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Lessons From the Polio Endgame: Overcoming the Failure to Vaccinate and the Role of Subpopulations in Maintaining Transmission.

Abstract Recent detections of circulating serotype 2 vaccine-derived poliovirus in northern Nigeria (Borno and Sokoto states) and Pakistan (Balochistan Province) and serotype 1 wild poliovirus in Pakistan, Afghanistan, and Nigeria (Borno) represent public health emergencies that require aggressive response.
PMID
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Authors

Mayor MeshTerms

Global Health

Poliomyelitis

Poliovirus

Keywords
Journal Title the journal of infectious diseases
Publication Year Start




PMID- 28838194
OWN - NLM
STAT- MEDLINE
DA  - 20170825
DCOM- 20170905
LR  - 20170906
IS  - 1537-6613 (Electronic)
IS  - 0022-1899 (Linking)
VI  - 216
IP  - suppl_1
DP  - 2017 Jul 01
TI  - Lessons From the Polio Endgame: Overcoming the Failure to Vaccinate and the Role 
      of Subpopulations in Maintaining Transmission.
PG  - S176-S182
LID - 10.1093/infdis/jix108 [doi]
AB  - Background: Recent detections of circulating serotype 2 vaccine-derived
      poliovirus in northern Nigeria (Borno and Sokoto states) and Pakistan
      (Balochistan Province) and serotype 1 wild poliovirus in Pakistan, Afghanistan,
      and Nigeria (Borno) represent public health emergencies that require aggressive
      response. Methods: We demonstrate the importance of undervaccinated
      subpopulations, using an existing dynamic poliovirus transmission and oral
      poliovirus vaccine evolution model. We review the lessons learned during the
      polio endgame about the role of subpopulations in sustaining transmission, and we
      explore the implications of subpopulations for other vaccine-preventable disease 
      eradication efforts. Results: Relatively isolated subpopulations benefit little
      from high surrounding population immunity to transmission and will sustain
      transmission as long as they do not attain high vaccination coverage. Failing to 
      reach such subpopulations with high coverage represents the root cause of polio
      eradication delays. Achieving and maintaining eradication requires addressing the
      weakest links, which includes immunizing populations in insecure areas and/or
      with disrupted or poor-performing health systems and managing the risks of
      individuals with primary immunodeficiencies who can excrete vaccine-derived
      poliovirus long-term. Conclusions: Eradication efforts for vaccine-preventable
      diseases need to create performance expectations for countries to immunize all
      people living within their borders and maintain high coverage with appropriate
      interventions.Keywords. Polio; eradication; transmission; heterogeneity.
FAU - Thompson, Kimberly M
AU  - Thompson KM
AD  - Kid Risk.
AD  - College of Medicine, University of Central Florida, Orlando.
FAU - Duintjer Tebbens, Radboud J
AU  - Duintjer Tebbens RJ
AD  - Kid Risk.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Infect Dis
JT  - The Journal of infectious diseases
JID - 0413675
RN  - 0 (Poliovirus Vaccine, Oral)
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Disease Outbreaks/*prevention & control
MH  - *Global Health
MH  - Health Services Accessibility
MH  - Humans
MH  - Immunization
MH  - Infant
MH  - Infant, Newborn
MH  - Models, Biological
MH  - Models, Statistical
MH  - *Poliomyelitis/immunology/prevention & control/transmission/virology
MH  - *Poliovirus/immunology/pathogenicity
MH  - Poliovirus Vaccine, Oral
EDAT- 2017/08/26 06:00
MHDA- 2017/09/07 06:00
CRDT- 2017/08/26 06:00
AID - 3935072 [pii]
AID - 10.1093/infdis/jix108 [doi]
PST - ppublish
SO  - J Infect Dis. 2017 Jul 1;216(suppl_1):S176-S182. doi: 10.1093/infdis/jix108.