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Cited by 131Viral Infections and Immunology ResearchVirology and Viral DiseasesVaccine Coverage and Hesitancy

Implications of a circulating vaccine-derived poliovirus in Nigeria

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Jenkins, Helen E., Aylward, R. Bruce, Gasasira, Alex, Donnelly, Christl A., Mwanza, Michael, Corander, Jukka, Garnier, Sandra, Chauvin, Claire +5 more·2010·New England Journal of Medicine
DOI 10.1056/nejmoa0910074
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Abstract

BACKGROUND: The largest recorded outbreak of a circulating vaccine-derived poliovirus (cVDPV), detected in Nigeria, provides a unique opportunity to analyze the pathogenicity of the virus, the clinical severity of the disease, and the effectiveness of control measures for cVDPVs as compared with wild-type poliovirus (WPV). METHODS: We identified cases of acute flaccid paralysis associated with fecal excretion of type 2 cVDPV, type 1 WPV, or type 3 WPV reported in Nigeria through routine surveillance from January 1, 2005, through June 30, 2009. The clinical characteristics of these cases, the clinical attack rates for each virus, and the effectiveness of oral polio vaccines in preventing paralysis from each virus were compared. RESULTS: No significant differences were found in the clinical severity of paralysis among the 278 cases of type 2 cVDPV, the 2323 cases of type 1 WPV, and the 1059 cases of type 3 WPV. The estimated average annual clinical attack rates of type 1 WPV, type 2 cVDPV, and type 3 WPV per 100,000 susceptible children under 5 years of age were 6.8 (95% confidence interval [CI], 5.9 to 7.7), 2.7 (95% CI, 1.9 to 3.6), and 4.0 (95% CI, 3.4 to 4.7), respectively. The estimated effectiveness of trivalent oral polio vaccine against paralysis from type 2 cVDPV was 38% (95% CI, 15 to 54%) per dose, which was substantially higher than that against paralysis from type 1 WPV (13%; 95% CI, 8 to 18%), or type 3 WPV (20%; 95% CI, 12 to 26%). The more frequent use of serotype 1 and serotype 3 monovalent oral polio vaccines has resulted in improvements in vaccine-induced population immunity against these serotypes and in declines in immunity to type 2 cVDPV. CONCLUSIONS: The attack rate and severity of disease associated with the recent cVDPV identified in Nigeria are similar to those associated with WPV. International planning for the management of the risk of WPV, both before and after eradication, must include scenarios in which equally virulent and pathogenic cVDPVs could emerge.

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  • A severe outbreak of cVDPV2 occurred in Nigeria from 2005 for more than six years, with more than 300 cases of polio.

    “A severe outbreak of cVDPV2 occurred in Nigeria from 2005 for more than six years, with more than 300 cases of polio [97,98,99].”

    From The Fight against Poliovirus Is Not Over (2023) · cites this paper as [98]

    The Abstract (page not available) identifies Nigeria’s type 2 cVDPV outbreak as the largest recorded and reports 278 cases in surveillance from January 2005 through June 2009. The Discussion (page not available) reports 10 further cases in the second half of 2009. Our copy does not establish that the outbreak began in 2005, lasted more than six years, or caused more than 300 cases. (LLM, conf=0.90)

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Research works printed but not linked: 4

  1. [1]1. Global Polio Eradication Initiative web- 1. site. (Accessed May 28, 2010, at http:// www.polioeradication.org/.) Resurgence of wild poliovirus types 1 2. and 3 in 15 African countries, January 2008-March 2009. Wkly Epidemiol Rec 2009;84:133-40. Global update on vaccine-derived po- 3. lioviruses, January 2006-August 2007. Wkly Epidemiol Rec 2007;82:337-43.
  2. [11]11. Eradication. Recommendations on the use of bivalent oral poliovirus vaccine types 1 and 3. Wkly Epidemiol Rec 2009;84:289- 90.
  3. [13]13. cation -Nigeria, 1996-1998. Wkly Epi- demiol Rec 1997;74:121-4. Vaccine-derived polioviruses detected 17. worldwide, January 2008-June 2009. Wkly Epidemiol Rec 2009;84:390-6.
  4. [19]19. Patriarca PA, Wright PF, John TJ. Fac- 22. tors affecting the immunogenicity of oral poliovirus vaccine in developing coun- tries. Rev Infect Dis 1991;13:926-39.

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Authors
Jenkins, H. E., Aylward, R. B., Gasasira, A., Donnelly, C. A., Mwanza, M., Corander, J., Garnier, S., Chauvin, C., Abanida, E., Pate, M. A., Adu, F., Baba, M., & Grassly, N. C.
Affiliations
  • Imperial College London (GB)
  • World Health Organization - Nigeria (NG)
  • University of Helsinki (FI)
  • National Primary Health Care Development Agency (NG)
  • University of Ibadan (NG)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2010-06-24
Volume
362
Issue
25
Pages
2360-2369
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa0910074
OpenAlex
W2134095241
Cited by
131
References
17
Citations by year
2025: 4 · 2024: 1 · 2023: 5 · 2022: 6 · 2021: 2 · 2020: 9 · 2019: 4 · 2018: 5 · 2017: 6 · 2016: 10 · 2015: 12 · 2014: 15 · 2013: 15 · 2012: 20
FWCI
11.51
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
Keywords
circulating vaccine-derived poliovirus, poliovirus type 2, acute flaccid paralysis, clinical severity, trivalent oral polio vaccine, vaccine-induced immunity, wild-type poliovirus, polio eradication, serotype 1
MeSH terms
Adolescent, Child, Child, Preschool, Humans, Infant, Nigeria, Paraplegia, Poliomyelitis, Poliovirus Vaccine, Oral, Population Surveillance, Severity of Illness Index, Vaccination, Poliovirus

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