Worst-case scenarios: Modeling uncontrolled type 2 polio transmission.
Autor: | Kalkowska DA; Kid Risk, Inc., Orlando, Florida, USA., Wiesen E; Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Wassilak SGF; Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Burns CC; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Pallansch MA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Badizadegan K; Kid Risk, Inc., Orlando, Florida, USA., Thompson KM; Kid Risk, Inc., Orlando, Florida, USA. |
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Jazyk: | angličtina |
Zdroj: | Risk analysis : an official publication of the Society for Risk Analysis [Risk Anal] 2024 Feb; Vol. 44 (2), pp. 379-389. Date of Electronic Publication: 2023 Jun 21. |
DOI: | 10.1111/risa.14159 |
Abstrakt: | In May 2016, the Global Polio Eradication Initiative (GPEI) coordinated the cessation of all use of type 2 oral poliovirus vaccine (OPV2), except for emergency outbreak response. Since then, paralytic polio cases caused by type 2 vaccine-derived polioviruses now exceed 3,000 cases reported by 39 countries. In 2022 (as of April 25, 2023), 20 countries reported detection of cases and nine other countries reported environmental surveillance detection, but no reported cases. Recent development of a genetically modified novel type 2 OPV (nOPV2) may help curb the generation of neurovirulent vaccine-derived strains; its use since 2021 under Emergency Use Listing is limited to outbreak response activities. Prior modeling studies showed that the expected trajectory for global type 2 viruses does not appear headed toward eradication, even with the best possible properties of nOPV2 assuming current outbreak response performance. Continued persistence of type 2 poliovirus transmission exposes the world to the risks of potentially high-consequence events such as the importation of virus into high-transmission areas of India or Bangladesh. Building on prior polio endgame modeling and assuming current national and GPEI outbreak response performance, we show no probability of successfully eradicating type 2 polioviruses in the near term regardless of vaccine choice. We also demonstrate the possible worst-case scenarios could result in rapid expansion of paralytic cases and preclude the goal of permanently ending all cases of poliomyelitis in the foreseeable future. Avoiding such catastrophic scenarios will depend on the development of strategies that raise population immunity to type 2 polioviruses. (© 2023 Society for Risk Analysis.) |
Databáze: | MEDLINE |
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