Estívariz Concepción F, Watkins Margaret A, Handoko Darmawali, Rusipah Rusipah, Deshpande Jagadish, Rana Bardan J, Irawan Eveline, Widhiastuti Dyah, Pallansch Mark A, Thapa Arun, Imari Sholah
Global Immunization Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Infect Dis. 2008 Feb 1;197(3):347-54. doi: 10.1086/525049.
Between June and October 2005, 45 laboratory-confirmed type 1 vaccine-derived poliovirus (VDPV) cases were identified on Madura Island in Indonesia. Genetic sequencing data on VDPV isolates were consistent with replication and circulation for up to approximately 2 years. Concurrent circulation with type 1 wild poliovirus (WPV) enabled comparisons of VDPV and WPV cases and found that clinical and epidemiological features of both were similar. Attack rates for VDPV were as high as those for WPV. Of 41 VDPV case patients with known vaccination status, 25 (61%) had received zero oral polio vaccine (OPV) doses. Low population immunity due to low routine OPV coverage in rural areas and the absence of WPV circulation for more than a decade were major predisposing factors for the emergence of VDPV. Suboptimal surveillance and a limited initial immunization response may have contributed to widespread circulation. Sensitive surveillance and prompt high-quality immunization responses are recommended to prevent the spread of VDPVs.
2005年6月至10月期间，印度尼西亚马都拉岛确诊了45例实验室确诊的1型疫苗衍生脊髓灰质炎病毒（VDPV）病例。VDPV分离株的基因测序数据与长达约2年的复制和传播情况相符。与1型野生脊髓灰质炎病毒（WPV）同时传播使得能够对VDPV病例和WPV病例进行比较，结果发现两者的临床和流行病学特征相似。VDPV的发病率与WPV一样高。在41例已知疫苗接种状况的VDPV病例患者中，25例（61%）未接种过口服脊髓灰质炎疫苗（OPV）。农村地区常规OPV覆盖率低导致人群免疫力低下，以及WPV十多年未传播，是VDPV出现的主要诱发因素。监测不力和初始免疫反应有限可能促使了VDPV的广泛传播。建议进行敏感监测并迅速做出高质量的免疫反应，以防止VDPV传播。
