Diop Ousmane M, Asghar Humayun, Gavrilin Evgeniy, Moeletsi Nicksy Gumede, Benito Gloria Rey, Paladin Fem, Pattamadilok Sirima, Zhang Yan, Goel Ajay, Quddus Arshad
MMWR Morb Mortal Wkly Rep. 2017 May 26;66(20):538-542. doi: 10.15585/mmwr.mm6620a4.
The Global Polio Eradication Initiative (GPEI) has made substantial progress since its launch in 1988; only 37 wild poliovirus type 1 (WPV1) cases were detected in 2016, the lowest annual count ever. Wild poliovirus type 3 has not been detected since November 2012, and wild poliovirus type 2 was officially declared eradicated in September 2015. This success is attributable to the wide use of live oral poliovirus vaccines (OPVs). Since 2001, numerous outbreaks were caused by the emergence of genetically divergent vaccine-derived polioviruses (VDPVs) whose genetic drift from the parental OPV strains indicates prolonged replication or circulation (1). In 2015, circulating VDPV type 2 (cVDPV2) outbreaks were detected in five countries worldwide (Nigeria, Pakistan, Guinea, Burma, and South Sudan), and VDPV2 single events were reported in 22 countries. These events prompted the GPEI to withdraw the type 2 component (Sabin2) of trivalent OPV (tOPV) in a globally coordinated, synchronized manner in April 2016 (2,3), at which time all OPV-using countries switched to using bivalent OPV (bOPV), containing Sabin types 1 and 3. This report details for the first time the virologic tracking of elimination of a live vaccine that has been withdrawn from routine and mass immunization systems worldwide (3). To secure elimination, further monitoring is warranted to detect any use of tOPV or monovalent OPV type 2 (mOPV2).
全球根除脊髓灰质炎行动（GPEI）自1988年启动以来已取得重大进展；2016年仅检测到37例1型野生脊髓灰质炎病毒（WPV1）病例，为历年最低年度病例数。自2012年11月以来未检测到3型野生脊髓灰质炎病毒，2型野生脊髓灰质炎病毒于2015年9月被正式宣布根除。这一成功归因于口服脊髓灰质炎减毒活疫苗（OPV）的广泛使用。自2001年以来，出现了许多由基因分化的疫苗衍生脊髓灰质炎病毒（VDPV）引起的疫情，这些病毒与其亲本OPV株的基因漂移表明其复制或传播时间延长（1）。2015年，在全球五个国家（尼日利亚、巴基斯坦、几内亚、缅甸和南苏丹）检测到2型循环疫苗衍生脊髓灰质炎病毒（cVDPV2）疫情，22个国家报告了VDPV2单例事件。这些事件促使GPEI于2016年4月以全球协调、同步的方式撤回三价OPV（tOPV）的2型成分（Sabin2）（2,3），此时所有使用OPV的国家都转而使用含有Sabin 1型和3型的二价OPV（bOPV）。本报告首次详细介绍了对一种已从全球常规和大规模免疫系统中撤出的活疫苗进行消除的病毒学追踪（3）。为确保根除，有必要进一步监测，以发现任何tOPV或2型单价OPV（mOPV2）的使用情况。
