Post 01346e: Wild Polio Virus 1,2 & 3 And Vapp

POST 01346E: WILD POLIO VIRUS 1,2 & 3 AND VAPP REQUIRE AN EFFECTIVE VACCINE FOR ERADICATION FOLLOW-UP ON POSTS 01339E, 01341E, 013342E, 01343E, 01344E & 01345E 5 NOVEMBER 2008 ****************************************** Dear Editor, As per your suggestion I looked up the web-page: "Weekly Update"and found a large but interesting table "Wild Polio Virus List". I have copied the "total" columns and files below. What strikes you when studying carefully this table, is what has happened in 2007 and 2008: 1. In 2007 the cases of Wild Polio 1 went very much down, but unfortunately the cases of Wild Polio 3 went up. 2. In 2008 the number of cases of both Polio Wild 1 and Polio Wild 3 have been high. You get the impression that a vaccine against Wild Polio 1 is not that good for eradicating Polio Wild 3. Do we have a vaccine that is equally good for all strains of polio? Do we not have an epidemiologist between the readers of Technet Forum who can explain this puzzle? 2000 2001 2002 2003 2004 2005 2006 2007 Jan-end Oct. 2007 2008 Total Polio cases 719 483 1918 784 1255 1979 1997 1315 669 1431 Wild type 1 349 1744 555 1045 1716 1666 321 236 853 Wild type 3 134 174 229 210 263 331 994 433 578 Number of countries 23 15 9 15 18 16 17 12 11 15 Best regards, Mogens Munck ([[email protected]][email protected][/email]) -------- Robert Steinglass shares with us the Indian Academy of Pediatrics’ (IAP) position paper on polio and RI. Many thanks. Extracts from the paper Universal Immunization Program and Polio Eradication in India While India had the potential to be the leader of Universal Immunization Programme (UIP) and polio eradication in the SE Asia Region, the national policies, strategies, tactics and achievements have not matched that potential. On the contrary, India’s UIP remains one of the weakest and India is the only country in the Region with no effective measles control program and the only one that did not achieve polio eradication by the year 2000. We believe there is a nexus between poorly performing UIP and the delays to achieve polio eradication. We also believe that with political will and well-designed action plan India can rapidly improve UIP. A high-performing UIP will be essential to sustain polio eradication in the long term after interruption of transmission of wild polioviruses is achieved. ... While PEI and UIP are intimately intertwined, it was indeed unfortunate that PEI was virtually de-linked from UIP in terms of technical issues while burdening UIP managers with additional workload. The long term sustainability of PEI and the protection of the enormous investments made to date for PEI will rest in future on an efficiently functioning UIP. ... Scientific studies in India had shown clearly that the protective efficacy (vaccine efficacy, VE) of tOPV was very low for types 1 and 3 but satisfactory for type 2. Large numbers of children developed polio in spite of 3 doses of tOPV every year. Indian studies had also shown very high efficacy of IPV for all three types (1-2). ... Countries that used IPV achieved complete eradication straightaway, but countries that eradicated wild viruses using OPV had to go through a second phase to eliminate vaccine viruses, for which many have switched to IPV from OPV from the 1980s onwards. ... The GoI embarked on the mission of PEI as if eradication should be achieved first, and improvement of UIP could be attempted later. It will be extremely unwise to postpone the reconstruction of the damaged UIP system – a likely temptation in view of the fact that WPV types 1 and 3 may be eradicated using mOPVs. ... The need for high vaccination coverage with all UIP vaccines pre-existed the era of PEI. The importance and need for efficient UIP will outlive PEI. The need to monitor the progress of control of diseases under UIP has not been realized; one element of the poor performance of UIP is precisely this lack of monitoring. Targeting polio for eradication before controlling diphtheria, pertussis and measles would have been justified only if high UIP vaccination coverages were achieved against these diseases. ... The full paper is attached. Post generated using Mail2Forum (http://www.mail2forum.com) ##text##