Lagos, Nigeria, from Monrovia, Liberia, setting off an outbreak in Lagos and later in Port Harcourt city. The government of Nigeria, supported by the World Health Organization and other partners, mounted a response to the outbreak relying on the polio program experiences and infrastructure. On 20 October 2014, the country was declared free of EVD. Methods. We examined the organization and operations of the response to the 2014 EVD outbreak in Nigeria and how experiences and support from the country's polio program infrastructure accelerated the outbreak response. Results. The deputy incident manager of the National Polio Emergency Operations Centre was appointed the incident manager of the Ebola Emergency Operations Centre (EEOC), the body that coordinated and directed the response to the EVD outbreak in the country. A total of 892 contacts were followed up, and blood specimens were collected from 61 persons with suspected EVD and tested in designated laboratories. Of these, 19 (31%) were positive for Ebola, and 11 (58%) of the case patients were healthcare workers. The overall case-fatality rate was 40%. EVD sensitization and training were conducted during the outbreak and for 2 months after the outbreak ended. The World Health Organization deployed its surveillance and logistics personnel from non–Ebola-infected states to support response activities in Lagos and Rivers states. Conclusions. The support from the polio program infrastructure, particularly the coordination mechanism adopted (the EEOC), the availability of skilled personnel in the polio program, and lessons learned from managing the polio eradication program greatly contributed to the speedy containment of the 2014 EVD outbreak in Nigeria. PMID:26908718
... Haitian Creole (Kreyol) Hmong (Hmoob) Ilocano (ilokano) Italian (italiano) Khmer (Khmer) Korean (한국어) Laotian (Lao) Polish (polski) ... Coalition; Centers for Disease Control and Prevention Italian (italiano) Polio Vaccine English Vaccino Antipoliomelite - italiano (Italian) PDF ...
... 6756 fax *Polio Services Victoria, Melbourne Russel Anbiah, Physiotherapist St. Vincent’s Hospital Melbourne PO Box 2900, Bolte ... Oliveira, Chief, Neurology Dept Tatiana Mesquita e Silva, Physiotherapist Abrahão Quadros, Physiotherapist Rua Estado de Israel 899 - ...
Gali, Emmanuel; Mkanda, Pascal; Banda, Richard; Korir, Charles; Bawa, Samuel; Warigon, Charity; Abdullahi, Suleiman; Abba, Bashir; Isiaka, Ayodeji; Yahualashet, Yared G.; Touray, Kebba; Chevez, Ana; Tegegne, Sisay G.; Nsubuga, Peter; Etsano, Andrew; Shuaib, Faisal; Vaz, Rui G.
Background. Remarkable progress had been made since the launch of the Global Polio Eradication Initiative in 1988. However endemic wild poliovirus transmission in Nigeria, Pakistan, and Afghanistan remains an issue of international concern. Poor microplanning has been identified as a major contributor to the high numbers of chronically missed children. Methods. We assessed the contribution of the revised household-based microplanning process implemented in Kano State from September 2013 to April 2014 to the outcomes of subsequent polio supplemental immunization activities using used preselected planning and outcome indicators. Results. There was a 38% increase in the number of settlements enumerated, a 30% reduction in the number of target households, and a 54% reduction in target children. The reported number of children vaccinated and the doses of oral polio vaccine used during subsequent polio supplemental immunization activities showed a decline. Postvaccination lot quality assurance sampling and chronically missed settlement reports also showed a progressive reduction in the number of children and settlements missed. Conclusions. We observed improvement in Kano State's performance based on the selected postcampaign performance evaluation indicators and reliability of baseline demographic estimates after the revised household-based microplanning exercise. PMID:26908755
Han, Soo Jeong; Lim, Jae-Young
Objective To examine the correlation between obesity and pulmonary function in polio survivors. Methods This study was conducted based on a questionnaire survey and physical examination. The questionnaire included gender, age, paralyzed regions, physical activity levels, and accompanying diseases. The physical examination included measuring body mass index, waist circumference, muscle power, total fat amount, body fat percentage, and lean body mass. In addition, pulmonary function was tested based on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1 to FVC, and chest circumference. Five university hospitals and a local health clinic participated in this study. Results Pearson and partial correlation coefficients that used data collected from 73 polio survivors showed that obesity had a negative correlation with pulmonary function. Conclusion This study found that pulmonary function has a negative correlation with obesity for polio survivors. Therefore, it is necessary to develop specialized exercise programs to help polio survivors reduce their weight and strengthen their respiratory muscles. PMID:26798602
Technological advancements, including landmark innovations in vaccinology through molecular virology, and significant transformation and changes in the society have taken place since the eradication of smallpox thirty years ago. The success with eradicating smallpox gave confidence for initiating the eradication of other diseases, such as malaria and polio. However, these efforts have not been as effective, as recorded for small pox, for a variety of reasons. There is now a debate within the global health community as to whether eradication campaigns should be abandoned in favor of less costly and perhaps more effective primary health and containment or control programmes. Significant changes that have taken place in the last thirty years, since the eradication of smallpox include, among others, (i) post-colonial political changes, with varying commitment to disease eradication initiatives, especially in the parts of the world most burdened by infectious and vaccine preventable diseases, (ii) innovations leading to the development of new and highly effective vaccines, targeted to specific diseases, (iii) the transformation brought about by improvement in education and the new global access to information (cell phones, internet, etc.), leading to an unlimited access to different types of information, subject to either positive or negative use. At the onset of eradication of smallpox, global health was confined in its operation. Today, global health is at the intersection of medical and social science disciplines-including demography, economics, epidemiology, political economy and sociology. Therefore, in considering the issue of disease eradication, medical and social perspectives must be brought into play, if future eradication programmes must succeed. The paper discusses the roles of these disciplines in disease control and eradication, especially as it affects sub Saharan Africa, the melting pot and verdant pasture of infectious diseases. PMID:22185830
Pakistan is one of three countries where transmission of indigenous wild poliovirus (WPV) has never been interrupted. This report describes polio eradication activities and progress in Pakistan during January 2012-September 2013 and updates previous reports. During 2012, 58 WPV cases were reported in selected areas, compared with 198 cases throughout the country in 2011; 52 WPV cases were reported during January-September 2013, compared with 54 cases during the same period in 2012. Of the 110 WPV cases reported since January 2012, 92 cases (84%) occurred in the conflict-affected Federally Administered Tribal Areas (FATA) and in security-compromised Khyber Pakhtunkhwa (KP) Province. WPV type 3 (WPV3) was isolated from only three persons with polio in a single district in 2012; the most recent case occurred in April 2012. During August 2012-September 2013, 52 circulating vaccine-derived poliovirus type 2 (cVDPV2) cases were detected, including 30 cases (58%) identified in FATA during January-September 2013. Approximately 350,000 children in certain districts of FATA have not received polio vaccine during supplementary immunization activities (SIAs) conducted since mid-2012 because local authorities have banned polio vaccination. In some other areas of Pakistan, SIAs have been compromised by attacks targeting polio workers that started in mid-2012. Further efforts to reach children in conflict-affected and security-compromised areas, including vaccinating at transit points and conducting additional short-interval-additional-dose (SIAD) SIAs as areas become accessible, will be necessary to prevent reintroduction of WPV into other areas of Pakistan and other parts of the world. PMID:24257203
Full Text Available Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question.We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009.We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404.The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.
Calabrese, Edward J.
The production of the Salk vaccine polio virus by monkey kidney cells was generated using the synthetic tissue culture medium, Mixture 199. In this paper’s retrospective assessment of this process, it was discovered that Mixture 199 was modified by the addition of ethanol to optimize animal cell survival based on experimentation that revealed a hormetic-like biphasic response relationship. This hormesis-based optimization procedure was then applied to all uses of Mixture 199 and modifications...
Full Text Available "nBackground: The long-term effects of poliomyelitis are known in many of countries. In despite of one accrue title for these signs and symptoms; there are similarity aspects in patients' problems. In the signs of explained, absence of strength and endurance, musculoskeletal difficulties, respiratory dysfunction, sleep disorders are more generalized. Prevalence of post polio syndrome (PPS is aim of this study. "nMethods: 150 subjects with history of poliomyelitis (80 male and 70 female in Tehran city contributes in this study and complete question forms. "nResults: Muscle pain was reported in 88% of subjects. Thigh muscle weakness was at 42/28%, also muscle spasm indicated at 66%. Recurrent falling of subjects appeared in 74/7%. Early fatigue reported 86%. Above five signs selected for PPS. In this study 85 subjects had four signs of above criteria or 56.66% of subjects had PPS. "nConclusion: Depended of evaluation and observation there is post polio syndrome in Tehran. Recommended for physical therapy of post polio syndrome attend to stages of progression of this syndrome. In aim to this procedure, physical treatment of these patients must limit to muscle fatigue and also severe physical and exercise activities must be reduce, also some mild aerobic activities without fatigue can be useful.
Narain, Jai P
During the past 60 years, a number of infectious diseases have been targeted for eradication or elimination, with mixed results. While smallpox is the only one successfully eradicated so far, campaigns on yaws and malaria brought about a dramatic reduction in the incidence in the beginning of the campaign but ultimately could not achieve the desired goal. There is again a renewed interest in disease eradication. The World Health assembly in May 2010 passed a resolution calling for eradication...
Minor, Philip D
Poliomyelitis is caused by poliovirus, which is a positive strand non-enveloped virus that occurs in three distinct serotypes (1, 2, and 3). Infection is mainly by the fecal-oral route and can be confined to the gut by antibodies induced either by vaccine, previous infection or maternally acquired. Vaccines include the live attenuated strains developed by Sabin and the inactivated vaccines developed by Salk; the live attenuated vaccine (Oral Polio Vaccine or OPV) has been the main tool in the Global Program of Polio eradication of the World Health Organisation. Wild type 2 virus has not caused a case since 1999 and type 3 since 2012 and eradication seems near. However most infections are entirely silent so that sophisticated environmental surveillance may be needed to ensure that the virus has been eradicated, and the live vaccine can sometimes revert to virulent circulating forms under conditions that are not wholly understood. Cessation of vaccination is therefore an increasingly important issue and inactivated polio vaccine (IPV) is playing a larger part in the end game. PMID:26983727
In 1988, the World Health Assembly resolved to eradicate poliomyelitis by December 31, 2000 (1). Although progress has been extraordinary (2), full implementation of polio eradication strategies has been delayed in several countries affected by war. The Democratic Republic of Congo (DRC) has experienced continual armed conflict since October 1996. As a result, DRC is the last country in the African Region of the World Health Organization (WHO) to implement National Immunization Days (NIDs*). DRC is an important global reservoir for wild poliovirus and shares more than 5580 miles (9000 km) of border with nine countries; in at least seven of these countries polio is endemic. The large area of DRC, substantial amount of poverty, weak health-care infrastructure, poor transportation and communication, and competing demands for resources present considerable challenges to polio eradication. This report summarizes information on the existing health-care infrastructure and routine coverage, information from NIDs carried out in 1999, and results from the recently established surveillance system for acute flaccid paralysis (AFP). PMID:10774546
Sørup, Signe; Stensballe, Lone G; Krause, Tyra G;
inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods. A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997-1999, who had received 3 doses...
In 1988, the World Health Organization (WHO) established the goal of global eradication of poliomyelitis by the year 2000 (1), and the Western Pacific Region (WPR) of WHO established the goal of regional eradication by 1995 (2). In 1990, the Socialist Republic of Vietnam (1993 population: 70.9 million; approximately 2 million births annually) endorsed this regional goal and enacted a National Plan of Action for eradication. This plan comprises three main strategies: 1) maintenance of high coverage with three doses of oral poliovirus vaccine (OPV) through routine vaccination; 2) supplemental vaccination with OPV, including National Immunization Days (NIDs) and outbreak-response vaccination; and 3) surveillance of acute flaccid paralysis (AFP) cases. This report summarizes the polio eradication effort in Vietnam during 1991-1993. PMID:8183231
Full Text Available Poliomyelitis, an acute viral infectious disease caused by poliovirus, still remains a public health problem in developing countries. Despite the global effort to eradicate polio, continuing the polio immunization with a potent and safe vaccine is essential. For accurate vaccine evaluation, three types of cell lines including Hela, Hep2C and Vero were evaluated and compared using two methods of polio vaccine potency tests (micro & macro. For cells comparison, five different batches from polio vaccines were tested and to develop the test, five variables including viruses, cells, serum, media and Co2 were studied. For validation, the titer of which has been well established as a working reference preparation (WRP was applied to control the accuracy and reproducibility of the testing system. Multiple comparisons were performed by analysis of variance (ANOVA followed by Tokey HDS and LSD. No significant differences were found between the potency of vaccine batches and between macro and micro methods. Reduction in cells sensitivity and potency of vaccines was found with increasing passage number. Significant differences were found between the sensitivity of the cell lines. The highest potency of polio vaccines was obtained using Hela cells (GMT in macro and micro test = 10 6.35; Hep2C cells were afterwards (GMT in macro= 10 6.01 and in micro test= 10 5.94; Vero cells were lowest (GMT in macro= 10 5.78 and in micro test= 10 5.72. So, the sensitivity and accuracy of the potency test for evaluation of the polio vaccine in immunization program in Iran will be assured using the Hela cell line with low passage number in macro and micro methods.
routine polio vaccination, still we carried out supplementary vaccination to establish an effective immune barrier among the population; (2) To strengthen the AFP surveillance. The AFP surveillance system had been established in 1991 in Jiangsu Province, the various surveillance indexes now has reached every requirements for proving no polio virus exists. In the course of surveillance, we pursued a case-reporting encouragement system and an active AFP searching at regular intervals to strengthen AFP case reporting and surveillance. Since 1993, there was no wild-type polio virus found. To summarize and evaluate the strategies for poliomyelitis eradication not only can consolidate the achievements of the work but also can provide reference in controlling other viral diseases.
Sakamoto, Masaaki; Watanabe, Hitoshi; Kubosawa, Hitoshi; Ishii, Takeshi
A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI) showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused by Staphylococcus aureus with no atypia. After treatment, serum inflammatory markers normalized and MRI showed homogeneous fat signal intensity in the muscle, which was consistent with poliomyelitis. Total hip arthroplasty was performed due to progression of osteoarthritis. Intraoperative findings showed flaccidity of the gluteus medius muscle, and histological examination of the specimen also was compatible with poliomyelitis. Postoperatively there was no hip instability and the patient has been able to resume his previous physical activity. To our knowledge, this is the first report regarding polio survivors combined with septic arthritis, and sole MRI examination was unable to lead to the diagnosis. The current patient demonstrates the possibility that the involved muscles in poliomyelitis exist even in asymptomatic regions, which will be helpful for accurate diagnosis and life guidance in polio survivors. PMID:27069705
Ndiaye, Abdou Kader; Diop, Pape Amadou Mbathio; Diop, Ousmane Madiagne
Introduction Global poliomyelitis eradication initiative relies on (i) laboratory based surveillance of acute flaccid surveillance (AFP) to monitor the circulation of wild poliovirus in a population, and (ii) vaccination to prevent its diffusion. However, as poliovirus can survive in the environment namely in sewage, environmental surveillance (ES) is of growing importance as the eradication target is close. This study aimed to assess polioviruses and non polio enteroviruses circulation in sewage drains covering a significant population of Dakar. Methods From April 2007 to May 2013, 271 specimens of raw sewage were collected using the grab method in 6 neighborhoods of Dakar. Samples were processed to extract and concentrate viruses using polyethylene glycol and Dextran (two-phase separation method). Isolation of enteroviruses was attempted in RD, L20B and Hep2 cell lines. Polioviruses were identified by RT-PCR and Elisa. Non Polio Enteroviruses (NPEVs) were identified by RT-PCR and microneutralisation tests. Results Polioviruses and NPEVs were respectively detected in 34,3% and 42,8% sewage samples. No wild poliovirus neither circulating vaccine-derived Poliovirus (cVDPV) was detected. Neutralization assays have identified 49 non polio enteroviruses that were subsequently classified in 13 serotypes belonging to HEV-A (22, 4%), HEV-B (12, 24%), HEV-C (26, 53%) and HEV-D (6, 12%) species. Conclusion This study is the first documentation of enteroviruses environmental detection in Senegal. It shows the usefulness of environmental surveillance for indirect monitoring of the circulation and distribution of enteroviruses in the community. PMID:25848458
US Fish and Wildlife Service, Department of the Interior — Willapa NWR and its partners continue the ongoing and successful program aimed at eradication of the nonnative cordgrass, Spartina alterniflora (Spartina) in...
Tsetse flies (Glossina sp.) continue to make livestock production difficult or impossible throughout a very large part of Africa. One of the most promising techniques for eradicating tsetse from certain locations is the environmentally safe Sterile Insect Technique (SIT). In collaboration with the Tanzanian authorities, the Department of Technical Co-operation is sponsoring a programme, with technical support from the Joint FAO/IAEA Division, to eradicate tsetse from Zanzibar using the SIT. (IAEA)
Hopkins, D R; Ruiz-Tiben, E.
In 1991 the Forty-fourth World Health Assembly declared the goal of eradicating dracunculiasis (guinea worm disease) by the end of 1995. This article summarizes the recommended strategies for surveillance and interventions in national dracunculiasis eradication programmes. It is based on personal experience with dracunculiasis programmes in Ghana, Nigeria and Pakistan. Three phases are described: establishment of a national programme office and conduct of a baseline survey; implementation of ...
O'Connor, John P. Anthony; Taneike, Ikue; O'Morain, Colm
Compliance with therapy is the single most important factor in Helicobacter pylori (H. pylori) eradication. Poorer levels of compliance with therapy are associated with significantly lower levels of eradication. Numerous factors can contribute to achieving good levels of compliance. These include the complexity and duration of treatment. It is also important that the physicia...
Norton, Elizabeth B; Bauer, David L; Weldon, William C; Oberste, M Steven; Lawson, Louise B; Clements, John D
One option for achieving global polio eradication is to replace the oral poliovirus vaccine (OPV), which has the risk of reversion to wild-type virulence, with the inactivated poliovirus vaccine (IPV) vaccine. Adjuvants and alternate routes of immunization are promising options that may reduce antigen dose in IPV vaccinations, potentially allowing dose sparing and cost savings. Use of adjuvants and alternate routes of immunization could also help promote mucosal immunity, potentially mimicking the protection against intestinal virus shedding seen with OPV. In the current study, we examined the impact of combining the novel adjuvant dmLT with trivalent IPV for dose sparing, induction of mucosal immunity and increasing longevity of anti-poliovirus (PV) responses in a mouse model following either intradermal (ID) or intramuscular (IM) delivery. We found that non-adjuvanted ID delivery was not superior to IM delivery for fractional dose sparing, but was associated with development of mucosal immunity. Vaccination with IPV+dmLT promoted serum anti-PV neutralizing antibodies with fractional IPV doses by either IM or ID delivery, achieving at least five-fold dose sparing above non-adjuvanted fractional doses. These responses were most noticeable with the PV1 component of the trivalent vaccine. dmLT also promoted germinal center formation and longevity of serum anti-PV neutralizing titers. Lastly, dmLT enhanced mucosal immunity, as defined by fecal and intestinal anti-PV IgA secretion, when included in IPV immunization by ID or IM delivery. These studies demonstrate that dmLT is an effective adjuvant for either IM or ID delivery of IPV. Inclusion of dmLT in IPV immunizations allows antigen dose sparing and enhances mucosal immunity and longevity of anti-PV responses. PMID:25765967
Angez, Mehar; Shaukat, Shahzad; Zahra, Rabaab; Khurshid, Adnan; Sharif, Salmaan; Alam, Muhammad Masroor; Zaidi, Syed Sohail Zahoor
Human enteroviruses are associated with various clinical syndromes and severe neurological disorders. The aim of this study was to determine the molecular epidemiology of non polio enteroviruses and their correlation with acute flaccid paralysis (AFP) patients living in Khyber Pakhtunkhwa (KP) and Federally Administered Tribal Areas (FATA) of Pakistan. The stool samples collected from these patients were used for isolation of non polio enteroviruses (NPEVs). Out of 38 samples, 29 (76.3%) were successfully typed by microneutralization assay into eleven serotypes including echovirus (E)-3 (5.3%), E-7 (2.6%), E-11 (13.2%), E-12 (7.9%), E-13 (10.5%), E-20 (7.9%), E-27 (5.3%), E-29 (10.5%), E-30 (7.9%), E-33 (2.6%), coxsackievirus (CV) B5 (2.6%) and nine isolates (23.7%) remained untyped which were confirmed as NPEVs by real time RT-PCR. Complete VP1 genetic sequencing data characterized untypeable isolates into enterovirus B77 (EV-B77). Moreover, molecular phylogenetic analysis classified these viruses into two new genotypes having high genetic diversity (at least 17.7%) with prototype. This study provides valuable information on extensive genetic diversity of EV-B77 genotypes. Although, its association with neurological disorder has not yet been known but isolation of nine EV-B77 viruses from AFP cases highlights the fact that they may have a contributing role in the etiology of AFP. In addition, it is needed to establish enterovirus surveillance system and laboratory diagnostic facilities for early detection of NPEVs that may cause poliomyelitis like paralysis especially in the situation when we are at the verge of polio eradication. PMID:25433133
Harrison, Tracie; Stuifbergen, Alexa; Walker, Janiece; Scott, Tiffany; Choban, Robin
The purpose of this paper is to report the influence of gender on aging with childhood onset paralytic polio. The hermeneutic phenomenological exploration of gender was done using multiple qualitative interviews with 25 women, age 55 to 75 years of age, who had polio since before 14 years of age. We noted three themes: 1) The movement of her body, 2) Integrating body and gender, and 3) Gender discrepancies. Findings are discussed in the context of gendered expectations and the women’s bodies.
Fruit exports account for 9% of Argentina's total agricultural exports and generate annually close to $450 million. This could be increased but for fruit flies that cause damage equivalent to 15% to 20% of present production value of fruit and also deny export access to countries imposing quarantine barriers. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Joint FAO/IAEA Division, to eradicate the Mediterranean fruit fly using the Sterile Insect Technique (SIT). (IAEA)
An ideal antibiotic regimen for Helicobacter pylori should achieve eradication rates of approximately 90%. Current 7-day triple therapy is successful in about two-thirds of patients. A novel treatment is required to achieve higher eradication with minimal induction of bacterial resistance. The aim of this article is to evaluate the safety and efficacy of a single triple capsule (Pylera) containing bismuth, metronidazole and tetracycline, given with omeprazole for the eradication of H. pylori infection. Extensive literature searches were conducted using PubMed data from 1982 to 2007. This search included headings of H. pylori, bismuth and eradication therapy. The triple capsule Pylera, when given with omeprazole, achieved eradication rates ranging between 84 and 97%. Eradication rates were similar for clarithromycin- and metronidazole-resistant strains. Eradication rates with an omeprazole, bismuth, metronidazole and tetracycline regimen appeared comparable for metronidazole-resistant and -sensitive strains. This effect is not seen with the use of triple therapy in cases of clarithromycin resistance. Clinical trials did not report any serious side effects from bismuth-based regimens and compliance was similar to standard triple therapy. Bismuth-based triple therapy using Pylera is a simplified, effective and well-tolerated regimen achieving cure rates of above 90%.
Walker, Janiece L.; Harrison, Tracie C.
In this study we tested the Gendered Outcome Scale as a measure of gender satisfaction among 295 women aging with the disabling affects of paralytic polio. Principal components analysis, reliability analyses, and content validity were analyzed on the scale. The scale had a Cronbach’s alpha of .90. Younger women had more gender satisfaction (r=−.173, p
On, Arzu Yağız; Sungur, Ulaş
Background: Post-polio syndrome (PPS) is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG) evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient's self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5%) met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42%) limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013). Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS. PMID:27011627
Arzu Yagiz On
Full Text Available Background: Post-polio syndrome (PPS is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient′s self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5% met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42% limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013. Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS.
Sørup, Signe; Stensballe, Lone G; Krause, Tyra G; Aaby, Peter; Benn, Christine S; Ravn, Henrik
Background. Live vaccines may have nonspecific beneficial effects on morbidity and mortality. This study examines whether children who had the live-attenuated oral polio vaccine (OPV) as the most recent vaccine had a different rate of admissions for infectious diseases than children with inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods. A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997-1999, who had received 3 doses of DTaP-IPV-Hib, were observed from 24 months (first OPV dose) to 36 months of age. Results. Oral polio vaccine was associated with a lower rate of admissions with any type of non-polio infection compared with DTaP-IPV-Hib as most recent vaccine (adjusted incidence rate ratio [IRR], 0.85; 95% confidence interval [CI], .77-.95). The association was separately significant for admissions with lower respiratory infections (adjusted IRR, 0.73; 95% CI, .61-.87). The admission rates did not differ for OPV versus MMR. Conclusions. Like MMR, OPV was associated with fewer admissions for lower respiratory infections than having DTaP-IPV-Hib as the most recent vaccination. Because OPV is now being phased-out globally, further studies of the potential beneficial nonspecific effects of OPV are warranted. PMID:26885538
After its introduction into Africa in the 1880s, rinderpest became the most feared and most devastating disease to afflict the continent's cattle and wildlife herds. Outbreaks of the classical disease in cattle caused mortality rates of 10 to 90 percent. So devastating was this 'cattle plague' that many countries worldwide made concerted efforts to stamp it out and, having once eliminated it, prevent its re-emergence. The disease was a serious threat to the livelihoods of millions of people in Africa. The presence or suspected presence in a country served as a major barrier to livestock trade, and many countries of the world, particularly in Africa, were denied access to valuable external livestock markets. This devastating blow to trade impoverished the pastoral peoples of Africa and dealt considerable blows to the economies of their countries. The present-day African Union3 Inter-African Bureau for Animal Resources (AUIBAR) 4 was established in 1951 with responsibility for eliminating rinderpest from Egypt and sub-Saharan Africa, where continual east-west cattle movements prevented effective control by individual countries. Since then, with the European Union (EU) as the main donor, AU-IBAR has coordinated the eradication of rinderpest from Africa through five main projects: Joint Project 15 (JP15), 1962 to 1976; the Pan African Rinderpest Campaign (PARC), 1986 to 1998; the Pan African Programme for the Control of Epizootics (PACE), 1999 to 2007; the African Wildlife Veterinary Project (AWVP), 2002 to 2003; and the Somali Ecosystem Rinderpest Eradication Coordination Unit (SERECU) project, 2006 to 2010. In tandem with rinderpest eradication, the need to strengthen veterinary services was addressed. From JP15 to SERECU, the main objective was the eradication of rinderpest from Africa. Alongside this main objective were other complementary and synergistic objectives. Under PARC, these were controlling contagious bovine pleuropneumonia (CBPP) through mass
Anna Sofie Hansen
Conclusions: OPV0 may contribute to early polio protection, particularly in children of mothers with low antibody levels. However, OPV0 did not contribute to overall polio immunity after subsequent doses of OPV were given, and was associated with significantly lower antibody titers in children of mothers with high antibody levels. However, it did not negatively affect the proportion of seropositive children.
García-Sánchez, José Elías; García-Sánchez, Enrique; García-Merino, Enrique; Fresnadillo-Martínez, María José
Although the WHO original target date for the global eradication of poliomyelitis was the year 2000 -thanks to vaccination and institutional, public and private, resources for that purpose-, in 2013 the disease remained endemic in three countries, Afghanistan, Pakistan and Nigeria, and some cases were described in five others. The circulation of wild type 1 poliovirus in Israel, Gaza and the West Bank and the cases in Syria were a wakeup call, as at that time there were polioviruses derived from the oral vaccine that are still circulating among the human population and can cause the development of the disease. Travelling "from" and "to" endemic areas are factors to consider in poliovirus exportation and in its spread when it reaches areas with poor immunogenicity. Wars, terrorism, intolerance, lack of culture and proliferation of anti-vaccine groups and the rise of the anti-vaccination movement are important factors in the maintenance and expansion of the virus and in the "non-vaccination" against it. Based on the international situation to date, the Emergency Committee of WHO met in May 2014 to address the problem. It is still necessary to enhance the knowledge of the disease and its agent. In the first case to perform a differential diagnosis of flaccid paralysis and to continue vaccination programs, and in the second case to keep studying and looking for the poliovirus in environmental samples, which is a model for the study of many other viruses. PMID:25595690
Marks, Michael; Mitjà, Oriol; Vestergaard, Lasse S; Pillay, Allan; Knauf, Sascha; Chen, Cheng-Yen; Bassat, Quique; Martin, Diana L.; Fegan, David; Taleo, Fasihah; Kool, Jacob; Lukehart, Sheila; Emerson, Paul M.; Solomon, Anthony W; Ye, Tun
Yaws is endemic in West Africa, Southeast Asia and the Pacific. The WHO has launched a campaign based on mass treatment with azithromycin, to eradicate yaws by 2020. Progress has been made towards achieving this ambitious goal, including the validation of point-of-care and molecular diagnostic tests and piloting of the strategy in a number of countries including Ghana, Vanuatu and Papua New Guinea. There is a need to address gaps in knowledge to allow refinement of the eradication strategy. S...
Shaw, Chandan Kumar; Shaw, Prachi; Malla, Tejesh; Malla, Kalpana K.; Baxi, Jalaj
Abstract. The National polio surveillance programme is one ofthe prime health projects in Nepaland its neighboring countries. A huge amount of effort and money is beingpumped into polio surveillance in these areas. Vaccine associated Paralyticpolio is one of the prime concerns as far as the side effects are considered.In the past there has been concern over the relationship of Oral Polio Vaccine(OPV) with intussusception as with rotavirus vaccine. We report a case ofileo-colic intussusception...
Tzeng, Stephany Y; Guarecuco, Rohiverth; McHugh, Kevin J; Rose, Sviatlana; Rosenberg, Evan M; Zeng, Yingying; Langer, Robert; Jaklenec, Ana
Vaccines are a critical clinical tool in preventing illness and death due to infectious diseases and are regularly administered to children and adults across the globe. In order to obtain full protection from many vaccines, an individual needs to receive multiple doses over the course of months. However, vaccine administration in developing countries is limited by the difficulty in consistently delivering a second or third dose, and some vaccines, including the inactivated polio vaccine (IPV), must be injected more than once for efficacy. In addition, IPV does not remain stable over time at elevated temperatures, such as those it would encounter over time in the body if it were to be injected as a single-administration vaccine. In this manuscript, we describe microspheres composed of poly(lactic-co-glycolic acid) (PLGA) that can encapsulate IPV along with stabilizing excipients and release immunogenic IPV over the course of several weeks. Additionally, pH-sensitive, cationic dopants such as Eudragit E polymer caused clinically relevant amounts of stable IPV release upon degradation of the PLGA matrix. Specifically, IPV was released in two separate bursts, mimicking the delivery of two boluses approximately one month apart. In one of our top formulations, 1.4, 1.1, and 1.2 doses of the IPV serotype 1, 2, and 3, respectively, were released within the first few days from 50mg of particles. During the delayed, second burst, 0.5, 0.8, and 0.6 doses of each serotype, respectively, were released; thus, 50mg of these particles released approximately two clinical doses spaced a month apart. Immunization of rats with the leading microsphere formulation showed more robust and long-lasting humoral immune response compared to a single bolus injection and was statistically non-inferior from two bolus injections spaced 1 month apart. By minimizing the number of administrations of a vaccine, such as IPV, this technology can serve as a tool to aid in the eradication of polio and
Malaria modeling can inform policy and guide research for malaria elimination and eradication from local implementation to global policy. A research and development agenda for malaria modeling is proposed, to support operations and to enhance the broader eradication research agenda. Models are envisioned as an integral part of research, planning, and evaluation, and modelers should ideally be integrated into multidisciplinary teams to update the models iteratively, communicate their appropriate use, and serve the needs of other research scientists, public health specialists, and government officials. A competitive and collaborative framework will result in policy recommendations from multiple, independently derived models and model systems that share harmonized databases. As planned, modeling results will be produced in five priority areas: (1) strategic planning to determine where and when resources should be optimally allocated to achieve eradication; (2) management plans to minimize the evolution of drug and pesticide resistance; (3) impact assessments of new and needed tools to interrupt transmission; (4) technical feasibility assessments to determine appropriate combinations of tools, an associated set of target intervention coverage levels, and the expected timelines for achieving a set of goals in different socio-ecological settings and different health systems; and (5) operational feasibility assessments to weigh the economic costs, capital investments, and human resource capacities required. PMID:21283605
Aditya Krishna Mootha; Priyanka Majety; Vishal Kumar
Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare.A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures.Here we report a case of medial Hoffa fracture in a post-polio limb presenting as chronic pain.Management of such fractures in limbs affected by late sequelae of poliomyelitis is particularly problematic in view ofosteoporosis and osseous hypoplasia.The fracture was approached through medial parapatellar arthrotomy and fixation was done with cannulated cancellous screws in anteroposterior direction.Union was achieved at 16 weeks.
US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continued a successful program aimed at eradicating the non-native cordgrass, Spartina alterniflora (Spartina)...
US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continues to work toward the eradication of the non-native cordgrass, Spartina alterniflora (Spartina) from...
Small, Parker A., Jr.; Small, Natalie S.
Illustrates the complex interactions between disease, societal attitudes, and technology by looking at the history of smallpox. Describes one of mankind's most magnificent accomplishments--the eradication of smallpox from the earth. (JRH)
Howald, Gregg; Donlan, C Josh; Galván, Juan Pablo; Russell, James C; Parkes, John; Samaniego, Araceli; Wang, Yiwei; Veitch, Dick; Genovesi, Piero; Pascal, Michel; Saunders, Alan; Tershy, Bernie
Invasive mammals are the greatest threat to island biodiversity and invasive rodents are likely responsible for the greatest number of extinctions and ecosystem changes. Techniques for eradicating rodents from islands were developed over 2 decades ago. Since that time there has been a significant development and application of this conservation tool. We reviewed the literature on invasive rodent eradications to assess its current state and identify actions to make it more effective. Worldwide, 332 successful rodent eradications have been undertaken; we identified 35 failed eradications and 20 campaigns of unknown result. Invasive rodents have been eradicated from 284 islands (47,628 ha). With the exception of two small islands, rodenticides were used in all eradication campaigns. Brodifacoum was used in 71% of campaigns and 91% of the total area treated. The most frequent rodenticide distribution methods (from most to least) are bait stations, hand broadcasting, and aerial broadcasting. Nevertheless, campaigns using aerial broadcast made up 76% of the total area treated. Mortality of native vertebrates due to nontarget poisoning has been documented, but affected species quickly recover to pre-eradication population levels or higher. A variety of methods have been developed to mitigate nontarget impacts, and applied research can further aid in minimizing impacts. Land managers should routinely remove invasive rodents from islands <100 ha that lack vertebrates susceptible to nontarget poisoning. For larger islands and those that require nontarget mitigation, expert consultation and greater planning effort are needed. With the exception of house mice (Mus musculus), island size may no longer be the limiting factor for rodent eradications; rather, social acceptance and funding may be the main challenges. To be successful, large-scale rodent campaigns should be integrated with programs to improve the livelihoods of residents, island biosecurity, and reinvasion response
Aaby, Peter; Hedegaard, Kathryn; Sodemann, Morten;
Though previous studies have suggested a non-specific beneficial effect of oral polio vaccine (OPV), there has been no evaluation of the mortality impact of national polio immunization days. On the other hand, studies examining the effect of OPV and diphtheria-tetanus-pertussis (DTP) vaccines, wh...
B C Ravikumar
Full Text Available Psoriasis being a common skin condition, atypical forms and unusual localizations of this disease are quite frequently seen. However, psoriasis sparing a polio-affected limb is extremely rare. We report a case of an adult male, who presented with psoriasis distributed all over the body but with almost complete sparing of the polio-affected left lower limb.
Shulman, Lester M; Manor, Yossi; Hindiyeh, Musa; Sofer, Danit; Mendelson, Ella
Polioviruses are enteric viruses that cause paralytic poliomyelitis in less than 0.5 % of infections and are asymptomatic in >90 % infections of naïve hosts. Environmental surveillance monitors polio in populations rather than in individuals. When this very low morbidity to infection ratio, drops drastically in highly vaccinated populations, environmental surveillance employing manual or automatic sampling coupled with molecular analysis carried out in well-equipped central laboratories becomes the surveillance method of choice since polioviruses are excreted by infected individuals regardless of whether or not the infection is symptomatic. This chapter describes a high throughput rapid turn-around time method for molecular characterization of polioviruses from sewage. It is presented in five modules: (1) Sewage collection and concentration of the viruses in the sewage; (2) Cell cultures for identification of virus in the concentrated sewage; (3) Nucleic acid extractions directly from sewage and from tissue cultures infected with aliquots of concentrated sewage; (4) Nucleic Acid Amplification for poliovirus serotype identification and intratypic differentiation (discriminating wild and vaccine derived polioviruses form vaccine strains); and (5) Molecular characterization of viral RNA by qRT-PCR, TR-PCR, and Sequence analysis. Monitoring silent or symptomatic transmission of vaccine-derived polioviruses or wild polioviruses is critical for the endgame of poliovirus eradication. We present methods for adapting standard kits and validating the changes for this purpose based on experience gained during the recent introduction and sustained transmission of a wild type 1 poliovirus in Israel in 2013 in a population with an initial IPV vaccine coverage >90 %. PMID:26983731
Derrough, Tarik; Salekeen, Alexandra
Between 1973 and 2013, 12 outbreaks of paralytic poliomyelitis with a cumulative total of 660 cases were reported in the European Union, European Economic Area and candidate countries. Outbreaks lasted seven to 90 weeks (median: 24 weeks) and were identified through the diagnosis of cases of acute flaccid paralysis, for which infection with wild poliovirus was subsequently identified. In two countries, environmental surveillance was in place before the outbreaks, but did not detect any wild strain before the occurrence of clinical cases. This surveillance nonetheless provided useful information to monitor the outbreaks and their geographical spread. Outbreaks were predominantly caused by poliovirus type 1 and typically involved unvaccinated or inadequately vaccinated groups within highly immunised communities. Oral polio vaccine was primarily used to respond to the outbreaks with catch-up campaigns implemented either nationwide or in restricted geographical areas or age groups. The introduction of supplementary immunisation contained the outbreaks. In 2002, the European region of the World Health Organization was declared polio-free and it has maintained this status since. However, as long as there are non-vaccinated or under-vaccinated groups in European countries and poliomyelitis is not eradicated, countries remain continuously at risk of reintroduction and establishment of the virus. Continued efforts to reach these groups are needed in order to ensure a uniform and high vaccination coverage. PMID:27123992
The simian immunodeficiency virus (SIV) of the common chimpanzee is widely acknowledged as the direct ancestor of HIV-1. There is increasing historical evidence that during the late 1950s, kidneys were routinely excised from central African chimpanzees by scientists who were collaborating with the polio vaccine research of Dr Hilary Koprowski, and sent - inter alia - to vaccine-making laboratories in the USA and Africa, and to unspecified destinations in Belgium. While there is no direct evidence that cells from these kidneys were used as a substrate for growing Dr Koprowski's oral polio vaccines, there is a startling coincidence between places in Africa where his CHAT vaccine was fed, and the first appearances in the world of HIV-1 group M and group-M-related AIDS. Because of the enormous implications of the hypothesis that AIDS may be an unintended iatrogenic (physician-caused) disease, it is almost inevitable that this theory will engender heated opposition from many of those in the scientific establishment, and those with vested interests. PMID:11405924
The programme on eradication of the Mediterranean fruit fly (Ceratitis capitata) in Guatemala has successfully demonstrated that this pest can be eradicated from large areas with the use of the sterile insect technique (SIT), supplemented by a series of control measures. More than 60% of the country is now free of the medfly as a result of the measures taken in the last few years. In the coffee growing areas, the large wild fly populations have been reduced by a factor of more than 1000, in terms of fertile flies per trap per day, and many areas have been totally freed of the pest. (author). 4 refs, 4 figs, 2 tabs
In 1972, MAFF, Japan and the Okinawa Prefectural Government initiated an experimental eradication project of the melon fly from Kume Island, Okinawa Prefecture, Japan using the sterile insect technique (SIT). Following the successful eradication on Kume Island in 1978, large scale SIT was started to eradicate the melon fly on the 3 groups of islands, Miyako, Okinawa and Yaeyama of Okinawa Prefecture, Japan in 1984, 1986 and 1989, and eradication was achieved in 1987, 1990 and 1993, respectively. For the successful eradication on Miyako, Okinawa and Yaeyama groups of islands, about 6,340, 30,940 and 15,440 million sterile melon flies were released, respectively
Mohammad, Ausaf F
Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP.
T. S. Saraswathy Subramaniam
Full Text Available Since 1992, surveillance for acute flaccid paralysis (AFP cases was introduced in Malaysia along with the establishment of the National Poliovirus Laboratory at the Institute for Medical Research. In 2008, the Ministry of Health, Malaysia, approved a vaccine policy change from oral polio vaccine to inactivated polio vaccine (IPV. Eight states started using IPV in the Expanded Immunization Programme, followed by the remaining states in January 2010. The objective of this study was to determine the viral aetiology of AFP cases below 15 years of age, before and after vaccine policy change from oral polio vaccine to inactivated polio vaccine. One hundred and seventy-nine enteroviruses were isolated from the 3394 stool specimens investigated between 1992 and December 2012. Fifty-six out of 107 virus isolates were polioviruses and the remaining were non-polio enteroviruses. Since 2009 after the sequential introduction of IPV in the childhood immunization programme, no Sabin polioviruses were isolated from AFP cases. In 2012, the laboratory AFP surveillance was supplemented with environmental surveillance with sewage sampling. Thirteen Sabin polioviruses were also isolated from sewage in the same year, but no vaccine-derived poliovirus was detected during this period.
Holzmann, Heidemarie; Hengel, Hartmut; Tenbusch, Matthias; Doerr, H W
Measles virus (MeV) is an aerosol-borne and one of the most contagious pathogenic viruses known. Almost every MeV infection becomes clinically manifest and can lead to serious and even fatal complications, especially under conditions of malnutrition in developing countries, where still 115,000 to 160,000 patients die from measles every year. There is no specific antiviral treatment. In addition, MeV infections cause long-lasting memory B and T cell impairment, predisposing people susceptible to opportunistic infections for years. A rare, but fatal long-term consequence of measles is subacute sclerosing panencephalitis. Fifteen years ago (2001), WHO has launched a programme to eliminate measles by a worldwide vaccination strategy. This is promising, because MeV is a human-specific morbillivirus (i.e. without relevant animal reservoir), safe and potent vaccine viruses are sufficiently produced since decades for common application, and millions of vaccine doses have been used globally without any indications of safety and efficacy issues. Though the prevalence of wild-type MeV infection has decreased by >90 % in Europe, measles is still not eliminated and has even re-emerged with recurrent outbreaks in developed countries, in which effective vaccination programmes had been installed for decades. Here, we discuss the crucial factors for a worldwide elimination of MeV: (1) efficacy of current vaccines, (2) the extremely high contagiosity of MeV demanding a >95 % vaccination rate based on two doses to avoid primary vaccine failure as well as the installation of catch-up vaccination programmes to fill immunity gaps and to achieve herd immunity, (3) the implications of sporadic cases of secondary vaccine failure, (4) organisation, acceptance and drawbacks of modern vaccination campaigns, (5) waning public attention to measles, but increasing concerns from vaccine-associated adverse reactions in societies with high socio-economic standards and (6) clinical
Marks, Michael; Mitjà, Oriol; Vestergaard, Lasse S; Pillay, Allan; Knauf, Sascha; Chen, Cheng-Yen; Bassat, Quique; Martin, Diana L; Fegan, David; Taleo, Fasihah; Kool, Jacob; Lukehart, Sheila; Emerson, Paul M; Solomon, Anthony W; Ye, Tun; Ballard, Ronald C; Mabey, David C W; Asiedu, Kingsley B
Yaws is endemic in west Africa, southeast Asia, and the Pacific region. To eradicate yaws by 2020, WHO has launched a campaign of mass treatment with azithromycin. Progress has been made towards achievement of this ambitious goal, including the validation of point-of-care and molecular diagnostic tests and piloting of the strategy in several countries, including Ghana, Vanuatu, and Papua New Guinea. Gaps in knowledge need to be addressed to allow refinement of the eradication strategy. Studies exploring determinants of the spatial distribution of yaws are needed to help with the completion of baseline mapping. The finding that Haemophilus ducreyi causes lesions similar to yaws is particularly important and further work is needed to assess the effect of azithromycin on these lesions. The integration of diagnostic tests into different stages of the eradication campaign needs investigation. Finally, studies must be done to inform the optimum mass-treatment strategy for sustainable interruption of transmission. PMID:26362174
Kraan, Heleen; Ten Have, Rimko; van der Maas, Larissa; Kersten, Gideon; Amorij, Jean-Pierre
A hexavalent vaccine containing diphtheria toxoid, tetanus toxoid, whole cell pertussis, Haemophilius influenza type B, hepatitis B and inactivated polio vaccine (IPV) may: (i) increase the efficiency of vaccination campaigns, (ii) reduce the number of injections thereby reducing needlestick injuries, and (iii) ensure better protection against pertussis as compared to vaccines containing acellular pertussis antigens. An approach to obtain a hexavalent vaccine might be reconstituting lyophilized polio vaccine (IPV-LYO) with liquid pentavalent vaccine just before intramuscular delivery. The potential limitations of this approach were investigated including thermostability of IPV as measured by D-antigen ELISA and rat potency, the compatibility of fluid and lyophilized IPV in combination with thimerosal and thimerosal containing hexavalent vaccine. The rat potency of polio type 3 in IPV-LYO was 2 to 3-fold lower than standardized on the D-antigen content, suggesting an alteration of the polio type 3 D-antigen particle by lyophilization. Type 1 and 2 had unaffected antigenicity/immunogenicity ratios. Alteration of type 3 D-antigen could be detected by showing reduced thermostability at 45°C compared to type 3 in non-lyophilized liquid controls. Reconstituting IPV-LYO in the presence of thimerosal (TM) resulted in a fast temperature dependent loss of polio type 1-3 D-antigen. The presence of 0.005% TM reduced the D-antigen content by ∼20% (polio type 2/3) and ∼60% (polio type 1) in 6h at 25°C, which are WHO open vial policy conditions. At 37°C, D-antigen was diminished even faster, suggesting that very fast, i.e., immediately after preparation, intramuscular delivery of the conceived hexavalent vaccine would not be a feasible option. Use of the TM-scavenger, l-cysteine, to bind TM (or mercury containing TM degradation products), resulted in a hexavalent vaccine mixture in which polio D-antigen was more stable. PMID:27470209
Calain, Philippe; Abu Sa’Da, Caroline
Background In 2014, the World Health Organization (WHO) declared two "public health emergencies of international concern", in response to the worldwide polio situation and the Ebola epidemic in West Africa respectively. Both emergencies can be seen as testing moments, challenging the current model of epidemic governance, where two worldviews co-exist: global health security and humanitarian biomedicine. Discussion The resurgence of polio and the spread of Ebola in 2014 have not only exposed t...
Luiza Helena Falleiros Carvalho
terms of worldwide eradication and the World Health Organization.s (WHO proposals in this transition period between global eradication and the post-eradication period. SOURCES OF DATA: Data for the period from 1955 to 2005 were searched in MEDLINE, LILACS, The Web, Doctor's Guide, WHO website and Pan American Health Organization (PAHO website and text book. SUMMARY OF THE FINDINGS: In 1988, the WHO established the goal of eradicating the disease and interrupting transmission of the wild virus globally. Since then, there has been a dramatic decline of the disease, although in 2005 there were still some countries considered endemic and others where polio returned on account of imported viruses. The vaccines used worldwide are the classical tOPV and IPV, and in this eradication process, the use of mOPV vaccines has been encouraged in places where only one type of poliovirus circulates. In addition to spreading the virus in the community, the OPV vaccines may, however, cause paralyses by reversal of the neurovirulence process. CONCLUSIONS: For a world free of poliomyelitis disease, it would be necessary to interrupt circulation of the virus, which will only be possible if the OPV virus were to be discontinued, in accordance with the WHO proposals for this transition period and the post-eradication period.
Marcus, Elizabeth A; Sachs, George; Scott, David R
Helicobacter pylori infects about 50 % of the world's population, causing at a minimum chronic gastritis. A subset of infected patients will ultimately develop gastric or duodenal ulcer disease, gastric adenocarcinoma, or MALT (mucosa-associated lymphoid tissue) lymphoma. Eradication of H. pylori requires complex regimens that include acid suppression and multiple antibiotics. The efficacy of treatment using what were once considered standard regimens have declined in recent years, mainly due to widespread development of antibiotic resistance. Addition of bismuth to standard triple therapy regimens, use of alternate antibiotics, or development of alternative regimens using known therapies in novel combinations have improved treatment efficacy in specific populations, but overall success of eradication remains less than ideal. Novel regimens under investigation either in vivo or in vitro, involving increased acid suppression ideally with fewer antibiotics or development of non-antibiotic treatment targets, show promise for future therapy. PMID:27177639
Hostnik Peter; Barlič-Maganja Darja; Grom Jože; Malovrh Tadej; Bidovec Andrej
Oral vaccination as a method of rabies eradication in the field was first started in Switzerland in 1978 and after 1984 several other EU countries followed this practice. Due to oral vaccination some European countries are now rabies-free in terrestrial animals. In Slovenia, after the first experimental oral vaccination and study of vaccination models from 1988 -1992, the spring-autumn campaigns have been carried out since 1995. The model of oral vaccination of wildlife requires 16-20 baits p...
The screwworm is thought to have reached North Africa with a shipment of contaminated livestock imported from Central or South America. The parasite's presence in Libya poses a great threat to livestock, wildlife, and the environment in Africa, the Middle East, and the Mediterranean Basin. The parasite's present restricted distribution in Africa - confined to an area of approximately 20,000 square kilometers, 30 kilometers south of Tripoli and 60 kilometers east of the border with Tunisia - offers the possibility for eradication, if an international emergency action programme can be fully instituted. The programme is a collaborative effort of the Government of Libya and international agencies including FAO, IAEA, International Fund for Agricultural Development (IFAD), and United Nations Development Programme (UNDP). If eradication is achieved before much additional spread occurs, savings will be very great indeed. The sterile insect technique, in conjunction with surveillance, preventive, and curative treatment of animal wounds, is the only available technique for eradicating the New World Screwworm. The sterile insect technique requires the releases of huge numbers of factory-reared, sexually sterile insects. Sexual sterility is induced by exposing the late pupal stage to gamma rays. When these sterile insects mate with native females, the eggs laid on open wounds fail to hatch and no progeny are produced. By sustained releases and maintaining a ratio of 10 or more sterile insects to each native insect over several generations, eradication is achieved in a relatively short period of time
The New World screwworm, Cochliomyia hominivorax (Coquerel), invaded North Africa in the late 1980s. It became established in the Libyan Arab Jamahiriya, where it was first detected in 1988 and confirmed in 1989. This devastating pest of livestock became the target of a major eradication programme costing approximately US $80 million. The basis of the eradication programme was the sterile insect technique. A total of 1400 million sterile screwworm flies from Mexico were released over a 40,000 km2 area between December 1990 and October 1991. Total eradication was achieved. The eradication programme included a very strong quarantine effort to prevent expansion of the infested area in the Libyan Arab Jamahiriya. Animals in the infested area were inspected and wounds treated about every three or four weeks. Trapping of adults determined the presence or absence of adult screwworm flies. A major information programme supported the eradication effort. (author). 11 refs, 12 figs
Di, Jiabo; Boer, Tjitske Duiveman-de; Figdor, Carl G.; Torensma, Ruurd
Eradication of cancer stem cells to abrogate tumor growth is a new treatment modality. However, like normal cells cancer cells show plasticity. Differentiated tumor stem cells can acquire stem cell properties when they gain access to the stem cell niche. This indicates that eradicating of stem cells (emptying of the niche) alone will not lead to eradication of the tumor. Treatment should be directed to cancer stem cells ànd more mature cancer cells.
Following the unexpected reoccurrence of rinderpest in Belgium in 1920, due to infected zebu cattle in transit at Antwerp on the way from India to Brazil, chief veterinary officers from various regions of the world gathered in Paris in March 1921 and agreed to support a concerted international effort in the fight against rinderpest. This conference led to the creation of OIE in 1924. The main objectives of OIE have remained unchanged since: to ensure transparency in the global animal disease situation; to collect, analyse and disseminate veterinary scientific information; to elaborate scientifically sound international standards and recommendations on disease control and on the quality of animal vaccines; and to encourage international solidarity in the control of animal diseases. Immediately following the Second World War, in 1947 OIE was actively promoting international solidarity for rinderpest control by mediating among donors, vaccine producers and countries in need, thereby facilitating large-scale campaigns based on the most recent scientific information available. OIE started to commission national research institutes around the world to conduct work tailored to the needs of the international community of veterinary services, e.g., research on appropriate methods, including suitable virus inactivation procedures, to prevent the spread of rinderpest from occurring through international trade in bovine meat as well as on the standardization of safety of rinderpest vaccines. Commencing in the 1960s, OIE, FAO and regional organizations launched and coordinated large-scale campaigns to strengthen capacities of member countries' in endemic areas to eradicate rinderpest and control other major transboundary diseases. Through these intensive control programmes, the eradication of rinderpest was achieved in almost all areas of the world between the 1960s and mid-1970s. However, the disappearance of clinical disease led to a discontinuation of vaccination campaigns
Waller, Andrew S
Strangles, caused by the host adapted Lancefield group C bacterium Streptococcus equi sub-species equi (S. equi), is one of the oldest recognised infectious diseases of horses and continues to cause significant welfare and economic cost throughout the world. The ability of S. equi to establish sub-clinical persistent infections primarily in the guttural pouches of convalescent horses has been instrumental to its success. However, the implementation of simple control measures that permit the identification and treatment of persistently infected carriers can prevent further outbreaks of disease at a local level. This review summarises some of the molecular mechanisms exploited by S. equi to cause disease. New qPCR and iELISA diagnostic tests replace culture methodologies as the gold standard for the detection of infected animals. A strategy to maximise the effective application of these tests to direct management methods for the eradication of S. equi infection is presented and the role of preventative vaccines is discussed. In contrast to current understanding, emerging data illustrates the dynamism of the global S. equi population and potential consequences for the effectiveness of currently available vaccines. The ability to use modern vaccines alongside conventional biosecurity and screening procedures will be critical to the large-scale prevention and even eradication of strangles, providing an opportunity to finally break the stranglehold that this disease has on the world's equine industry. PMID:23642414
Lau, Christine S M; Ward, Amanda; Chamberlain, Ronald S
Helicobacter pylori is a common infection associated with many gastrointestinal diseases. Triple or quadruple therapy is the current recommendation for H pylori eradication in children but is associated with success rates as low as 50%. Recent studies have demonstrated that a 10-day sequential therapy regimen, rather than simultaneous antibiotic administration, achieved eradication rates of nearly 95%. This meta-analysis found that sequential therapy increased eradication rates by 14.2% (relative risk [RR] = 1.142; 95% confidence interval [CI] = 1.082-1.207; P pylori eradication rates compared to the 7-day standard therapy (RR = 1.182; 95% CI = 1.102-1.269; p eradication rates compared to 14-day standard therapy (RR = 0.926; 95% CI = 0.811-1.059; P = .261). The use of sequential therapy is associated with increased H pylori eradication rates in children compared to standard therapy of equal or shorter duration. PMID:26297295
suggests that the fitness of irradiated males used in the New Zealand painted apple moth eradication programme was close to optimal. A raster-based spatial analogue was constructed for this model, including additional parameters describing the dispersal kernels for female, male, and irradiated insects. Initial wild populations were assigned according to different spatial patterns (random or aggregated), and different release strategies (many small releases versus few large ones, and random, aggregated or regular spatial releases) were explored, depending on how well the wild distribution was presumed to be known. Scenarios were run for representative parameter sets corresponding to the biology of different insect pests for which Sterile Insect Technique has been employed, such as moths and fruit flies. Here, the basic problem was to ensure that the critical overflooding ratio was achieved over the entire (possibly poorly known) pest distribution. Representative results are presented to help guide future SIT eradication efforts
Gasbarrini, Antonio; Gasbarrini, Giovanni; Pelosini, Iva; Scarpignato, Carmelo
Rifaximin is a non-absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. Being the antibiotic active against Helicobacter pylori, even towards clarithromycin-resistant strain, and being the primary resistance very rare, several investigations explored its potential use for eradication of the microorganism. Rifaximin alone proved to be effective, but even the highest dose (1,200 mg daily) gave a cure rate of only 30%. Dual and triple therapies were also studied, with the better results obtained with rifaximin-clarithromycin and rifaximin-clarithromycin-esomeprazole combinations. However, the eradication rates (60-70%) obtained with these regimens were still below the standard set by the Maastricht Consensus guidelines. Although rifaximin-based eradication therapies are promising, new antimicrobial combinations (with and without proton pump inhibitors) need to be explored in well-designed clinical trials including a large cohort of H. pylori-infected patients. The remarkable safety of rifaximin will allow high-dose regimens of longer duration (e.g. 10 or 14 days) to be tested with confidence in the hope of achieving better eradication rates. A drawback of rifaximin could be its inability to reach sufficiently high concentrations in the gastric mucus layer under and within which H. pylori is commonly located and this would likely affect eradication rate. Taking these considerations into account, bioadhesive rifaximin formulations able to better and persistently cover gastric mucosa, or combination with mucolytic agents, such as pronase or acetylcysteine, need to be evaluated in order to better define the place of this
Glomski, Matthew; Ohanian, Edward
Smallpox remains the only human disease ever eradicated. In this paper, we consider the mathematics behind control strategies used in the effort to eradicate smallpox, from the life tables of Daniel Bernoulli, to the more modern susceptible-infected-removed (SIR)-type compartmental models. In addition, we examine the mathematical feasibility of…
Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries.Recrudescence(recolonization of the same strain within 12 mo after eradication)rather than reinfection(colonization with a new strain,more than 12 mo after eradication)is considered to be responsiblefor most of the cases.This observation was confirmed only in developed countries,while in developing countries a recent meta-analysis demonstrated a high rate of reinfection.The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries,respectively.Nested meta-analysis(only cases with a longer follow-up and a negative 13CUBT a year after eradication)revealed annual recurrence rate of 1.45%[relative risk(RR),0.54]and 12.00%(RR,0.92)in developed and developing countries,respectively.These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication,with a 46% drop in the recurrence rate after the first year post eradication,while in developing countries reinfection is more pronounced,and continue at the same rate since eradication.A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries,since reinfection is highly prevalent.
Pons-Salort, Margarita; Burns, Cara C; Lyons, Hil; Blake, Isobel M; Jafari, Hamid; Oberste, M Steven; Kew, Olen M; Grassly, Nicholas C
Reversion and spread of vaccine-derived poliovirus (VDPV) to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs). Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2) in April 2016. Supplementary immunisation activities (SIAs) with trivalent OPV (tOPV) in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2). Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently "missed" groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004-2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55-0.82]). We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population immunity above the
Full Text Available Reversion and spread of vaccine-derived poliovirus (VDPV to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs. Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2 in April 2016. Supplementary immunisation activities (SIAs with trivalent OPV (tOPV in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2. Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently "missed" groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004-2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55-0.82]. We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population
Lucia Ferro Bricks
, from January 2000 to December 2006. DATA SYNTHESIS: Acknowledgement of vaccine-associated paralysis and oral vaccine-derived circulating viruses’ paralysis shall certainly require discontinuation of oral vaccination for poliomyelitis use in a short time. After eradication of the wild viruses, oral vaccination for poliomyelitis should be discontinued, preferably in a synchronized manner in all the countries. After termination of vaccination programs, people will become susceptible again to poliomyelitis virus and disease outbreaks caused by wild viruses may occur (accidental escape from laboratories or bioterrorism. In countries already using inactivated poliovirus vaccine, it is unlikely that vaccination will be interrupted. Countries that currently use exclusively oral poliovirus vaccine will have to rely on epidemiological surveillance and on oral vaccine inventories to control potential polio outbreaks. If the oral poliovirus vaccine is reintroduced in those populations, there will be again a risk for vaccine-associated paralysis and oral vaccine-derived circulating viruses’ that may spread rapidly to other regions and to nearby countries. CONCLUSIONS: Inactivated poliovirus vaccine introduction in the routine Brazilian vaccination calendar should be programmed as well as acquisition of technology for inactivated poliovirus vaccine production since the latter is currently insufficient to cover global demand.
Pethe, V P
This article offers a new paradigm for eradicating poverty in India. It was assumed incorrectly by Mahatma Gandhi that a good society without mass poverty would follow after independence. India copied Western models of development and developed giant factories, big dams, and megacities. Agriculture did not expand the number of jobs for people. The Western paradigm failed in India because of the false assumption of "trickle down" of income to the masses. The targeted programs to the poor did not directly benefit enough of the poor. Mega-industrialization led to reduced employment and higher skill needs. The model failed mainly because it was a proxy and relied on indirect ways of reaching the poor. The models failed to be adapted to conditions in India. The Swadeshi paradigm is a direct model for addressing mass poverty. Poverty is affected by immediate, intermediate, and ultimate determinants. Poverty begets social and economic problems, such as ignorance, ill health, high fertility, unemployment, and crime. In India and developing countries, mass poverty results from under use of human resources; lack of equal opportunities; and an outdated non-egalitarian social structure, an unjust global economic order, human cruelty, and erosion of ethical values. Indians are squandering their precious resources mimicking Western consumerism. Poverty leads to rapid population growth. People become productive assets with universal literacy, compulsory and free education, health services and sanitation, vocational training, and work ethics. India needs people-oriented policies with less emphasis on capital accumulation. PMID:12294462
Raafat A. Abdel-Twab¹, Kouka S. Abdel-Wahab2. Ahmed O. El-Kafrawi3, Moustafa A. Aly3, Laila A. EL-Bassiony4, May EL-Maamoun4, Caroline Fayez5
Full Text Available Human enteroviruses (EV cause a wide spectrum of both common and uncommon illnesses among all age groups. Enterically transmitted. The objective of this study was to identify non-poliovirus EV as a cause of viral aseptic meningitis (VAM by two methods (cell culture and Real time PCR. From October 2010 to August 2011 cerebrospinal fluid (CSF samples were collected from 85 patients Embaba fever hospital admitted with symptoms of aseptic meningitis of any age and both sexes. The 85 CSF samples were inoculated into RD (human rhabdomyosarcoma cell line in three blind passages to amplify isolates producing EV-like CPE. A total of 14 (16.5% out of 85 CSF samples showed EV-like CPE. By Real time PCR 11 out of the 14 culture positive samples and 5 out of the 14 source of virus isolation original CSF were non polio EV positive. The frequency of non-polio EV meningitis hospital admissions was in the summer season (50%, spring (25%, late autumn (16.6% and least frequency in winter (8.4%. non-polio EV meningitis was detected in 6 out of 41 male patients (14.5% and in 6 out of 44 female patients (13.5%. Also non-polio EV meningitis was detected in all ages with marked increase of incidence in young children (41.6% and old age (50% and less in adult (8.4%. . In conclusionOur data showed that the non-polioviruses EV was associated with the majority of VAM during 2010 – 2011 at the Embaba fever hospital which serves Embaba, Shoubra Elkheema, Qualyba and neighbors localities in Egypt. Rapid detection of non-polio EV meningitis is essential for making decisions about patient management and treatment
US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continued a successful program aimed at eradicating the non-native cordgrass, Spartina alterniflora (Spartina)...
US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continues to work toward the eradication of the non-native cordgrass, Spartina alterniflora (Spartina) from...
Iijima, Katsunori; Koike, Tomoyuki; Shimosegawa, Tooru
In the February 2013 Revision of Insured Medical Treatment, bacterial eradication for all Helicobacter pylori-positive individuals in Japan was covered under the insurance scheme. However, reflux esophagitis is believed to occur in approximately 10% of Japanese patients who undergo eradication therapy. Hence, the risk of reflux esophagitis among such cases should be carefully considered, particularly in the treatment for H. pylori-positive patients who are otherwise healthy. The eradication o...
Presi, P.; Heim, D.
Abstract Diverse concepts for BVD eradication or control have been applied in several countries with varying success. Results of previous studies conducted in Switzerland have shown that the prevalence of antibody-positive animals is high and that BVDV is wide spread in the country causing serious economic losses. A new approach to eradicate BVD in the cattle population in Switzerland was chosen. It consists in testing the whole Swiss cattle population for virus detection in a shor...
Malaria modeling can inform policy and guide research for malaria elimination and eradication from local implementation to global policy. A research and development agenda for malaria modeling is proposed, to support operations and to enhance the broader eradication research agenda. Models are envisioned as an integral part of research, planning, and evaluation, and modelers should ideally be integrated into multidisciplinary teams to update the models iteratively, communicate their appropria...
Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of “vaccines that interrupt...
Abdulla, S.; Agre, P; P.L. Alonso; Arevalo-Herrera, M.; Bassat, Q.; Binka, F.; Chitnis, C.; Corradin, G; Cowman, A. F.; Culpepper, J.; Portillo, H. del; Dinglasan, R. R.; Duffy, P.; Gargallo, D; Greenwood, B.
Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of "vaccines that interrupt...
Zhu, Jia-Ming; Wang, Lu; Liu, Jia-Bao
This paper mainly studies the eradication of the Ebola virus, proposing a scientific system, including three modules for the eradication of Ebola virus. Firstly, we build a basic model combined with nonlinear incidence rate and maximum treatment capacity. Secondly, we use the dynamic programming method and the Dijkstra Algorithm to set up M-S (storage) and several delivery locations in West Africa. Finally, we apply the previous results to calculate the total cost, production cost, storage cost, and shortage cost. PMID:27313655
Durand, Christine M.; Blankson, Joel N.; Siliciano, Robert F.
Highly active antiretroviral therapy (HAART) suppresses HIV-1 replication, transforming the outlook for infected patients. However, reservoirs of replication-competent forms of the virus persist during HAART, and when treatment is stopped, high rates of HIV-1 replication return. Recent insights into HIV-1 latency, as well as a report that HIV-1 infection was eradicated in one individual, have renewed interest in finding a cure for HIV-1 infection. Strategies for HIV-1 eradication include gene...
Zhu, Jia-Ming; Wang, Lu; Liu, Jia-Bao
This paper mainly studies the eradication of the Ebola virus, proposing a scientific system, including three modules for the eradication of Ebola virus. Firstly, we build a basic model combined with nonlinear incidence rate and maximum treatment capacity. Secondly, we use the dynamic programming method and the Dijkstra Algorithm to set up M-S (storage) and several delivery locations in West Africa. Finally, we apply the previous results to calculate the total cost, production cost, storage cost, and shortage cost. PMID:27313655
The use of the sterile insect technique (SIT) in New World screwworm Cochliomyia hominivorax (Coquerel) eradication programmes has been successfully demonstrated. As a result of a 45-year area-wide campaign, suppression and eradication have been achieved in the USA, Mexico, Belize, Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica, Panama north of the Canal, some Caribbean Islands, and the outbreak in Libya, North Africa. The humans, livestock, and wildlife in these countries are now free of this dangerous pest. It has been estimated that the annual producer benefits are: USA - USD 796 million, Mexico - USD 292 million, and Central America - USD 77.9 million. In Libya, the estimated benefit/cost ratio was 5:1 in the infested zone, and 10:1 in the whole country. If the New World screwworm were eradicated in South America, it has been estimated that each year USD 3592 million could be saved. Small field trials have confirmed that the SIT would be effective for the area-wide control of the Old World screwworm Chrysomya bezziana (Villeneuve). (author)
Full Text Available Oral vaccination as a method of rabies eradication in the field was first started in Switzerland in 1978 and after 1984 several other EU countries followed this practice. Due to oral vaccination some European countries are now rabies-free in terrestrial animals. In Slovenia, after the first experimental oral vaccination and study of vaccination models from 1988 -1992, the spring-autumn campaigns have been carried out since 1995. The model of oral vaccination of wildlife requires 16-20 baits per km2 in the vaccination area. The baits were distributed by plane. They were dispersed from a height of 300-500 m. The aeroplanes' paths were 1000 metres apart. In the vaccination campaigns two vaccines were used. Lysvulpen®, produced by the Bioveta company at the Czech Republic, was laid down in the southwestern part of the country, and Fuchsoral®, produced by the German company Impfstoffwerk Dessau-Tornau, was placed in the eastern part of Slovenia. A rapid decline of rabies was evidenced from 1995 to 1999, when the oral vaccination program in the whole territory using the aircraft baits distributing system was practiced. In 1999, only 6 rabies cases were laboratory-confirmed, whereas in 1995, 1089 rabies cases were documented. Of the 14 rabies cases detected in 1998, 12 were found as an island in a circle with a radius of 30 km in the centre of the vaccinated area. In 2000 and 2001, rabies incidence increased again, so it was decided to change the baits distribution system in the year 2001. The vaccination by crossing flights in certain areas was introduced. In the next year (2002, after changing the vaccination strategy, positive cases rapidly dropped and only 15 cases in 2002, and 8 cases were found in 2003, near the non-vaccinated border with Croatia.
Rozada, Ignacio; Coombs, Daniel; Lima, Viviane D
It is estimated that 80% of new hepatitis C virus (HCV) infections occur among people who inject drugs (PWID). Eradicating HCV from this population is key for the complete eradication of the disease, and the advent of simple to use, high efficacy treatments could conceivably make this scenario possible. This paper presents a mathematical model where transmission of HCV is studied in a simulated population of PWID where fibrosis progression is explicitly tracked. The stability thresholds that determine whether HCV will remain endemic or become eradicated were established numerically, and analytically on a reduced version of the model. Conditions on testing and treatment rates for eradication to occur were determined, within the context of the new high efficacy therapies. The results show that HCV eradication in the PWID population of the Vancouver, BC test scenario is achievable, but testing and especially treatment rates will need to increase significantly from current rates. Parameter estimates were drawn from published data. PMID:26845310
Full Text Available Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting.Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district. Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting.Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place
. To a lesser extent, challenges associated with achieving elimination/eradication and ensuring equity have also been explored. Although elimination and eradication are, for some diseases, good investments compared with control, countries' incentives to eliminate do not always align with the global good and the most efficient elimination strategies may not prioritize the poorest populations. For any infectious disease, policy-makers will need to consider realigning contrasting incentives between the individual countries and the global community and to assure that the process towards elimination/eradication considers equity.
US Fish and Wildlife Service, Department of the Interior — The proposed project is a part of the Refuge invasive species management program and willhelp achieve goals and protect priority habitats identified in the Refuge...
Murray, Deirdre E
Many Polio survivors report new problems, including new muscle weakness, fatigue, decreased mobility and pain (Halstead, 2004). There is a lack of consensus regarding the rate of decline in muscle strength and function of Polio survivors (Stolwijk-Swuste et al., 2005), the reasons for the new symptoms such as fatigue and the cause of declining mobility. As a result of their disability many Polio survivors report significant barriers to physical activity (Becker and Stuifbergen, 2004) and the ...
Wallace, Gregory S; Seward, Jane F; Pallansch, Mark A
In the prevaccine era, infection with wild poliovirus (WPV) was common worldwide, with seasonal peaks and epidemics in the summer and fall in temperate areas. The incidence of poliomyelitis in the United States declined rapidly after the licensure of inactivated polio vaccine (IPV) in 1955 and live oral polio vaccine (OPV) in the 1960s. The last cases of indigenously acquired WPV in the United States occurred in 1979, the last WPV case in a U.S. resident traveling abroad occurred in 1986, and the last WPV imported case was in 1993. Since 2000, the United States has exclusively used IPV, resulting in prevention of 8-10 vaccine-associated paralytic poliomyelitis cases annually. In 2005, an unvaccinated U.S. adult traveling abroad acquired vaccine-associated paralytic poliomyelitis after contact with an infant recently vaccinated with OPV. PMID:25006826
Cesare Efrati; Giorgia Nicolini; Claudio Cannaviello; Nicole Piazza O'Sed; Stefano Valabrega
incidence of adverse effects in all groups of patients with sequential therapy,probably due to the presence of the L.reuteri supplementation.CONCLUSION:The sequential treatment regimen achieved a significantly higher eradication rate of H.pylori compared with standard 7-d regimen.L.reuteri supplementation could reduce the frequency and the intensity of antibiotic-associated side-effects.
Full Text Available This study examines the possible education for the eradication of poverty in Nigeria. It defines poverty as a state pf shortage or deficiency of meeting basic needs. Majors causes of poverty are overpopulation, illiteracy, unemployment, environmental degradation and government insensitive to the welfare of the people. Effects of poverty include homelessness, malnutrition and starvation, illness, crime, violence and antisocial behaviour like Internet Fraud (Yahoo business and Advance Fee Fraud Populace (419. Some poverty eradication strategies highlighted include: (i Organisation of international workshops on eradication of poverty, (ii Respect for human rights, (iii Quality basic education for girls (iv Meaningful contributions by NGOs, (v Provision of jobs for the people. Some recommendations are made for the way forward.
Full Text Available The term post-polio syndrome (PPS was introduced in 1985 by Halstead. It is characterized by sudden or progressive muscle weakness, new muscular atrophy, muscle pain, fatigue, functional impotence, cold intolerance, after a period of at least 15 years from acute polio virus infection, a period of neurological and functional stability, in the absence of other medical explanation . The reported prevalence of PPS is between 15% and 80% of all patients with previous polio virus infections [2, 3]. Poliomyelitis continues to be a public health problem, because the consequences of the disease last throughout life. In Europe, there are about 700,000 persons who survived the infection and are still alive. Non-randomized studies with kinesitherapy programs with a duration between 6 weeks and 7 months, involving isokinetic and isometric endurance muscle training, have demonstrated an increase of muscle strength in the case of patients with mild or moderate muscle weakness, and a reduction of muscle fatigue [7, 8, 9]. The differential diagnosis of PPS can be difficult because of the need to exclude both neurological and non-neurological conditions that aggravate the pre-existing motor deficit. Rehabilitation programs using therapeutic means: kinesitherapy, thermotherapy, hydrothermotherapy, occupational therapy represent the only way to limit functional deficit and to improve pain, playing an important role in the long-term management and care of patients.
Bickerstaffe, A; Beelen, A; Nollet, F
Post-polio syndrome is characterised by progressive muscle weakness and other symptoms which can limit physical mobility. We assessed the rate of decline in mobility over 10 years in relation to strength decline; and investigated potential predictors for the rate of decline of walking capacity, a measure of mobility, in 48 patients with post-polio syndrome and proven quadriceps dysfunction at baseline. Average walking capacity and self-reported physical mobility declined over 10 years, by 6 and 14%, respectively. Concomitantly people lost an average of 15% of isometric quadriceps strength. Significantly more people used walking aids offering greater support at follow-up. Notably, there was much individual variation, with 18% of participants losing a substantial amount of walking capacity (27% decline) and concomitant self-reported physical mobility (38% decline). Loss of quadriceps strength only explained a small proportion of the variance of the decline in walking capacity (R = 11%) and the rate of decline could not be predicted from baseline values for strength, walking capacity, self-reported physical mobility or basic demographics. The individual variability, yet lack of predictive factors, underscores the need for personally tailored care based on actual functional decline in patients with post-polio syndrome. PMID:25613808
The New World Screwworm (NWS) is an insect pest affecting warm-blooded animals and also humans. It causes widespread economic losses in livestock production as well as pain and suffering to animals and to those people unfortunate enough to become infected. Although it is endemic in Jamaica, the screwworm can be eradicated from the island using the well proven and successful Sterile Insect Technique. In collaboration with the Jamaican authorities, the Department of Technical Co-operation of the IAEA is planning to sponsor a Model Project to eradicate screwworm from Jamaica. (IAEA)
Full Text Available This paper mainly studies the eradication of the Ebola virus, proposing a scientific system, including three modules for the eradication of Ebola virus. Firstly, we build a basic model combined with nonlinear incidence rate and maximum treatment capacity. Secondly, we use the dynamic programming method and the Dijkstra Algorithm to set up M-S (storage and several delivery locations in West Africa. Finally, we apply the previous results to calculate the total cost, production cost, storage cost, and shortage cost.
Narain, Jai P; Jain, S K; Bora, D; Venkatesh, S
Yaws, a non-venereal treponematosis, affecting primarily the tribal populations, has been considered historically as one of the most neglected tropical diseases in the world. In 1996, India piloted an initiative to eradicate yaws based on a strategy consisting of active case finding through house-to-house search and treatment of cases and their contacts with long acting penicillin. Thereafter, the campaign implemented in all 51 endemic districts in 10 states of the country led to the achievement of a yaws-free status in 2004. In the post-elimination phase, surveillance activities accompanied by serological surveys were continued in the erstwhile endemic districts. These surveys carried out among children between the age of 1-5 yr, further confirmed the absence of community transmission in the country. The experience of India demonstrates that yaws can be eradicated in all endemic countries of Africa and Asia, provided that political commitment can be mobilized and community level activities sustained until the goal is achieved. PMID:26139778
Hamed Said Ali Habib; Hussam Aly Sayed Murad; Elamir Mahmoud Amir; Taher Fawzy Halawa
Objectives: Helicobacter pylori infection may be associated with low iron stores and iron deficiency anemia. Eradication of infection by the standard 10-day therapy (a proton pump inhibitor [PPI], clarithromycin and amoxicillin; each given orally, twice daily) is decreasing. The sequential 10-day therapy (a PPI and amoxicillin; each given orally twice daily for 5 days; followed by a PPI, clarithromycin and tinidazole; each given orally twice daily for another 5 days) may achieve higher eradic...
The screwworm, Cochliomyia hominivorax (Coquerel) (Diptera: Calliphoridae), was a devastating pest to all warm blooded animals in the United States and the rest of North America. Successful eradication of the screwworm was achieved by using the unique approach called the sterile insect technique. He...
The report reviews evidence of child labor in Brazil, and the Government's efforts to eradicate its worst forms, by examining background assessments of ongoing programs for its prevention. It seeks to identify promising strategies, addressing the needs of highly vulnerable children in urban areas, engaged in activities such as drug commerce, prostitution, or other dangerous activities. One...
In addition to health risk, animal diseases inflict a broad spectrum of direct and indirect economic costs on society, many of which are neither well-understood nor rigorously analysed. Various methods exist to evaluate economic impacts, but many of these focus only on specific aspects or stakeholder interests and how they are affected by a disease, and do not capture the totality of impacts across the economy. However, these economy-wide considerations are essential to comprehensive expost evaluation of disease control or eradication programmes. Direct disease incidence and control costs may be focused on particular stakeholder groupings, but spill-over costs and benefits are dispersed more widely, traversing agricultural supply chains and associated households and enterprises. These extensive indirect effects often outweigh the direct ones. For this reason, cost-benefit analysis of animal disease and policy response must include a broad spectrum of both direct and indirect impacts in the assessment. Rinderpest was once one of the world's most feared livestock diseases, but concerted international control campaigns have now eradicated the disease globally. Despite this success, a major gap remains in the history of rinderpest eradication, namely a comprehensive assessment of the socio-economic costs and benefits of its control and eventual eradication. Such an assessment would make an important additional contribution, offering policy-makers an instrument for assessing the risk, cost and reward of enhanced investment in the control of other (present and future) animal diseases. Although it may be desirable to eradicate any health threat, cost-effectiveness is an important consideration, especially in developing countries, where public resources have many high priorities, and sustained expenditures re-quire clearly discernable benefits for large segments of society. While much has been documented on the epidemiological, technical and institutional lessons resulting
The aim of this article is to summarise certain positive results achieved by the Lula government in the sphere of social policy and to highlight the new challenges taken on by President Dilma Rousseff in terms of eradicating extreme poverty, after her first year in government. After Lula’s success with social policy, Rousseff has committed herself to eradicating extreme poverty over the short term (the four years of her mandate) in a federation that is marked by weak links in cooperation, a d...
Cameron S. Fletcher; Westcott, David A.; Murphy, Helen T; Grice, Anthony C; Clarkson, John R
Containment can be a viable strategy for managing invasive plants, but it is not always cheaper than eradication. In many cases, converting a failed eradication programme to a containment programme is not economically justified. Despite this, many contemporary invasive plant management strategies invoke containment as a fallback for failed eradication, often without detailing how containment would be implemented. We demonstrate a generalized analysis of the costs of eradication and containmen...
Khan, Tahir Mehmood; Sahibzada, Muhammad Umar Khayam
A qualitative study design was adapted to explore the challenges faced by health workers (HWs) during the polio health campaign. In addition, HWs' opinions about the factors causing parents to refuse oral polio vaccination (OPV) were also explored. Four focus group discussions (FGDs) were held (from 1st January 2015-31st March 2015) with the HWs who participated in the OPV campaigns in the polio red zones of Khyber Pakhtoon Khawa (KPK) province of Pakistan, namely Kohat (FG 1), Domel and Bannu (FG 2), Hangoo (FG 3), and Peshawar (FG 4). A total of N=42 HWs (10-11 in each FG) agreed to participate in this study. Overall, HWs disclosed that public attitude and harsh behaviour towards the HWs and security threats are the two main challenges they face. Common issues hindering parents' willingness to vaccinate their children against OPV are: OPV is seen as haram and not permitted in Islam, it is said to contain the blood of pigs (Khinzir) and monkeys, and parents are afraid that it is done to induce sterility among their children. HWs also shared that parents have a strong belief in the conspiracies that are associated with OPV, i.e. the USA and CIA, are spying on us and our government is helping them to achieve their agenda. Furthermore, HWs revealed that frequent visits may further strengthen parents' perceptions and make them more resistant to OPV. The common side effects of OPV reported by parents were mainly gastro-intestinal problems and in some cases mild to moderate fever with some respiratory symptoms. There is a great need to improve the logistics and facilities for HWs assisting in vaccination programmes. Furthermore, it is necessary to improve education, so people understand the basic concept of revaccination and booster doses, thereby assisting in creating a basic understanding of vaccinations, which may trigger changes in attitudes and make people believe in the benefits of OPV rather than following the conspiracies that lead them to refuse it. PMID
Corcoran, M; Morris, D; De Lappe, N; O'Connor, J; Lalor, P; Dockery, P; Cormican, M
Salmonellosis is the second most common cause of food-borne illness worldwide. Contamination of surfaces in food processing environments may result in biofilm formation with a risk of food contamination. Effective decontamination of biofilm-contaminated surfaces is challenging. Using the CDC biofilm reactor, the activities of sodium hypochlorite, sodium hydroxide, and benzalkonium chloride were examined against an early (48-h) and relatively mature (168-h) Salmonella biofilm. All 3 agents result in reduction in viable counts of Salmonella; however, only sodium hydroxide resulted in eradication of the early biofilm. None of the agents achieved eradication of mature biofilm, even at the 90-min contact time. Studies of activity of chemical disinfection against biofilm should include assessment of activity against mature biofilm. The difficulty of eradication of established Salmonella biofilm serves to emphasize the priority of preventing access of Salmonella to postcook areas of food production facilities. PMID:24362427
Iijima, Katsunori; Koike, Tomoyuki; Shimosegawa, Tooru
In the February 2013 Revision of Insured Medical Treatment, bacterial eradication for all Helicobacter pylori-positive individuals in Japan was covered under the insurance scheme. However, reflux esophagitis is believed to occur in approximately 10% of Japanese patients who undergo eradication therapy. Hence, the risk of reflux esophagitis among such cases should be carefully considered, particularly in the treatment for H. pylori-positive patients who are otherwise healthy. The eradication of H. pylori in cases of H. pylori-positive gastritis markedly suppresses gastric inflammation, and inhibits gastric mucosal atrophy and its progression to intestinal metaplasia. In a long-term follow-up study (10-20 years), eradication treatment was found to reduce the risk of subsequent gastric cancer. However, the fact that eradication-induced reflux esophagitis could increase the long-term risk of Barrett's esophagus and esophageal adenocarcinoma should also be considered in the Japanese population. Appropriate treatment with proton pump inhibitors should be taken into consideration for patients undergoing eradication therapy in clinical practice. PMID:26106373
Full Text Available In the February 2013 Revision of Insured Medical Treatment, bacterial eradication for all Helicobacter pylori-positive individuals in Japan was covered under the insurance scheme. However, reflux esophagitis is believed to occur in approximately 10% of Japanese patients who undergo eradication therapy. Hence, the risk of reflux esophagitis among such cases should be carefully considered, particularly in the treatment for H. pylori-positive patients who are otherwise healthy. The eradication of Helicobacter pylori in cases of H. pylori-positive gastritis markedly suppresses gastric inflammation, and inhibits gastric mucosal atrophy and its progression to intestinal metaplasia. In a long-term follow-up study (10-20 years, eradication treatment was found to reduce the risk of subsequent gastric cancer. However, the fact that eradication-induced reflux esophagitis could increase the long-term risk of Barrett’s esophagus and esophageal adenocarcinoma should also be considered in the Japanese population. Appropriate treatment with proton pump inhibitors should be taken into consideration for patients undergoing eradication therapy in clinical practice.
Ling Lan; Jing Yu; Yu-Long Chen; Ya-Li Zhong; Hao Zhang; Chang-He Jia; Yuan Yuan; Bo-Wei Liu
AIM: To investigate whether there were symptombased tendencies in the Helicobacter pylori (H. pylori ) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conducted. A total of 195 FD patients with H. pylori infection were divided into two groups: 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching, epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS: By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group (P 0.05). In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain (73.8%) and epigastric burning (80.7%) were higher than those in the placebo group (P 0.05). By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group (33.3% and 31.8%) (P 0.05). CONCLUSION: The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome.
Full Text Available The ultimate goal of the global programme against lymphatic filariasis is eradication through irrevocable cessation of transmission using 4 to 6 years of annual single dose mass drug administration. The costs of eradication, managerial impediments to executing national control programmes, and scientific uncertainty about transmission endpoints, are challenges to the success of this effort, especially in areas of high endemicity where financial resources are limited. We used a combined analysis of empirical community data describing the association between infection and chronic disease prevalence, mathematical modelling, and economic analyses to identify and evaluate the feasibility of setting an infection target level at which the chronic pathology attributable to lymphatic filariasis--lymphoedema of the extremities and hydroceles--becomes negligible in the face of continuing transmission as a first stage option in achieving the elimination of this parasitic disease. The results show that microfilaria prevalences below a threshold of 3.55% at a blood sampling volume of 1 ml could constitute readily achievable and sustainable targets to control lymphatic filarial disease. They also show that as a result of the high marginal cost of curing the last few individuals to achieve elimination, maximal benefits can occur at this threshold. Indeed, a key finding from our coupled economic and epidemiological analysis is that when initial uncertainty regarding eradication occurs and prospects for resolving this uncertainty over time exist, it is economically beneficial to adopt a flexible, sequential, eradication strategy based on controlling chronic disease initially.
Full Text Available Elisabeth Farbu Neurocenter and National Competence Center for Movement Disorders, Stavanger University Hospital, Stavanger, NorwayAbstract: Post-polio syndrome (PPS refers to the clinical deterioration experienced by many polio survivors several decades after their acute illness. The symptoms are new muscle weakness, decreased muscle endurance, fatigue, muscle pain, joint pain, cold intolerance, and this typical clinical entity is reported from different parts of the world. The pathophysiology behind PPS is not fully understood, but a combination of distal degeneration of enlarged motor units caused by increased metabolic demands and the normal aging process, in addition to inflammatory mechanisms, are thought to be involved. There is no diagnostic test for PPS, and the diagnosis is based on a proper clinical workup where all other possible explanations for the new symptoms are ruled out. The basic principle of management of PPS lies in physical activity, individually tailored training programs, and lifestyle modification. Muscle weakness and muscle pain may be helped with specific training programs, in which training in warm water seems to be particularly helpful. Properly fitted orthoses can improve the biomechanical movement pattern and be energy-saving. Fatigue can be relieved with lifestyle changes, assistive devices, and training programs. Respiratory insufficiency can be controlled with noninvasive respiratory aids including biphasic positive pressure ventilators. Pharmacologic agents like prednisone, amantadine, pyridostigmine, and coenzyme Q10 are of no benefit in PPS. Intravenous immunoglobulin (IVIG has been tried in three studies, all having positive results. IVIG could probably be a therapeutic alternative, but the potential benefit is modest, and some important questions are still unanswered, in particular to which patients this treatment is useful, the dose, and the therapeutic interval.Keywords: polio, survivors, fatigue, aging
Zulkipli; Aminuddin Ilmar; H.M. Djafar Saidi; Slamet Sampurno
A mandate of the constitution of the Republic of Indonesia as the highest law is the creation of Indonesia people that is just and prosperous and then the development in all sectors becomes a necessity for achieving that goal. To achieve continuity and development success the enforcement of law supremacy in the form of prevention and eradication of corruption is a necessary condition condition sine qua non. Type of legal research conducted is normative. This research was carried out by discu...
From 1804 to 1974, the colonial Dutch East Indies government and the postcolonial Indonesian state attempted to tackle the problem of smallpox. The vaccination efforts in the colonial era virtually eliminated smallpox by 1940. Unfortunately, as a consequence of the war smallpox was reintroduced into the archipelago in 1947. Indonesia finally succeeded in eradicating smallpox in 1974 through campaigns of mass vaccination and surveillance. In the last few years of the fight against smallpox, a detection system was set up in order to have every suspected case of smallpox isolated and investigated by the health authorities until verified in the government laboratory at Bandung. This paper looks at the impact of the archipelagic nature of Indonesia on the smallpox eradication campaigns. PMID:20973337
Spivak, Adam M; Planelles, Vicente
Antiretroviral therapy (ART) has rendered HIV-1 infection a manageable illness for those with access to treatment. However, ART does not lead to viral eradication owing to the persistence of replication-competent, unexpressed proviruses in long-lived cellular reservoirs. The potential for long-term drug toxicities and the lack of access to ART for most people living with HIV-1 infection have fueled scientific interest in understanding the nature of this latent reservoir. Exploration of HIV-1 persistence at the cellular and molecular level in resting memory CD4(+) T cells, the predominant viral reservoir in patients on ART, has uncovered potential strategies to reverse latency. We review recent advances in pharmacologically based 'shock and kill' HIV-1 eradication strategies, including comparative analysis of early clinical trials. PMID:26691297
Sartono, Erliyani; Lisse, Ida M.; Terveer, Elisabeth M.; van de Sande, Paula J. M.; Whittle, Hilton; Fisker, Ane B; ROTH, ADAM; Aaby, Peter; Yazdanbakhsh, Maria; Benn, Christine S
Background: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. Methods and Findings: We compared the in vitro ...
Bipin Vasava, Goti Pravin, Rupani Mihir, Mandaviya Vipul, Chudasma Rajesh
Full Text Available Two rounds of pulse polio immunization in January and February 2008 were evaluated in rural areas of Dang district. Randomly selected team members of 24% booths and teams working during house to house activity were interviewed. Approximately 78% of eligible children were immunized on booths whereas remaining eligible were covered during house to house activity. In January & February 2008 round, tOPV was used for immunization purpose. Utilizers of booth services received information about these rounds mainly from health worker/anganwadi worker and television. During house to house activity, few unimmunized children were found. Adequate manpower with proper training and community mobilization can improve the coverage.
Kim, Sun Jun; Kim, Sung Han; Jee, Young Mee; Kim, Jung Soo
This report describes a case of acute flaccid paralysis after administration of oral polio vaccine (OPV). A 4 month-old male patient with the decreased movement of left lower extremity for 1 month was transferred to the Department of Pediatrics. He received OPV with DTaP at 2 months of age. Flaccid paralysis was detected 4 weeks after OPV immunization. Attempts to isolate Sabin-like viruses in the two stool and CSF samples failed because those specimens were collected more than 2 month after ...
Wilson, Daniel J.
Full Text Available This essay explores the significance that rehabilitation physicians and polio patients in the United States put on recovering the ability to walk. Polio often paralyzed or severely weakened the legs of those who contracted the disease. Regaining the ability to walk was thus a significant measure of recovery from the disease. However, walking meant more than the physical act itself. Regaining the ability to walk meant, in a symbolic sense, that one was no longer disabled, that one had again become normal. This attitude was shared by rehabilitation specialists and patients alike. This essay examines this attitude and the cultural values it embodied through a study of the efforts of selected polio survivors to learn to walk again and of the rehabilitation literature that held walking as an ideal. It also explores what happened when polio patients were unable to walk again because of the severity of their paralysis.
En este artículo se analiza la importancia que tiene la recuperación de la capacidad de andar para los especialistas en rehabilitación y los pacientes de polio en los Estados Unidos. La polio iba a menudo acompañada de parálisis o de una grave debilitación de las piernas en aquellas personas que contraían la enfermedad. El recuperar la capacidad de andar era por lo tanto un importante factor indicativo de la recuperación de la enfermedad. Sin embargo, el andar significaba algo más que la simple acción física. El recuperar la movilidad significaba simbólicamente que uno dejaba de ser un minusválido y que volvía a ser una persona normal. Esta postura la compartían tanto los especialistas en rehabilitación como los pacientes. Este artículo analiza esta actitud y los valores culturales derivados de la misma, a través de un estudio sobre los esfuerzos llevados a cabo por un grupo seleccionado de supervivientes de polio para aprender a andar de nuevo así como de un análisis de la literatura sobre la rehabilitaci
Song, Zhi-Qiang; Liu, Jian; Zhou, Li-Ya
Objective: Helicobacter pylori (H. pylori) eradication remains a challenge with increasing antibiotic resistance. Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety. However, many issues on hybrid therapy are still unclear such as the eradication efficacy, safety, compliance, influencing factors, correlation with antibiotic resistance, and comparison with other regimens. Therefore, a comprehensive review on the evidence of hybrid therapy for H. pylori infection was conducted. Data Sources: The data used in this review were mainly from PubMed articles published in English up to September 30, 2015, searching by the terms of “Helicobacter pylori” or “H. pylori”, and “hybrid”. Study Selection: Clinical research articles were selected mainly according to their level of relevance to this topic. Results: Totally, 1871 patients of 12 studies received hybrid therapy. The eradication rates were 77.6–97.4% in intention-to-treat and 82.6–99.1% in per-protocol analyses. Compliance was 93.3–100.0%, overall adverse effects rate was 14.5–67.5%, and discontinued medication rate due to adverse effects was 0–6.7%. H. pylori culture and sensitivity test were performed only in 13.3% patients. Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible, isolated metronidazole or clarithromycin resistance, and dual clarithromycin and metronidazole resistance were 98.5%, 97.6%, 92.9%, and 80.0%, respectively. Overall, the efficacy, compliance, and safety of hybrid therapy were similar with sequential or concomitant therapy. However, hybrid therapy might be superior to sequential therapy in Asians. Conclusions: Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant
C.I. Oriahi; A.O. Aitufe
This study examines the possible education for the eradication of poverty in Nigeria. It defines poverty as a state pf shortage or deficiency of meeting basic needs. Majors causes of poverty are overpopulation, illiteracy, unemployment, environmental degradation and government insensitive to the welfare of the people. Effects of poverty include homelessness, malnutrition and starvation, illness, crime, violence and antisocial behaviour like Internet Fraud (Yahoo business) and Advance Fee Frau...
The goal of the Mexican Fruit Fly Eradication Programme is to control, suppress or eradicate from Mexico four species of fruit flies of economic and quarantine importance (Anastrepha ludens Loew, A. obliqua Macquart, A. serpentina Wied. and A. striata Schiner). These pests cause damage amounting to US$710 million per year. In addition to this cost, there are other expenses from pest control actions and the loss of international markets, because fruit importing countries have established stringent quarantine measures to restrict the entry of these pests. For purposes of the programme's implementation, Mexico was divided into three working zones, defined by agro-ecological characteristics, the number of fruit fly species present and the size of fruit growing regions. In addition, a cost:benefit analysis was carried out which indicated that the rate of return, in a 12-year time frame, might be as much as 33:1 in Northern Mexico, and 17:1 in the rest of the country, for an area over 100,000 hectares. Eradication technology involves: 1) surveys of pest populations by trapping and host fruit harvesting to monitor the presence and density of fruit flies, 2) reduction of pest populations applying cultural practices and using selective bait sprays, 3) mass release of sterile flies and augmentative release of parasitoids to eliminate populations and, 4) enforcement of quarantine measures to protect fruit fly free areas
Full text: Invasive species increasingly threaten ecosystems, food production, and human welfare worldwide. Hundreds of eradication programs have targeted a wide range of nonnative insect species to mitigate the economic and ecological impacts of biological invasions. Many such programs used multiple tactics to achieve this goal, but interactions between tactics have received little formal consideration, specifically as they interact with Allee dynamics. If a population can be driven below an Allee threshold, extinction becomes more probable because of factors such as the failure to find mates, satiate natural enemies, or successfully exploit food resources, as well as demographic and environmental stochasticity. A key implication of an Allee threshold is that the population can be eradicated without the need and expense of killing the last individuals. Some combinations of control tactics could interact with Allee dynamics to increase the probability of successful eradication. Combinations of tactics can be considered to have synergistic (greater efficiency in achieving extinction from the combination), additive (no improvement over single tactics alone), or antagonistic (reduced efficiency from the combination) effects on Allee dynamics. We highlight examples of combinations of tactics likely to act synergistically, additively, or antagonistically on pest populations. By exploiting the interacting effects of multiple tactics on Allee dynamics, the success and costeffectiveness of eradication programs can be enhanced. (author)
Lashkevich, V A
against poliomyelitis. In some developing countries the vaccination data are falsified, thereby threatening the polio epidemics reappearance and the virus spreading to other countries. Methods must be developed for detection and dealing with extremely rare persistent virus carriers. Because of all these constraints the outcome of poliomyelitis eradication at present is uncertain and vaccination must be continued. The world has become poliovaccine dependent. PMID:23785754
Wing-Chui Chong; Rusliza Basir; Yam Mun Fei
Malaria is an intra-cellular parasitic protozoon responsible for millions of deaths annually.Host and parasite genetic factors are crucial in affecting susceptibility to malaria and progression of the disease.Recent increased deployment of vector controls and new artemisinin combination therapies have dramatically reduced the mortality and morbidity of malaria worldwide.However, the gradual emergence of parasite and mosquito resistance has raised alarm regarding the effectiveness of current artemisinin-based therapies.In this review, mechanisms of anti-malarial drug resistance in thePlasmodium parasite and new genetically engineered tools of research priorities are discussed.The complexity of the parasite lifecycle demands novel interventions to achieve global eradication.However, turning laboratory discovered transgenic interventions into functional products entails multiple experimental phases in addition to ethical and safety hurdles.Uncertainty over the regulatory status and public acceptance further discourage the implementation of genetically modified organisms.
Warburton, B; Livingstone, P
Tuberculosis (TB) due to Mycobacterium bovis infection was first identified in brushtail possums (Trichosurus vulpecula) in New Zealand in the late 1960s. Since the early 1970s, possums in New Zealand have been controlled as part of an ongoing strategy to manage the disease in livestock. The TB management authority (TBfree New Zealand) currently implements three strategic choices for disease-related possum control: firstly TB eradication in areas selected for eradication of the disease from livestock and wildlife, secondly Free Area Protection in areas in which possums are maintained at low densities, normally along a Vector Risk Area (VRA) boundary, and thirdly Infected Herd Suppression, which includes the remaining parts of VRA where possums are targeted to minimise the infection risk to livestock. Management is primarily through a range of lethal control options. The frequency and intensity of control is driven by a requirement to reduce populations to very low levels (usually to a trap-catch index below 2%), then to hold them at or below this level for 5-10 years to ensure disease eradication.Lethal possum control is implemented using aerial- and ground-based applications, under various regulatory and operational constraints. Extensive research has been undertaken aimed at improving the efficacy and efficiency of control. Aerial applications use sodium fluoroacetate (1080) bait for controlling possums over extensive and rugged areas of forest that are difficult to access by foot. Ground-based control uses a range of toxins (primarily, a potassium cyanide-based product) and traps. In the last 5 years there has been a shift from simple possum population control to the collection of spatial data on possum presence/absence and relative density, using simple possum detection devices using global positioning system-supported data collection tools, with recovery of possum carcasses for diagnostic necropsy. Such data provide information subsequently used in predictive
Full Text Available Background:This study conducted to find out the effectiveness of trunk flexion rotation, extension rotationand combined flexion rotation & extension rotation exercises in reduction of scoliosis. Twenty fivemale scolioticsubjects secondary to post-polio residual paralysis were selected for the study as per the inclusionand exclusioncriteria.Method:Materials used for the study were Rontgenograph, Protractor, Pencil and Scale to evaluate the Cobb’sangle. Purposive random sampling method used to select the subjects in three groups for the study. Each groupA, B and C performed trunk flexion rotation, extension rotation and combined flexion rotation and extensionrotation exercises respectively. Subjects performed exercise regularly twice a day for five months under thesupervision of the researcher. The subjects did exercise for one hour with one minute rest in between eachmovement. Cobb’s angle was measured before and after the treatment program for each subject.Results:The calculated t’ value of group A, B and C were 11.00, 9.00 and 10.95 respectively at 5% level andP < 0.0001 for all groups, there for it was significant in reduction of angle of scoliosis among post- polio residualparalysis. The comparative study found that there was no significant difference in reduction of scoliosis amongthe groups.Conclusion:Based on the statistical analysis performed it could conclude that all the groups undergone trunkrotation exercises have improvement in terms of reduction of scoliosis but there was no much difference betweenthe groups on reduction of scoliosis
Gordon Scott did much to inspire the eradication of rinderpest, probably the most outstanding veterinary achievement of the twentieth century, and one currently inspiring is the proposed eradication of peste des petits ruminants (PPR), a disease of sheep and goats caused by a closely related Morbillivirus. The evolution and geographic spread of PPR along with its epidemiological characteristics are discussed and related to ways in which its spread can be reduced through the provision of diagnostic aids to sanitary livestock movement at local level. Taking a historical look at rinderpest eradication, it was shown that much could be achieved using a legislation-backed zoosanitary approach or, once developed, the build up of herd immunities in isolated populations. As the final cap to this (circa), two hundred-year-long process, major national and internationally funded vaccination programmes falling within the informal coordinatorship of the OIE and FAO showed that final eradication could be achieved with remarkable rapidity if the seat of infection was known and if appropriate national and international interventions were aimed at ending virus transmission. Were such international cooperation to be forthcoming once more, the understanding, tools and experiences now on offer suggest that PPR could be controlled and eradicated far more rapidly than rinderpest. PMID:26851956
Touray, Kebba; Mkanda, Pascal; Tegegn, Sisay G.; Nsubuga, Peter; Erbeto, Tesfaye B.; Banda, Richard; Etsano, Andrew; Shuaib, Faisal; Vaz, Rui G.
Introduction. Nigeria is among the 3 countries in which polio remains endemic. The country made significant efforts to reduce polio transmission but remains challenged by poor-quality campaigns and poor team performance in some areas. This article demonstrates the application of geographic information system technology to track vaccination teams to monitor settlement coverage, reduce the number of missed settlements, and improve team performance. Methods. In each local government area where tracking was conducted, global positioning system–enabled Android phones were given to each team on a daily basis and were used to record team tracks. These tracks were uploaded to a dashboard to show the level of coverage and identify areas missed by the teams. Results. From 2012 to June 2015, tracking covered 119 immunization days. A total of 1149 tracking activities were conducted. Of these, 681 (59%) were implemented in Kano state. There was an improvement in the geographic coverage of settlements and an overall reduction in the number of missed settlements. Conclusions. The tracking of vaccination teams provided significant feedback during polio campaigns and enabled supervisors to evaluate performance of vaccination teams. The reports supported other polio program activities, such as review of microplans and the deployment of other interventions, for increasing population immunity in northern Nigeria. PMID:26609004
Full Text Available In 2000, the UN established its Millennium Development Goals, with the notable aim of halving extreme poverty by 2015. That same year, the European Union launched its Lisbon strategy, containing an injunction to “make a decisive impact on the eradication of poverty by 2010”. Since 2007, France has set a national target of reducing poverty by one third over five years. These proactive policies call, in all three cases, for technical elucidation to define and describe poverty. Each of the three scales – French, European and international – has its own approaches and methods of quantification. And yet their similarities are more significant than their differences.
O'Connor, H J
This review presents a critical evaluation of the role of Helicobacter pylori eradication in the management of peptic ulcer disease and non-ulcer dyspepsia. On current evidence, H. pylori eradication therapy seems likely to emerge as the most rational and cost-effective treatment for duodenal ulcer. The role of H. pylori eradication in the treatment of gastric ulcer and non-ulcer dyspepsia is unclear and requires further study. The emerging problem of antibiotic resistance in H. pylori is of ...
Chuan-Yong Guo; Yun-Bin Wu; Heng-Lu Liu; Jian-Ye Wu; Min-Zhang Zhong
AIM: TO evaluate clinical efficacy of four one-week triple therapies in eradicating Helicobacter pylori infection.METHODS: In this clinical trial, 132 patients with duodenal ulcer and chronic gastritis were randomly divided into four 20 mg+ amoxicillin 1 000 mg + clarithromycin 250 mg), OFC (omeprazole 20 mg + furazolidone 100 mg + clarithromycin 250 mg), OFA (omeprazole 20 mg + furazolidone 100 mg + amoxicillin 1000 mg) and OMC (omeprazole 20 mg +metronidazole 200 mg + cladthromycin 250 mg), respectively.Each drug was taken twice daily for one week. The 13C urea breath test was carried out 4-8 weeks after treatment to determine the success of H pylori eradication.RESULTS: A total of 127 patients completed the treatment.The eradication rate for H pylori infection was 90.3%,90.9%, 70.9% and 65.6%, respectively in OAC, OFC OMC and OFA groups.CONCLUSION: A high eradication rate can be achieved with one-week OAC or OFC triple therapy. Thus, oneweek triple therapies with OAC and OFC are recommended for Chinese patients with duodenal ulcers and chronic gastritis.
Betting, David J; Hurvitz, Sara A; Steward, Kristopher K; Yamada, Reiko E; Kafi, Kamran; van Rooijen, Nico; Timmerman, John M
Rituximab plus chemotherapy is standard therapy for patients with non-Hodgkin B cell lymphoma, but often complete response or cure is not achieved. Toll-like receptor 9 agonist CpG oligodeoxynucleotides (CpG) can improve antibody-dependent cellular cytotoxicity and adaptive antitumor immune responses. Using a syngeneic murine B cell lymphoma expressing human CD20 (38C13-huCD20), we previously demonstrated that rituximab plus intratumoral CpG, but not systemic CpG, could eradicate up to half of 7-day established 38C13-huCD20 tumors. However, larger 10-day established tumors could not be cured with this regimen. We thus hypothesized that cytoreduction with cyclophosphamide (Cy) before immunotherapy might permit eradication of these more advanced tumor burdens. Pretreatment with Cy resulted in tumor eradication from 83% of animals treated with rituximab/CpG, whereas Cy/CpG or Cy/rituximab treatments only cured 30% or 17%, respectively (P<0.005). Tumor eradication depended on natural killer cells, but not T cells, macrophages, or complement. Only mice treated with Cy/rituximab/CpG partially resisted rechallenge with tumor cells. Foxp3 Treg and CD11bGr1 myeloid suppressor cells persisted within lymphoid organs after therapy, possibly influencing the ability to establish adaptive tumor immunity. In conclusion, cytoreduction with Cy permitted the cure of large, established lymphomas not otherwise responsive to rituximab plus intratumoral CpG immunotherapy. PMID:22892450
Project URT/5/007 was initiated in 1984 to assist the Government of the United Republic of Tanzania in developing membrane feeding technology for the mass breeding of tsetse flies, which is required for the application of the sterile insect technique to eradicate the tsetse fly from the island of Zanzibar. As the project progressed the objectives focused on the development of inter-related management practices with SIT to control and eventually eradicate the tsetse species infesting Zanzibar. As depicted by the project title, tsetse fly eradication on Zanzibar is the ultimate goal of on-going work of project URT/5/007; however, tsetse fly eradication is not the immediate objective of this project. The total budget of the project for the years 1984 through 1994 includes 53 man-months of expert services, $402,755 for equipment, and $1,959 for fellowship training. Additional funds for 57 man-months of fellowship training were provided from sources outside of the project. Resources provided by the United Republic of Tanzania for the project included staff, local facilities, and local running costs. A Desk Evaluation Review (DER) of Project URT/5/007 was requested by the Africa Section to provide an assessment of project achievements and to determine to what end the project may lead in the near future. Also the review could help determine how experiences gained during the developments of this project might be utilized in the management and implementation of similar projects in Tanzania or the region
Full Text Available Abstract Background In India, children who are traveling during mass immunization campaigns for polio represent a substantial component of the total target population. These children are not easily accessible to health workers and may thus not receive vaccine. Vaccination activities at mass transit sites (such as major intersections, bus depots and train stations, can increase the proportion of children vaccinated but the effectiveness of these activities, and factors associated with their success, have not been rigorously evaluated. Methods We assessed data from polio vaccination activities in Jyotiba Phule Nagar district, Uttar Pradesh, India, conducted in June 2006. We used trends in the vaccination results from the June activities to plan the timing, locations, and human resource requirements for transit vaccination activities in two out of the seven blocks in the district for the July 2006 supplementary immunization activity (SIA. In July, similar data was collected and for the first time vaccination teams also recorded the proportion of children encountered each day who were vaccinated (a new monitoring system. Results In June, out of the 360,937 total children vaccinated, 34,643 (9.6% received vaccinations at mass transit sites. In the July SIA, after implementation of a number of changes based on the June monitoring data, 36,475 children were vaccinated at transit sites (a 5.3% increase. Transit site vaccinations in July increased in the two intervention blocks from 18,194 to 21,588 (18.7% and decreased from 16,449 to 14,887 (9.5% in the five other blocks. The new monitoring system showed the proportion of unvaccinated children at street intersection transit sites in the July campaign decreased from 24% (1,784/7,405 at the start of the campaign to 3% (143/5,057 by the end of the SIA, consistent with findings from the more labor-intensive post-vaccination coverage surveys routinely performed by the program. Conclusions Analysis of
Xie, Wei; Ng, Davis T W
During protein synthesis, the orderly progression of folding, modification, and assembly is paramount to function and vis-à-vis cellular viability. Accordingly, sophisticated quality control mechanisms have evolved to monitor protein maturation throughout the cell. Proteins failing at any step are segregated and degraded as a preventative measure against potential toxicity. Although protein quality control is generally poorly understood, recent research advances in endoplasmic reticulum-associated degradation (ERAD) pathways have provided the most detailed view so far. The discovery of distinct substrate processing sites established a biochemical basis for genetic profiles of model misfolded proteins. Detailed mechanisms for substrate recognition were recently uncovered. For some proteins, sequential glycan trimming steps set a time window for folding. Proteins still unfolded at the final stage expose a specific degradation signal recognized by the ERAD machinery. Through this mechanism, the system does not in fact know that a molecule is "misfolded". Instead, it goes by the premise that proteins past due have veered off their normal folding pathways and therefore aberrant. PMID:20178855
Burt, Alison; Hughes, Barry; Milante, Gary
As the world approaches the target year of the Millennium Development Goals and passes into the new, post-2015 era, the development community has made a call for a new international development goal of eradication of extreme poverty by 2030. How feasible is that? For most of the developing world, the goal seems ambitious, yet achievable -- but what about the prospects for fragile states in...
Sartono, E.; Lisse, I.M.; Terveer, E.M.; van de Sande, P.J.M.; Whittle, H.; Fisker, Bent; Roth, A.; Aaby, Peter; Yazdanbakhsh, M.; Benn, Christine Stabell
Background: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did...... not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. Methods and Findings: We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who...... with OPV. Worryingly, the results indicate that the common practice in low-income countries of administering OPV together with BCG at birth may down-regulate the response to BCG vaccine...
Eriksen, Helle Brander; Lund, Najaaraq; Biering-Sørensen, Sofie;
BACKGROUND: There is increasing evidence that vaccines have an effect on general mortality which goes beyond specific disease protection. Oral polio vaccine (OPV) is widely used in low-income countries, but in observational studies in Guinea-Bissau we observed that not receiving OPV at birth was...... the effect was not seen after 4 weeks (GMR: 0.97 (0.92-1.03)) and 6 weeks (GMR: 0.99 (0.82-1.19)). There were no strong sex-differences. DISCUSSION: Overall there was no effect on thymic size of OPV0 when administered with BCG. The results could indicate that if an effect occurs, it is only within the...
BACKGROUND: The number of insect eradication programmes is rising in response to globalisation. A database of arthropod and plant pathogen eradications covers 1050 incursion responses, with 928 eradication programmes on 299 pest and disease taxa in 104 countries (global eradication database b3.net.nz/gerda). METHODS: A subset of the database was assembled with 211 eradication or response programmes against 17 species of fruit flies (Tephritidae) in 31 countries, in order to investigate factors affecting the outcome. RESULTS: The failure rate for fruit fly eradication programmes was about 7%, with 0% for Ceratitis capitata (n=85 programmes) and 0% for two Anastrepha species (n=12 programmes), but 12% for 13 Bactrocera species (n=108 programmes). A number of intended eradication programmesagainst long-established populations were not initiated because of cost and other considerations, or evolved during the planning phase into suppression programmes. Cost was dependent on area, ranged from $US 0.1 million to $US 240 million and averaged about $US 12 million (normalised to $US in 2012). In addition to the routine use of surveillance networks, quarantine and fruit destruction, the key tactics used in eradication programmes were male annihilation, protein bait sprays (which can attract both sexes), fruit destruction and the sterile insect technique. CONCLUSIONS: Eradication success generally required the combination of several tactics applied on an area-wide basis. Because the likelihood of eradication declines with an increase in the area infested, it pays to invest in effective surveillance networks that allow early detection and delimitation while invading populations are small, thereby greatly favouring eradication success. (author)
Hamisu, Abdullahi Walla; Johnson, Ticha Muluh; Craig, Kehinde; Mkanda, Pascal; Banda, Richard; Tegegne, Sisay G.; Oyetunji, Ajiboye; Ningi, Nuhu; Mohammed, Said M.; Adamu, Mohammed Isa; Abdulrahim, Khalid; Nsubuga, Peter; Vaz, Rui G.; Muhammed, Ado J. G.
Background. The security-challenged states of Adamawa, Borno, and Yobe bear most of the brunt of the Boko Haram insurgency in Nigeria. The security challenge has led to the killing of health workers, destruction of health facilities, and displacement of huge populations. To identify areas of polio transmission and promptly detect possible cases of importation in these states, polio surveillance must be very sensitive. Methods. We conducted a retrospective review of acute flaccid paralysis s...
Jones, Holly P; Holmes, Nick D; Butchart, Stuart H M; Tershy, Bernie R; Kappes, Peter J; Corkery, Ilse; Aguirre-Muñoz, Alfonso; Armstrong, Doug P; Bonnaud, Elsa; Burbidge, Andrew A; Campbell, Karl; Courchamp, Franck; Cowan, Philip E; Cuthbert, Richard J; Ebbert, Steve; Genovesi, Piero; Howald, Gregg R; Keitt, Bradford S; Kress, Stephen W; Miskelly, Colin M; Oppel, Steffen; Poncet, Sally; Rauzon, Mark J; Rocamora, Gérard; Russell, James C; Samaniego-Herrera, Araceli; Seddon, Philip J; Spatz, Dena R; Towns, David R; Croll, Donald A
More than US$21 billion is spent annually on biodiversity conservation. Despite their importance for preventing or slowing extinctions and preserving biodiversity, conservation interventions are rarely assessed systematically for their global impact. Islands house a disproportionately higher amount of biodiversity compared with mainlands, much of which is highly threatened with extinction. Indeed, island species make up nearly two-thirds of recent extinctions. Islands therefore are critical targets of conservation. We used an extensive literature and database review paired with expert interviews to estimate the global benefits of an increasingly used conservation action to stem biodiversity loss: eradication of invasive mammals on islands. We found 236 native terrestrial insular faunal species (596 populations) that benefitted through positive demographic and/or distributional responses from 251 eradications of invasive mammals on 181 islands. Seven native species (eight populations) were negatively impacted by invasive mammal eradication. Four threatened species had their International Union for the Conservation of Nature (IUCN) Red List extinction-risk categories reduced as a direct result of invasive mammal eradication, and no species moved to a higher extinction-risk category. We predict that 107 highly threatened birds, mammals, and reptiles on the IUCN Red List-6% of all these highly threatened species-likely have benefitted from invasive mammal eradications on islands. Because monitoring of eradication outcomes is sporadic and limited, the impacts of global eradications are likely greater than we report here. Our results highlight the importance of invasive mammal eradication on islands for protecting the world's most imperiled fauna. PMID:27001852
Uno, Kaname; Iijima, Katsunori; Shimosegawa, Tooru
Gastric cancer (GC) develops as a result of inflammation-associated carcinogenesis due to Helicobacter pylori (H. pylori) infection and subsequent defects in genetic/epigenetic events. Although the indication for eradication therapy has become widespread, clinical studies have revealed its limited effects in decreasing the incidence of GC. Moreover, research on biopsy specimens obtained by conventional endoscopy has demonstrated the feasibility of the restoration of some genetic/epigenetic alterations in the gastric mucosa. Practically, the number of sporadic cases of primary/metachronous GC that emerge after successful eradication has increased, while on-going guidelines recommend eradication therapy for patients with chronic gastritis and those with background mucosa after endoscopic resection for GC. Accordingly, regular surveillance of numerous individuals who have received eradication therapy is recommended despite the lack of biomarkers. Recently, the focus has been on functional reversibility after successful eradication as another cue to elucidate the mechanisms of restoration as well as those of carcinogenesis in the gastric mucosa after H. pylori eradication. We demonstrated that Congo-red chromoendoscopy enabled the identification of the multi-focal distribution of functionally irreversible mucosa compared with that of restored mucosa after successful eradication in individuals at extremely high risk for GC. Further research that uses functional imaging may provide new insights into the mechanisms of regeneration and carcinogenesis in the gastric mucosa post-eradication and may allow for the development of useful biomarkers. PMID:26989462
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Certification Related to Aerial Eradication in Colombia Pursuant to the authority vested in the Secretary of... for aerial eradication of illicit crops in Colombia is being used in accordance with EPA...
Houe, Hans; Nielsen, Liza Rosenbaum; Nielsen, Søren Saxmose
"Control and eradication of endemic infectious diseases in cattle" provides the key elements that should be addressed in the establishment of bovine disease control and eradication programmes. The book aims to reach a broad group of readers, including: students; professionals in veterinary practice...
Insect eradication programs are nearly always targeted at recently arrived invasive species with significant pest potential. They attempt to contain a pest to a defined area and then completely eliminate the pest from that area. From a Federal regulatory standpoint, eradication programs are undert...
Stott Alistair W
Full Text Available Abstract Bovine viral diarrhoea virus (BVDV causes an economically important endemic disease (BVD of cattle in Ireland and worldwide. Systematic eradication by detection and removal of infectious (BVDV carrier cattle has been successful in several regions. We therefore assessed the benefits (disease losses avoided and costs (testing and culling regime of a potential eradication programme in Ireland. Published bio-economic models of BVDV spread in beef suckler herds and dairy herds were adapted to estimate potential benefits of eradication in Ireland. A simple model of BVDV spread in beef finisher herds was devised to estimate the benefits of eradication in this sector. A six year eradication programme consisting of 5 inter-related virological and serological testing programmes is outlined and costed. We found that the annualised benefits of BVDV eradication in Ireland exceeded the costs by a factor of 5 in the beef suckler sector and a factor of 14 in the dairy sector. Corresponding payback periods were 1.2 and 0.5 years respectively. These results highlight the significant economic impact of BVDV on the Irish cattle industry and suggest a clear economic benefit to eradication using the proposed approach. This type of cost-benefit analysis is considered an essential prerequisite prior to undertaking an eradication campaign of this magnitude.
Full Text Available This article will address how Swedish scientists, physicians and public health officers tried to combat the polio epidemics in the pre-vaccine era. It shows that once polio was considered as an epidemic disease the preventive measures used were based on the hindrance of other infectious diseases. It also illustrates how epidemiological and laboratory studies to some degree affected the thoughts of how polio should be prevented, and that Swedish ideas and experiences differed from those put forward in the USA.
Este artículo trata sobre cómo los científicos, médicos y funcionarios de la sanidad pública de Suecia intentaron combatir la epidemia de la polio en la era anterior a la vacuna y expone que en cuanto la polio fue considerada como una epidemia, las medidas preventivas que se aplicaron se basaban en las de otras enfermedades contagiosas. También ilustra en qué medida los estudios epidemiológicos y los análisis de laboratorio influyeron en la manera de prevenir la polio y también demuestra que las opiniones y experiencias en Suecia eran diferentes a las de los Estados Unidos.
A survey sponsored by US/AID revealed that in 1970 direct crop losses due to Mediterranean fruit fly Ceratitis capitata (Wiedemann) infestations throughout 10 774 km2 (2.7 million acres) in Costa Rica, Nicaragua and Panama approximated US$2.4 million. Potential annual losses would reach US$6.8 million were the medfly to spread throughout presently uninfested Central America. The survey team members estimated that a 6-year eradication programme involving sterile flies, malathion mixed with protein bait, or malathion alone would cost US$30.8, US$25.7 or US$21.8 million, respectively. The subsequent revision of these estimates by agricultural officials of the OIRSA member countries resulted in a 5-year programme involving both malathion and sterile medflies at a cost of US$20.5 million. The financing would be provided by contributions from the governments of the USA, the five Central American countries, Panama, Mexico and the United Kingdom that would be deposited in CABEI to cover the operational costs. This sum would be repaid to CABEI within 10 years and would constitute the nucleus of an emergency fund to combat plant and animal diseases or pests within the OIRSA region. Additional monetary and/or technical support would be requested of UNDP, IAEA, the University of California and the Interamerican Institute of Agricultural Sciences. Intensive trapping for medflies within OIRSA countries that are ostensibly free of this pest and in Belice should be a prerequisite to an active eradication programme. Supplementary information concerning medfly ecology and methods of marking and aerial release is needed. (author)
Rinderpest, which was a major incentive for establishment of the first veterinary school at Lyon in 1764 and later of OIE, also motivated the implementation of an international training course in Maisons-Alfort (France) in 1921, which aimed to improve the control of rinderpest. This postgraduate teaching in exotic medicine was soon organized into an institute, Institut de medecine veterinaire exotique, then, the Institut d'Elevage et de Medecine Veterinaire Tropicale (IEMVT), which was created in 1948 and merged with other French agronomic institutes in 1984, to create CIRAD. For simplicity, this chapter uses the name CIRAD. All the scientists mentioned work at CIRAD unless otherwise stated. The history of CIRAD's contribution to rinderpest eradication is also the history of strong collaboration with national, regional and international veterinary services (OIE, FAO, AU-IBAR) and animal health research centres. A large and significant body of field and laboratory work was carried out during the period. A few years ago, it was still possible to meet pastoralists in remote areas of Chad or the Central African Republic who remembered seeing French vets use their goats to vaccinate cattle with the 'caprinized' rinderpest vaccine. Pan-African vaccination campaigns and the pledge for eradication. CIRAD was involved in all aspects of rinderpest research and control activities since the early 1950s. Most of this work was conducted in the national laboratories of Chad (Farcha; Provost, 1966), Senegal (Dakar) and Ethiopia (Debre Zeit; Lefevre and Domenech, 1974), which are now important components of their respective national animal disease control and research systems. Dakar and Debre Zeit laboratories are major international stakeholders in disease control, through the networks and reference centres of the West and Central Africa Veterinary Laboratory Network for Avian Influenza and other Transboundary Disease (RESOLAB, coordinated by FAO, OIE and AU-IBAR) and PANVAC
Hosken, F P
Female genital mutilation (FGM) is a term applied to genital cutting that can vary from a nick on the clitoris to total excision of all external genital tissue and closure of the vulva. FGM is practiced in many African countries, in some parts of the Arab peninsula and Persian Gulf, in some groups in Indonesia and Malaysia, and among immigrants in Western countries. The practice has been outlawed in the most European countries and in the US. The US legislation also requires all African countries receiving US aid to begin education programs to eradicate FGM mutilation. The first international recommendations to abolish FGM were made in 1979, and the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC) was formed in 1984. The IAC, which gained worldwide support at the 1985 UN Conference for women, has affiliated committees in 26 African countries. The IAC supports its affiliates by offering training, networking opportunities, and resources and by holding a major conference every 3 years. The fourth IAC conference, in 1997 in Dakar, attracted about 90 delegates, including two women from Japan and one from the US. The IAC is working to eradicate all forms of traditionally condoned violence against women and girls, including FGM, child marriage, food taboos, and force feeding. Efforts to reach rural populations rely on distribution of childbirth picture books that explain the biological facts of reproduction and then describe the effects of FGM on women's health. These include immediate complications (including death), long-term complications, pregnancy-associated problems, and psychosexual and psychological problems. PMID:12222522
Ismail, H I; Lal, M
Poliomyelitis in Malaysia has not been reported since 1986. We report two cases of poliomyelitis in non-immunized children whose parents, though relatively educated, opted not to vaccinate their children for socio-cultural reasons. This recent trend may interfere with our attempts to eradicate poliomyelitis globally by the year 2000. The clinical features, pathophysiology and differential diagnosis are discussed. PMID:7506880
Gyrgy; Miklós; Buzás
Studies concerning the eradication of Helicobacter pylori have resulted in a proliferation of meta-analyses. To date, there are 303 meta-analyses cited in PubMed, 113 dealing with the therapy of the infection. A chronological analysis of the results of meta-analyses performed between 1998 and 2010 shows that first-line standard triple therapies achieved eradication rates on an intention-to-treat basis of around 80%; prolonging treatment to 14, but not 10 d should improve the results. The proton pump inhibit...
Recent successes in interrupting indigenous transmission of measles virus in the Americas and in the United Kingdom prompted the World Health Organization (WHO), Pan American Health Organization (PAHO), and CDC to convene a meeting in July, 1996 to consider the feasibility of global measles eradication. Presentations at the meeting included an overview of global measles control and elimination efforts; detailed reviews of successful measles elimination efforts in Latin America, the English-speaking Caribbean, Canada, and the United States; surveillance for clinical disease; laboratory tools for antibody detection and virus identification; and other factors that might influence the feasibility of disease eradication. With this background information, meeting organizers asked participants to address five questions: 1) Is global measles eradication feasible? 2) Is measles eradication feasible with current vaccines? 3) What are the appropriate vaccination strategies for measles eradication? 4) How should surveillance for measles be carried out? 5) What role should outbreak control play in the strategy to eliminate measles? Participants agreed that measles eradication is technically feasible with available vaccines and recommended adoption of the goal of global eradication with a target date during 2005-2010, with the proviso that measles eradication efforts should not interfere with poliomyelitis eradication but should build on the successes of the global Poliomyelitis Eradication Initiative. Although existing vaccines are adequate for eradication, vaccination strategies that rely on administration of a single dose of vaccine are not. In the Americas, sustained interruption of indigenous measles virus transmission has been achieved through a three-tiered vaccination strategy that includes a) "catch-up" vaccination of all persons aged 1-14 years, regardless of disease history or vaccination status; b) "keep-up" vaccination of > or = 90% of children in each successive
Vaz, Rui G.; Mkanda, Pascal; Banda, Richard; Komkech, William; Ekundare-Famiyesin, Olubowale O.; Onyibe, Rosemary; Abidoye, Sunday; Nsubuga, Peter; Maleghemi, Sylvester; Hannah-Murele, Bolatito; Tegegne, Sisay G.
Background. The current West African outbreak of the Ebola virus disease (EVD) began in Guinea in December 2013 and rapidly spread to Liberia and Sierra Leone. On 20 July 2014, a sick individual flew into Lagos, Nigeria, from Monrovia, Liberia, setting off an outbreak in Lagos and later in Port Harcourt city. The government of Nigeria, supported by the World Health Organization and other partners, mounted a response to the outbreak relying on the polio program experiences and infrastructure....
Bakker, Minne; Schipper, Karen; Koopman, Fieke S.; Nollet, Frans; Abma, Tineke A
Background Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life. Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or improvement in secondary endpoints like Quality of Life and self-perceived activity limitations. The aim of this explorative study was to gain insight in the perceived effects and experiences of...
OBJECTIVE: Vaccine-associated paralytic poliomyelitis (VAPP) is a rare but serious consequence of the administration of oral polio vaccine (OPV). Intensified OPV administration has reduced wild poliovirus transmission in India but VAPP is becoming a matter of concern. METHODS: We analysed acute flaccid paralysis (AFP) surveillance data in order to estimate the VAPP risk in this country. VAPP was defined as occurring in AFP cases with onset of paralysis in 1999, residual weakness 60 days after...
Hai-Bo Wang; Shuang-Li Zhu; Jing-Shan Zheng; Ai-Li Gou; Hui Cui; Yong Zhang; Gui-Jun Ning; Chun-Xiang Fan; Yuan-Sheng Chen; Ke-Li Li; Ping Yuan; Chao Ma; Jing Ma; Hui Zheng; Xin-Chun Fan
Background After being polio free for more than 10 years, an outbreak following importation of wild poliovirus (WPV) was confirmed in Xinjiang Uygur Autonomous Region, China, in 2011. Methods A cross-sectional study was conducted prior to supplementary immunization activities (SIAs), immediately after the confirmation of the WPV outbreak. In selected prefectures, participants aged ≤60 years old who visited hospitals at county-level or above to have their blood drawn for reasons not related to...
Tegegne, Sisay G.; MKanda, Pascal; Yehualashet, Yared G.; Erbeto, Tesfaye B.; Touray, Kebba; Nsubuga, Peter; Banda, Richard; Vaz, Rui G.
Background. An accountability framework is a central feature of managing human and financial resources. One of its primary goals is to improve program performance through close monitoring of selected priority activities. The principal objective of this study was to determine the contribution of a systematic accountability framework to improving the performance of the World Health Organization (WHO)–Nigeria polio program staff, as well as the program itself. Methods. The effect of implementation of the accountability framework was evaluated using data on administrative actions and select process indicators associated with acute flaccid paralysis (AFP) surveillance, routine immunization, and polio supplemental immunization activities. Data were collected in 2014 during supportive supervision, using Magpi software (a company that provides service to collect data using mobile phones). A total of 2500 staff were studied. Results. Data on administrative actions and process indicators from quarters 2–4 in 2014 were compared. With respect to administrative actions, 1631 personnel (74%) received positive feedback (written or verbal commendation) in quarter 4 through the accountability framework, compared with 1569 (73%) and 1152 (61%) during quarters 3 and 2, respectively. These findings accorded with data on process indicators associated with AFP surveillance and routine immunization, showing statistically significant improvements in staff performance at the end of quarter 4, compared with other quarters. Conclusions. Improvements in staff performance and process indicators were observed for the WHO-Nigeria polio program after implementation of a systematic accountability framework. PMID:26823334
Mariner, Jeffrey C; Jones, Bryony A; Rich, Karl M; Thevasagayam, Samuel; Anderson, John; Jeggo, Martyn; Cai, Yi; Peters, Andrew R; Roeder, Peter L
Peste des petits ruminants (PPR) is a highly infectious disease of sheep and goats that is caused by PPR virus, a member of the genus Morbillivirus that includes the viruses that cause rinderpest (RP) in cattle. RP was the first animal disease to be globally eradicated in 2011 and is only the second disease, after smallpox, to have ever been eradicated. PPR is one of the principal constraints to small ruminant production in Africa, Asia, and the Middle East. The epidemiology of PPR and RP as well as the technologies available for their diagnosis and control are similar. The conditions that favored the eradication of RP are also largely present for PPR. In this work, we outline the evolving strategy for eradication in light of current opportunities and challenges, as well as the lessons from other eradication programs in animal and human health. The global PPR situation and technology for its control are summarized. A strategy based on the lessons from previous eradication efforts that integrate epidemiology, social science, and economics as tools to target and motivate vaccination is summarized. Major aspects of the cost and benefit-cost analysis of the indicated program are presented. The overall undiscounted cost of eradication was estimated as $3.1 billion, and the benefit-cost ratio for the most likely scenario was estimated at 33.8. We close with a discussion of the possible next steps. PMID:27183645
Vincenzo; De; Francesco; Angelo; Zullo; Cesare; Hassan
The study found that the 7 d of concomitant therapy (lansoprazole, amoxicillin, clarithromycin and metronidazole) achieved significantly higher eradication rates compared to 7 d of triple therapy (lansoprazole, amoxicillin, clarithromycin), the intention to treat (ITT) cure rates being 94.9% and 68.3%, respectively. According to our opinion, this study is clinically relevant for Japanese physicians for at least 2 reasons: (1) the standard triple therapy (clarithromycin plus amoxicillin) achieved disappointing cure rates in Japan-in agreement with what was observed in several countries; and (2) the concomitant quadruple therapy is an effective therapeutic alternative.
Full Text Available Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE, histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15% of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.
Satoshi; Mamori; Akihiro; Higashida; Fumiaki; Kawara; Katsuhiro; Ohnishi; Akihiko; Takeda; Eri; Senda; Cho; Ashida; Hajime; Yamada
AIM:To determine the general risk factors affecting the failure rate of first-line eradication therapy in Japanese patients with Helicobacter pylori(H.pylori)infection.METHODS:The present study enrolled 253 patients who had an H.pylori infection,underwent gastroendoscopy,and were treated with H.pylori eradication therapy.Eradication therapy consisted of 30 mg lansoprazole plus 750 mg amoxicillin and 400 mg clarithromycin twice daily for 7 d.All of the patients underwent a 13 C urea breath test at least 1 mo...
Full Text Available Eradication and elimination are increasingly a part of the global health agenda. Once control measures have driven infection to low levels, the ecology of disease may change posing challenges for eradication efforts. These challenges vary from identifying pockets of susceptibles, improving monitoring during and after the endgame, to quantifying the economics of disease eradication versus sustained control, all of which are shaped and influenced by processes of loss of immunity, susceptible build-up, emergence of resistance, population heterogeneities and non-compliance with control measures. Here we discuss how modelling can be used to address these challenges.
Rodriguez-Torres, J G
for FMD eradication (PHEFA), has been implemented and today Chile and Uruguay are FMD free without vaccination; Argentina, Paraguay, and the states of Rio Grande do Sul and Santa Catarina in Brazil are also recognized by the OIE to be FMD Free, with vaccination. The use of the continental surveillance system is the main strategy for achieving the eradication of FMD in South America. At this time PANAFTOSA is working to improve the system, and to add other diseases indicated by the governments of the Americas. PMID:11193621
Khan, Saiqa I; Blumrosen, Gaddi; Vecchio, Daniela; Golberg, Alexander; McCormack, Michael C; Yarmush, Martin L; Hamblin, Michael R; Austen, William G
Biofilm formation is a significant problem, accounting for over eighty percent of microbial infections in the body. Biofilm eradication is problematic due to increased resistance to antibiotics and antimicrobials as compared to planktonic cells. The purpose of this study was to investigate the effect of Pulsed Electric Fields (PEF) on biofilm-infected mesh. Prolene mesh was infected with bioluminescent Pseudomonas aeruginosa and treated with PEF using a concentric electrode system to derive, in a single experiment, the critical electric field strength needed to kill bacteria. The effect of the electric field strength and the number of pulses (with a fixed pulse length duration and frequency) on bacterial eradication was investigated. For all experiments, biofilm formation and disruption were confirmed with bioluminescent imaging and Scanning Electron Microscopy (SEM). Computation and statistical methods were used to analyze treatment efficiency and to compare it to existing theoretical models. In all experiments 1500 V are applied through a central electrode, with pulse duration of 50 μs, and pulse delivery frequency of 2 Hz. We found that the critical electric field strength (Ecr) needed to eradicate 100-80% of bacteria in the treated area was 121 ± 14 V/mm when 300 pulses were applied, and 235 ± 6.1 V/mm when 150 pulses were applied. The area at which 100-80% of bacteria were eradicated was 50.5 ± 9.9 mm(2) for 300 pulses, and 13.4 ± 0.65 mm(2) for 150 pulses. 80% threshold eradication was not achieved with 100 pulses. The results indicate that increased efficacy of treatment is due to increased number of pulses delivered. In addition, we that showed the bacterial death rate as a function of the electrical field follows the statistical Weibull model for 150 and 300 pulses. We hypothesize that in the clinical setting, combining systemic antibacterial therapy with PEF will yield a synergistic effect leading to improved
Full Text Available Porphyrio porphyrio (Fulica porphyrio Linnaeus was reported to the South Florida Water Management District in a Water Conservation Area and in constructed wetlands in the Everglades in 2006. A rapid assessment, including casual observations and surveys of land managers, indicated a limited number of P. porphyrio (~300 birds was present, and an eradication attempt was initiated. From 2006 – 2008, more than 3100 P. porphyrio were killed by shotgun from airboats during 73 hunts, suggesting the initial population assessment was severely underestimated. After removing nearly 1500 P. porphyrio in 2008, we concluded that eradication was not possible. Failure of this eradication attempt is attributed to P. porphyrio’s affinity with dense emergent vegetation, which greatly limited shooting effectiveness. Further, the failed eradication underscores the importance of a reporting network to improve early detection and the chance to eliminate naturalized or feral populations of non‐native species.
US Fish and Wildlife Service, Department of the Interior — The project as described was to attempt to eradicate yellow-flag iris from Toppenish, McNary and Columbia National Wildlife Refuges using chemical and, where...
US Fish and Wildlife Service, Department of the Interior — The project as described was to attempt to eradicate yellow-flag iris from Toppenish, McNary and Columbia National Wildlife Refuges using chemical and, where...
Full Text Available The correct choice and customization of an orthosis are crucial to obtain the best comfort and efficiency. This study explored the feasibility of a multivariate quantitative assessment of the functional efficiency of lower limb orthosis through a novel wearable system. Gait basographic parameters and energetic indexes were analysed during a Six-Minute Walking Test (6-MWT through a cost-effective, non-invasive polygraph device, with a multichannel wireless transmission, that carried out electro-cardiograph (ECG; impedance-cardiograph (ICG; and lower-limb accelerations detection. Four subjects affected by Post-Polio Syndrome (PPS were recruited. The wearable device and the semi-automatic post-processing software provided a novel set of objective data to assess the overall efficiency of the patient-orthosis system. Despite the small number of examined subjects, the results obtained with this new approach encourage the application of the method thus enlarging the dataset to validate this promising protocol and measuring system in supporting clinical decisions and out of a laboratory environment.
Full Text Available ABSTRACT: Introduction & Objective: The main purpose of radiotherapy is exposing enough doses of radiation to tumor tissue and protecting the normal tissues around it. Tumor dose for each session in radiotherapy will be considered based on radiosensitivity of the tissues. The presence of viral diseases in tumoral area can affect the radiosensitivity of cells. This study aimed to evaluate the radiosensitivity of Hela cells infected with poliomyelitis virus irradiated by Co 60. Materials & Methods: In this study, the radiosensitivity of HeLa cells, with or without the viral infection, after gamma radiation of cobalt 60, was assessed. Results: Results of comparison of the radisensitivity of infected and uninfected cells indicates that after 2 Gy irradiation by Co 60, polio infection in low, moderate and high virus load, increases the cell death by 20-30%, 30-40% and 70-90% respectively. Conclusion : Radiosensitivity of tumoral cells increase when they are infected with viral agents. Results of this study showed that non cancer diseases should be considered when prescribing dose fraction in radiotherapy of cancers.
Jensen, Kristoffer Jarlov; Karkov, Hanne Sophie; Lund, Najaaraq; Andersen, Andreas; Eriksen, Helle Brander; Barbosa, Amarildo Gomes; Kantsø, Bjørn; Aaby, Peter; Benn, Christine Stabell
BACKGROUND: Vaccines may have non-specific effects. An observational study from Guinea-Bissau suggested that oral polio vaccine at birth (OPV0) provided with Bacillus Calmette-Guérin (BCG) vaccine was associated with down-regulation of the immune response to BCG vaccine 6 weeks later. Based on the...... BCG alone at birth, and subsequently randomised to have a blood sample taken at 2, 4 or 6 weeks post-randomisation. Excreted levels of cytokines (IL-2, IL-5, IL-10, TNF-α and IFN-γ) were measured from whole blood in vitro stimulations with a panel of recall vaccine antigens (BCG, PPD, OPV), mitogen...... previous finding, we wanted to test our a priori hypothesis that OPV would dampen the immune response to BCG, and secondarily to test immune responses to other antigens. METHODS: The study was conducted at the Bandim Health Project in Guinea-Bissau in 2009-2010. Infants were randomised to OPV0+BCG versus...