Review and Assessment of Poliovirus Immunity and Transmission: Synthesis of Knowledge Gaps and Identification of Research Needs

    Authors

    R. J. D. Tebbens; M. A. Pallansch; K. M. Chumakov; N. A. Halsey; T. Hovi; P. D. Minor; J. F. Modlin; P. A. Patriarca; R. W. Sutter; P. F. Wright; S. G. F. Wassilak; S. L. Cochi; J. H. Kim;K. M. Thompson

    Comments

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    Abbreviated Journal Title

    Risk Anal.

    Keywords

    Dynamic modeling; expert judgment; polio eradication; VACCINE-DERIVED POLIOVIRUS; EXPERT JUDGMENT; SENSITIVITY ANALYSES; CONTROLLED-TRIAL; GLOBAL POLICIES; OPV CESSATION; DOUBLE-BLIND; POLIOMYELITIS; ERADICATION; MANAGEMENT; Public, Environmental & Occupational Health; Mathematics, ; Interdisciplinary Applications; Social Sciences, Mathematical Methods

    Abstract

    With the intensifying global efforts to eradicate wild polioviruses, policymakers face complex decisions related to achieving eradication and managing posteradication risks. These decisions and the expanding use of inactivated poliovirus vaccine (IPV) trigger renewed interest in poliovirus immunity, particularly the role of mucosal immunity in the transmission of polioviruses. Sustained high population immunity to poliovirus transmission represents a key prerequisite to eradication, but poliovirus immunity and transmission remain poorly understood despite decades of studies. In April 2010, the U.S. Centers for Disease Control and Prevention convened an international group of experts on poliovirus immunology and virology to review the literature relevant for modeling poliovirus transmission, develop a consensus about related uncertainties, and identify research needs. This article synthesizes the quantitative assessments and research needs identified during the process. Limitations in the evidence from oral poliovirus vaccine (OPV) challenge studies and other relevant data led to differences in expert assessments, indicating the need for additional data, particularly in several priority areas for research: (1) the ability of IPV-induced immunity to prevent or reduce excretion and affect transmission, (2) the impact of waning immunity on the probability and extent of poliovirus excretion, (3) the relationship between the concentration of poliovirus excreted and infectiousness to others in different settings, and (4) the relative role of fecal-oral versus oropharyngeal transmission. This assessment of current knowledge supports the immediate conduct of additional studies to address the gaps.

    Journal Title

    Risk Analysis

    Volume

    33

    Issue/Number

    4

    Publication Date

    1-1-2013

    Document Type

    Article

    Language

    English

    First Page

    606

    Last Page

    646

    WOS Identifier

    WOS:000317295900004

    ISSN

    0272-4332

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