Public Health Services, Ministry of Health, Jerusalem, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; South District Health Office, Public Health Services, Beer-Sheva, Israel.
Public Health Services, Ministry of Health, Jerusalem, Israel.
Clin Microbiol Infect. 2016 Dec 1;22 Suppl 5:S140-S145. doi: 10.1016/j.cmi.2016.06.018.
During 2013/14, Israel witnessed the silent reintroduction and sustained transmission of wild poliovirus type 1 (WPV1) detected through routine environmental surveillance performed on sewage samples. The public health response to silent poliovirus transmission in a population with high inactivated polio vaccine (IPV) coverage poses an emerging challenge towards the 'End Game' of global poliovirus eradication. This paper reviews the risk assessment, risk management and risk communication aspects of this poliovirus incident. Special emphasis is placed on the use of scientific data generated in the risk assessment phase to inform the public health response. Reintroducing a live vaccine in supplemental immunization activities in response to transmission of WPV or vaccine-derived poliovirus should be considered close to the 'End Game' of polio eradication, especially if targeting the population at risk is feasible. Such circumstances require a comprehensive contingency plan that will support the generation of important public health evidence at the risk assessment stage, thereby allowing to tailor the risk management approaches and underpin appropriate risk communication.
在 2013/14 年期间，以色列通过对污水样本进行常规环境监测发现，野生脊髓灰质炎 1 型病毒（WPV1）已悄然重现并持续传播。在高灭活脊髓灰质炎疫苗（IPV）覆盖率人群中发生无声脊髓灰质炎传播，对全球消灭脊髓灰质炎行动的“终局”构成了新的挑战。本文回顾了这一脊髓灰质炎事件的风险评估、风险管理和风险沟通方面。特别强调在风险评估阶段生成的科学数据用于指导公共卫生应对措施。在 WPV 或疫苗衍生脊髓灰质炎传播的情况下，为应对传播而开展补充免疫活动时重新引入活疫苗，应在接近消灭脊髓灰质炎的“终局”时考虑，特别是如果针对风险人群是可行的。这种情况需要一个全面的应急计划，以支持在风险评估阶段生成重要的公共卫生证据，从而能够调整风险管理方法并为适当的风险沟通提供支持。
