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Vaccine-Derived Poliovirus Outbreaks and Events - Three Provinces, Democratic Republic of the Congo, 2017.

Abstract The last confirmed wild poliovirus (WPV) case in Democratic Republic of the Congo (DRC) had paralysis onset in December 2011 (1). DRC has had cases of vaccine-derived polioviruses (VDPVs) documented since 2004 (Table 1) (1-6). After an outbreak of 30 circulating VDPV type 2 (cVDPV2) cases during 2011-2012, only five VDPV2 cases were reported during 2013-2016 (Table 1) (1-6). VDPVs can emerge from oral poliovirus vaccine (OPV types 1, 2, or 3; Sabin) polioviruses that have genetically mutated resulting in reversion to neurovirulence. This process occurs during extensive person-to-person transmission in populations with low immunity or after extended replication in the intestines of immune-deficient persons following vaccination (1-6). During 2017 (as of March 8, 2018), 25 VDPV cases were reported in three provinces in DRC: in Tanganyika province, an emergence with one VDPV2 case (pending final classification) in Kabalo health zone and an emergence with one ambiguous VDPV type 1 (aVDPV1) case in Ankoro health zone; in Maniema province, an emergence with two cVDPV2 cases; and in Haut Lomami province, an emergence with 20 cVDPV2 cases that originated in Haut Lomami province and later spread to Tanganyika province (hereafter referred to as the Haut Lomami outbreak area) and an emergence with one aVDPV type 2 (aVDPV2) case in Lwamba health zone (Table 1) (Figure) (6). Outbreak response supplementary immunization activities (SIAs) were conducted during June-December 2017 (Table 2) (6). Because of limitations in surveillance and suboptimal SIA quality and geographic scope, cVDPV2 circulation is likely continuing in 2018, requiring additional SIAs. DRC health officials and Global Polio Eradication Initiative (GPEI) partners are increasing human and financial resources to improve all aspects of outbreak response.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start




PMID- 29543791
OWN - NLM
STAT- MEDLINE
DCOM- 20180316
LR  - 20180316
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 67
IP  - 10
DP  - 2018 Mar 16
TI  - Vaccine-Derived Poliovirus Outbreaks and Events - Three Provinces, Democratic
      Republic of the Congo, 2017.
PG  - 300-305
LID - 10.15585/mmwr.mm6710a4 [doi]
AB  - The last confirmed wild poliovirus (WPV) case in Democratic Republic of the Congo
      (DRC) had paralysis onset in December 2011 (1). DRC has had cases of
      vaccine-derived polioviruses (VDPVs) documented since 2004 (Table 1) (1-6). After
      an outbreak of 30 circulating VDPV type 2 (cVDPV2) cases during 2011-2012, only
      five VDPV2 cases were reported during 2013-2016 (Table 1) (1-6). VDPVs can emerge
      from oral poliovirus vaccine (OPV types 1, 2, or 3; Sabin) polioviruses that have
      genetically mutated resulting in reversion to neurovirulence. This process occurs
      during extensive person-to-person transmission in populations with low immunity
      or after extended replication in the intestines of immune-deficient persons
      following vaccination (1-6). During 2017 (as of March 8, 2018), 25 VDPV cases
      were reported in three provinces in DRC: in Tanganyika province, an emergence
      with one VDPV2 case (pending final classification) in Kabalo health zone and an
      emergence with one ambiguous VDPV type 1 (aVDPV1) case in Ankoro health zone; in 
      Maniema province, an emergence with two cVDPV2 cases; and in Haut Lomami
      province, an emergence with 20 cVDPV2 cases that originated in Haut Lomami
      province and later spread to Tanganyika province (hereafter referred to as the
      Haut Lomami outbreak area) and an emergence with one aVDPV type 2 (aVDPV2) case
      in Lwamba health zone (Table 1) (Figure) (6). Outbreak response supplementary
      immunization activities (SIAs) were conducted during June-December 2017 (Table 2)
      (6). Because of limitations in surveillance and suboptimal SIA quality and
      geographic scope, cVDPV2 circulation is likely continuing in 2018, requiring
      additional SIAs. DRC health officials and Global Polio Eradication Initiative
      (GPEI) partners are increasing human and financial resources to improve all
      aspects of outbreak response.
FAU - Alleman, Mary M
AU  - Alleman MM
FAU - Chitale, Rohit
AU  - Chitale R
FAU - Burns, Cara C
AU  - Burns CC
FAU - Iber, Jane
AU  - Iber J
FAU - Dybdahl-Sissoko, Naomi
AU  - Dybdahl-Sissoko N
FAU - Chen, Qi
AU  - Chen Q
FAU - Van Koko, Djo-Roy
AU  - Van Koko DR
FAU - Ewetola, Raimi
AU  - Ewetola R
FAU - Riziki, Yogolelo
AU  - Riziki Y
FAU - Kavunga-Membo, Hugo
AU  - Kavunga-Membo H
FAU - Dah, Cheikh
AU  - Dah C
FAU - Andriamihantanirina, Rija
AU  - Andriamihantanirina R
LA  - eng
PT  - Journal Article
DEP - 20180316
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
RN  - 0 (Poliovirus Vaccine, Oral)
SB  - IM
MH  - Democratic Republic of the Congo/epidemiology
MH  - Disease Outbreaks/*statistics & numerical data
MH  - Humans
MH  - Poliomyelitis/*epidemiology
MH  - Poliovirus Vaccine, Oral/*adverse effects
COIS- No conflicts of interest were reported.
EDAT- 2018/03/16 06:00
MHDA- 2018/03/17 06:00
CRDT- 2018/03/16 06:00
PHST- 2018/03/16 06:00 [entrez]
PHST- 2018/03/16 06:00 [pubmed]
PHST- 2018/03/17 06:00 [medline]
AID - 10.15585/mmwr.mm6710a4 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2018 Mar 16;67(10):300-305. doi:
      10.15585/mmwr.mm6710a4.