Esteves-Jaramillo Alejandra, Estívariz Concepción F, Peñaranda Silvia, Richardson Vesta L, Reyna Jesús, Coronel Diana L, Carrión Veronica, Landaverde Jose M, Wassilak Steven G F, Pérez-Sánchez Elda E, López-Martínez Irma, Burns Cara C, Pallansch Mark A
Centro Nacional para la Salud de la Infancia y Adolescencia, México DF.
Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention.
J Infect Dis. 2014 Nov 1;210 Suppl 1(Suppl 1):S315-23. doi: 10.1093/infdis/jiu183.
Early detection and control of vaccine-derived poliovirus (VDPV) emergences are essential to secure the gains of polio eradication.
Serial sewage samples were collected in 4 towns of Mexico before, throughout, and after the May 2010 oral poliovirus vaccine (OPV) mass immunization campaign. Isolation and molecular analysis of polioviruses from sewage specimens monitored the duration of vaccine-related strains in the environment and emergence of vaccine-derived polioviruses in a population partially immunized with inactivated poliovirus vaccine (IPV).
Sabin strains were identified up to 5-8 weeks after the campaign in all towns; in Aguascalientes, 1 Sabin 3 was isolated 16 weeks after the campaign, following 7 weeks with no Sabin strains detected. In Tuxtla Gutiérrez, type 2 VDPV was isolated from 4 samples collected before and during the campaign, and type 1 VDPV from 1 sample collected 19 weeks afterward. During 2009-2010, coverage in 4 OPV campaigns conducted averaged only 57% and surveillance for acute flaccid paralysis (AFP) was suboptimal (AFP rate<1 per 100,000 population<15 years of age) in Tuxtla Gutierrez.
VDPVs may emerge and spread in settings with inadequate coverage with IPV/OPV vaccination. Environmental surveillance can facilitate early detection in these settings.
早期发现并控制疫苗衍生脊髓灰质炎病毒（VDPV）的出现对于巩固根除脊髓灰质炎所取得的成果至关重要。
在2010年5月口服脊髓灰质炎疫苗（OPV）大规模免疫活动之前、期间及之后，在墨西哥的4个城镇采集了系列污水样本。对污水样本中的脊髓灰质炎病毒进行分离和分子分析，监测环境中与疫苗相关毒株的持续时间以及在部分接种灭活脊髓灰质炎疫苗（IPV）人群中疫苗衍生脊髓灰质炎病毒的出现情况。
在所有城镇，活动结束后5 - 8周仍可检测到萨宾毒株；在阿瓜斯卡连特斯，活动结束16周后分离出1株萨宾3型毒株，此前7周未检测到萨宾毒株。在图斯特拉古铁雷斯，活动之前及期间采集的4份样本中分离出2型VDPV，活动结束19周后采集的1份样本中分离出1型VDPV。在2009 - 2010年期间，图斯特拉古铁雷斯开展的4次OPV活动的平均覆盖率仅为57%，急性弛缓性麻痹（AFP）监测效果欠佳（AFP发病率<15岁以下每十万人口1例）。
在IPV/OPV疫苗接种覆盖率不足的情况下，VDPV可能出现并传播。环境监测有助于在这些情况下进行早期发现。
