Estimating the Extent of Vaccine-Derived Poliovirus Infection 英文参考文献.docVIP

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Estimating the Extent of Vaccine-Derived Poliovirus Infection 英文参考文献.doc

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Estimating the Extent of Vaccine-Derived Poliovirus Infection 英文参考文献

EstimatingtheExtentofVaccine-DerivedPoliovirus Infection AlisonWringe1*,PaulE.M.Fine1,RolandW.Sutter2,OlenM.Kew3 1DepartmentofEpidemiologyandPopulationHealth,LondonSchoolofHygieneandTropicalMedicine,London,England,2PolioEradicationDepartment,WorldHealth Organization,Geneva,Switzerland,3DivisionofViralDiseases,CentersforDiseaseControlandPrevention,Atlanta,Georgia,UnitedStatesofAmerica Abstract Background: Eight outbreaks of paralytic polio attributable to circulating vaccine-derived poliovirus (cVDPV) have highlighted the risks associated with oral poliovirus vaccine (OPV) use in areas of low vaccination coverage and poor hygiene.AsthePolioEradicationInitiativeentersitsfinalstages,itisimportanttoconsidertheextenttowhichtheseviruses spread under different conditions, so that appropriate strategies canbe devised to prevent or respond to future cVDPV outbreaks. Methods and Findings: This paper examines epidemiological (temporal, geographic, age, vaccine history, social group, ascertainment),andvirological(type,geneticdiversity,virulence)parametersinordertoinferthenumbersofindividuals likelytohavebeeninfectedineachofthesecVDPVoutbreaks,andinassociationwithsingleacuteflaccidparalysis(AFP) casesattributabletoVDPVs.Althoughonly114virologically-confirmedparalyticcaseswereidentifiedintheeightcVDPV outbreaks,itislikelythataminimumofhundredsofthousands,andmorelikelyseveralmillionindividualswereinfected duringtheseevents,andthatmanythousandsmorehavebeeninfectedbyVDPVlineageswithinoutbreakswhichhave escapeddetection. Conclusions:OurestimatesoftheextentofcVDPVcirculationsuggestwidespreadtransmissioninsomecountries,asmight be expected from endemic wild poliovirus transmission in these same settings. These methods for inferring extent of infectionwillbeusefulinthecontextofidentifyingfuturesurveillanceneeds,planningforOPVcessationandpreparing outbreakresponseplans. Citation: WringeA, Fine PEM, Sutter RW, Kew OM (2008) Estimating the Extent of Vaccine-Derived Poliovirus Infection. P