Human Poliovirus

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Viral Pathogens".

Deadline for manuscript submissions: 20 January 2025 | Viewed by 19799

Special Issue Editors


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Guest Editor
Center for Vaccine Equity, The Task Force for Global Health, 325 Swanton Way, Decatur, GA 30030, USA
Interests: antivirals; vaccines; poliovirus eradication; enterovirus treatment; influenza vaccination program development in LMICs; coronavirus vaccines; hepatitis B&C elimination

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Guest Editor
Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 954 Gatewood Road, Atlanta, GA 30329, USA
Interests: influenza virus epidemiology; vaccine effectiveness; observational studies; methods to overcome vaccine hesitancy; polio eradication; immune responses to vaccines and infection; immunization against polio; measles; rubella; immunization; vaccines; viral surveillance; animal surveillance

Special Issue Information

Dear Colleagues, 

Human polioviruses are the cause of poliomyelitis, a highly infectious disease that most commonly affects children under the age of 5. Polioviruses are spread from person to person, typically through the fecal–oral route and less frequently through contaminated water. Most people who become infected with poliovirus do not develop symptoms. Approximately a quarter of infections result in flu-like symptoms lasting two to five days. In 0.1–0.5% of cases, poliovirus will infect the nervous system, and in some instances, lead to paralysis. Death occurs in 2 to 10% of paralyzed cases. Post-polio syndrome (weakness, muscle pain, or paralysis) can develop in those that recover from infection decades after the initial infection. Although there is no cure, there are safe and effective vaccines used to immunize over 2.5 billion children worldwide and antivirals in development to stop virus excretion in immune-deficient individuals. In 1988, the World Health Assembly adopted a resolution for the worldwide eradication of polio. Of the three polio serotypes, as of 2020, only wild poliovirus type 1 remains in two countries: Pakistan and Afghanistan.  Wild poliovirus types 2 and 3 have been certified as eradicated.  On the other hand, circulating vaccine-derived polioviruses (cVDPV), which have mutated and regained both the neurovirulence and transmissibility properties of wild polioviruses, are now causing outbreaks in many countries and are an impediment to achieving the final goal of the eradication of polio. 

This Special Issue is focused on the progress made in the eradication of poliovirus including the innovations in the development of antivirals and safer vaccines, improved surveillance, and vaccination campaigns. We invite you to submit original articles and review articles related to the above topics. This Special Issue will provide new knowledge about the advances that have been made that will help us reach our goal of polio eradication.

Dr. Mark A. McKinlay
Prof. Dr. Walter A. Orenstein
Guest Editors

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Keywords

  • poliovirus
  • vaccination
  • eradication
  • surveillance
  • antivirals

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Published Papers (9 papers)

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Research

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19 pages, 1523 KiB  
Article
Increasing Population Immunity Prior to Globally-Coordinated Cessation of Bivalent Oral Poliovirus Vaccine (bOPV)
by Nima D. Badizadegan, Steven G. F. Wassilak, Concepción F. Estívariz, Eric Wiesen, Cara C. Burns, Omotayo Bolu and Kimberly M. Thompson
Pathogens 2024, 13(9), 804; https://doi.org/10.3390/pathogens13090804 - 17 Sep 2024
Viewed by 691
Abstract
In 2022, global poliovirus modeling suggested that coordinated cessation of bivalent oral poliovirus vaccine (bOPV, containing Sabin-strain types 1 and 3) in 2027 would likely increase the risks of outbreaks and expected paralytic cases caused by circulating vaccine-derived polioviruses (cVDPVs), particularly type 1. [...] Read more.
In 2022, global poliovirus modeling suggested that coordinated cessation of bivalent oral poliovirus vaccine (bOPV, containing Sabin-strain types 1 and 3) in 2027 would likely increase the risks of outbreaks and expected paralytic cases caused by circulating vaccine-derived polioviruses (cVDPVs), particularly type 1. The analysis did not include the implementation of planned, preventive supplemental immunization activities (pSIAs) with bOPV to achieve and maintain higher population immunity for types 1 and 3 prior to bOPV cessation. We reviewed prior published OPV cessation modeling studies to support bOPV cessation planning. We applied an integrated global poliovirus transmission and OPV evolution model after updating assumptions to reflect the epidemiology, immunization, and polio eradication plans through the end of 2023. We explored the effects of bOPV cessation in 2027 with and without additional bOPV pSIAs prior to 2027. Increasing population immunity for types 1 and 3 with bOPV pSIAs (i.e., intensification) could substantially reduce the expected global risks of experiencing cVDPV outbreaks and the number of expected polio cases both before and after bOPV cessation. We identified the need for substantial increases in overall bOPV coverage prior to bOPV cessation to achieve a high probability of successful bOPV cessation. Full article
(This article belongs to the Special Issue Human Poliovirus)
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15 pages, 1274 KiB  
Article
A Low-Cost, Integrated Immunization, Health, and Nutrition Intervention in Conflict Settings in Pakistan—The Impact on Zero-Dose Children and Polio Coverage
by Amira M. Khan, Imran Ahmed, Muhammad Jawwad, Muhammad Islam, Rehman Tahir, Saeed Anwar, Ahmed Ali Nauman and Zulfiqar A. Bhutta
Pathogens 2024, 13(3), 185; https://doi.org/10.3390/pathogens13030185 - 20 Feb 2024
Viewed by 2842
Abstract
Pakistan is one of two countries globally still endemic for poliovirus. While increasing immunization coverage is a concern, providing equitable access to care is also a priority, especially for conflict-affected populations. Recognizing these challenges, Naunehal, an integrated model of maternal, newborn, and [...] Read more.
Pakistan is one of two countries globally still endemic for poliovirus. While increasing immunization coverage is a concern, providing equitable access to care is also a priority, especially for conflict-affected populations. Recognizing these challenges, Naunehal, an integrated model of maternal, newborn, and child health (MNCH), immunization, and nutrition services delivered through community mobilization, mobile outreach, and private-sector engagement was implemented in conflict-affected union councils (UCs) with high poliovirus transmission, including Kharotabad 1(Quetta, Balochistan) and Bakhmal Ahmedzai (Lakki Marwat, Khyber Pakhtunkhwa). A quasi-experimental pre–post-design was used to assess the impact of the interventions implemented between April 2021 and April 2022, with a baseline and an endline survey. For each of the intervention UCs, a separate, matched-control UC was identified. At endline, the proportion of fully immunized children increased significantly from 27.5% to 51.0% in intervention UCs with a difference-in-difference (DiD) estimate of 13.6%. The proportion of zero-dose children and non-recipients of routine immunization (NR-RI) children decreased from 31.6% to 0.9% and from 31.9% to 3.4%, respectively, with a significant decrease in the latter group. Scaling up and assessing the adoption and feasibility of integrated interventions to improve immunization coverage can inform policymakers of the viability of such services in such contexts. Full article
(This article belongs to the Special Issue Human Poliovirus)
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16 pages, 1488 KiB  
Article
Establishment of a Poliovirus Containment Program and Containment Certification Process for Poliovirus-Essential Facilities, United States 2017–2022
by Christy Ottendorfer, Bryan Shelby, Cecelia A. Sanders, Anna Llewellyn, Christy Myrick, Christye Brown, Suganthi Suppiah, Kortney Gustin and Lia Haynes Smith
Pathogens 2024, 13(2), 116; https://doi.org/10.3390/pathogens13020116 - 27 Jan 2024
Viewed by 1572
Abstract
Upon declaration of poliovirus (PV) type 2 eradication in 2015, the World Health Organization (WHO) published PV containment requirements in the Global Action Plan III (GAPIII) for mitigating the risk of a facility-associated release post eradication. In 2018, the 71st World Health Assembly [...] Read more.
Upon declaration of poliovirus (PV) type 2 eradication in 2015, the World Health Organization (WHO) published PV containment requirements in the Global Action Plan III (GAPIII) for mitigating the risk of a facility-associated release post eradication. In 2018, the 71st World Health Assembly resolution urged member states retaining PV to appoint a National Authority for Containment (NAC), reduce the number of PV facilities, and submit applications for containment certification. The United States (US) NAC was established in 2018 for containment oversight, and two paths to WHO GAPIII containment certification were developed. Facilities retaining PV were identified through national poliovirus containment surveys. The US NAC conducted 27 site visits at 18 facilities (20 laboratories: A/BSL-2 (65%), A/BSL-3 (20%), and storage-only (15%)) to verify the implementation of US NAC’s preliminary containment measures. The NAC identified areas for improvement in seven categories: primary containment, decontamination, hand hygiene, security, emergency response, training, and immunization practices. Sixteen facility applications were endorsed to pursue poliovirus-essential facility (PEF) certification, whereas four facilities opted to withdraw during the containment certification process. The US made noteworthy progress in PV containment to enhance biosafety and biosecurity practices at US PV facilities to safeguard the polio eradication effort. Full article
(This article belongs to the Special Issue Human Poliovirus)
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Review

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33 pages, 764 KiB  
Review
Review of Poliovirus Transmission and Economic Modeling to Support Global Polio Eradication: 2020–2024
by Kimberly M. Thompson and Kamran Badizadegan
Pathogens 2024, 13(6), 435; https://doi.org/10.3390/pathogens13060435 - 22 May 2024
Cited by 2 | Viewed by 1206
Abstract
Continued investment in the development and application of mathematical models of poliovirus transmission, economics, and risks leads to their use in support of polio endgame strategy development and risk management policies. This study complements an earlier review covering the period 2000–2019 and discusses [...] Read more.
Continued investment in the development and application of mathematical models of poliovirus transmission, economics, and risks leads to their use in support of polio endgame strategy development and risk management policies. This study complements an earlier review covering the period 2000–2019 and discusses the evolution of studies published since 2020 by modeling groups supported by the Global Polio Eradication Initiative (GPEI) partners and others. We systematically review modeling papers published in English in peer-reviewed journals from 2020–2024.25 that focus on poliovirus transmission and health economic analyses. In spite of the long-anticipated end of poliovirus transmission and the GPEI sunset, which would lead to the end of its support for modeling, we find that the number of modeling groups supported by GPEI partners doubled and the rate of their publications increased. Modeling continued to play a role in supporting GPEI and national/regional policies, but changes in polio eradication governance, decentralized management and decision-making, and increased heterogeneity in modeling approaches and findings decreased the overall impact of modeling results. Meanwhile, the failure of the 2016 globally coordinated cessation of type 2 oral poliovirus vaccine use for preventive immunization and the introduction of new poliovirus vaccines and formulation, increased the complexity and uncertainty of poliovirus transmission and economic models and policy recommendations during this time. Full article
(This article belongs to the Special Issue Human Poliovirus)
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12 pages, 3374 KiB  
Review
The Last Mile in Polio Eradication: Program Challenges and Perseverance
by Rocio Lopez Cavestany, Martin Eisenhawer, Ousmane M. Diop, Harish Verma, Arshad Quddus and Ondrej Mach
Pathogens 2024, 13(4), 323; https://doi.org/10.3390/pathogens13040323 - 15 Apr 2024
Cited by 2 | Viewed by 2733
Abstract
As the Global Polio Eradication Initiative (GPEI) strategizes towards the final steps of eradication, routine immunization schedules evolve, and high-quality vaccination campaigns and surveillance systems remain essential. New tools are consistently being developed, such as the novel oral poliovirus vaccine to combat outbreaks [...] Read more.
As the Global Polio Eradication Initiative (GPEI) strategizes towards the final steps of eradication, routine immunization schedules evolve, and high-quality vaccination campaigns and surveillance systems remain essential. New tools are consistently being developed, such as the novel oral poliovirus vaccine to combat outbreaks more sustainably, as well as non-infectiously manufactured vaccines such as virus-like particle vaccines to eliminate the risk of resurgence of polio on the eve of a polio-free world. As the GPEI inches towards eradication, re-strategizing in the face of evolving challenges and preparing for unknown risks in the post-certification era are critical. Full article
(This article belongs to the Special Issue Human Poliovirus)
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14 pages, 2824 KiB  
Review
Novel Oral Polio Vaccine Type 2 Use for Polio Outbreak Response: A Global Effort for a Global Health Emergency
by Feyrouz Damji Kurji, Ananda Sankar Bandyopadhyay, Simona Zipursky, Laura V. Cooper, Chris Gast, Margaret Toher, Ralf Clemens, Sue Ann Costa Clemens, Rayasam Prasad and Adriansjah Azhari
Pathogens 2024, 13(4), 273; https://doi.org/10.3390/pathogens13040273 - 23 Mar 2024
Cited by 2 | Viewed by 3529
Abstract
A sharp rise in circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks in the years following the cessation of routine use of poliovirus type 2-containing oral polio vaccine and the trend of seeding new emergences with suboptimal vaccination response during the same time-period led [...] Read more.
A sharp rise in circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks in the years following the cessation of routine use of poliovirus type 2-containing oral polio vaccine and the trend of seeding new emergences with suboptimal vaccination response during the same time-period led to the accelerated development of the novel oral polio vaccine type 2 (nOPV2), a vaccine with enhanced genetic stability and lower likelihood of reversion to neuroparalytic variants compared to its Sabin counterpart. In November 2020, nOPV2 became the first vaccine to be granted an Emergency Use Listing (EUL) by the World Health Organization (WHO) Prequalification Team (PQT), allowing close to a billion doses to be used by countries within three years after its first rollout and leading to full licensure and WHO prequalification (PQ) in December 2023. The nOPV2 development process exemplifies how scientific advances and innovative tools can be applied to combat global health emergencies in an urgent and adaptive way, building on a collaborative effort among scientific, regulatory and implementation partners and policymakers across the globe. Full article
(This article belongs to the Special Issue Human Poliovirus)
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16 pages, 1667 KiB  
Review
Inactivated Poliovirus Vaccine: Recent Developments and the Tortuous Path to Global Acceptance
by Roland W. Sutter, Martin Eisenhawer, Natalia A. Molodecky, Harish Verma and Hiromasa Okayasu
Pathogens 2024, 13(3), 224; https://doi.org/10.3390/pathogens13030224 - 4 Mar 2024
Cited by 2 | Viewed by 2754
Abstract
Inactivated poliovirus vaccine (IPV), available since 1955, became the first vaccine to be used to protect against poliomyelitis. While the immunogenicity of IPV to prevent paralytic poliomyelitis continues to be irrefutable, its requirement for strong containment (due to large quantities of live virus [...] Read more.
Inactivated poliovirus vaccine (IPV), available since 1955, became the first vaccine to be used to protect against poliomyelitis. While the immunogenicity of IPV to prevent paralytic poliomyelitis continues to be irrefutable, its requirement for strong containment (due to large quantities of live virus used in the manufacturing process), perceived lack of ability to induce intestinal mucosal immunity, high cost and increased complexity to administer compared to oral polio vaccine (OPV), have limited its use in the global efforts to eradicate poliomyelitis. In order to harvest the full potential of IPV, a program of work has been carried out by the Global Polio Eradication Initiative (GPEI) over the past two decades that has focused on: (1) increasing the scientific knowledge base of IPV; (2) translating new insights and evidence into programmatic action; (3) expanding the IPV manufacturing infrastructure for global demand; and (4) continuing to pursue an ambitious research program to develop more immunogenic and safer-to-produce vaccines. While the knowledge base of IPV continues to expand, further research and product development are necessary to ensure that the program priorities are met (e.g., non-infectious production through virus-like particles, non-transmissible vaccine inducing humoral and intestinal mucosal immunity and new methods for house-to-house administration through micro-needle patches and jet injectors), the discussions have largely moved from whether to how to use this vaccine most effectively. In this review, we summarize recent developments on expanding the science base of IPV and provide insight into policy development and the expansion of IPV manufacturing and production, and finally we provide an update on the current priorities. Full article
(This article belongs to the Special Issue Human Poliovirus)
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9 pages, 525 KiB  
Review
Population Immunity and Polio Eradication
by Paul E. M. Fine
Pathogens 2024, 13(3), 183; https://doi.org/10.3390/pathogens13030183 - 20 Feb 2024
Cited by 2 | Viewed by 2432
Abstract
The Global Polio Eradication Initiative made immense progress after its establishment in 1988 as a consequence of high coverage with various poliovirus vaccines in all populations of the world. Problems have arisen in recent years, however, related to security issues in some countries, [...] Read more.
The Global Polio Eradication Initiative made immense progress after its establishment in 1988 as a consequence of high coverage with various poliovirus vaccines in all populations of the world. Problems have arisen in recent years, however, related to security issues in some countries, to the circulation of vaccine-derived polioviruses, and to the recognition that individuals with certain immune deficiencies can remain infected and infectious for many months or years. As natural infection and different vaccines have different effects on the immune system, the patterns of humoral and mucosal immunity to polioviruses in the world today are complex but are crucial to the ultimate success of the eradication initiative. This paper describes the background of the current situation and current immunological patterns and discusses their implications for managing population immunity to polioviruses in the years ahead. Full article
(This article belongs to the Special Issue Human Poliovirus)
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Other

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6 pages, 481 KiB  
Project Report
Polio Surge Capacity Support Program Contributions to Building Country Capacities in Support of Polio Outbreak Preparedness and Response: Lessons Learned and Remaining Challenges
by Fikru Abebe, Victor Anochieboh Eboh, Mesfin Belew Weldetsadik, Ibrahima Kone, Tessema Assegid Kebede, Paul Thomas Harries and Veh Kesse Fabien Diomande
Pathogens 2024, 13(5), 377; https://doi.org/10.3390/pathogens13050377 - 1 May 2024
Viewed by 1101
Abstract
Despite coordinated efforts at global level, through the Global Polio Eradication Initiative (GPEI), poliomyelitis disease (Polio) is still a major public health issue. The wild poliovirus type-1 (WPV1) is still endemic in Afghanistan and Pakistan, and new circulations of the WPV1 were confirmed [...] Read more.
Despite coordinated efforts at global level, through the Global Polio Eradication Initiative (GPEI), poliomyelitis disease (Polio) is still a major public health issue. The wild poliovirus type-1 (WPV1) is still endemic in Afghanistan and Pakistan, and new circulations of the WPV1 were confirmed in southeast Africa in 2021, in Malawi and Mozambique. The circulating vaccine derived polioviruses (cVDPV) are also causing outbreaks worldwide. The Task Force for Global Health (TFGH)’s Polio Surge Capacity Support Program, established in 2019, is an effort to reinforce the existing partnership with the GPEI to strengthen countries’ capacities for polio outbreak preparedness and response. In four years, its coordinated efforts with GPEI partners have resulted in a remarkable improvement in the early detection of poliovirus circulation and reducing the missed children gaps in many countries. However, these encouraging results cannot hide an increasingly complex programmatic environment with numerous funding and operational challenges. Full article
(This article belongs to the Special Issue Human Poliovirus)
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