Department of Virology II, National Institute of Infectious Diseases, Japan.
Jpn J Infect Dis. 2022 Sep 22;75(5):431-444. doi: 10.7883/yoken.JJID.2022.312. Epub 2022 Aug 31.
The World Health Organization Western Pacific Region (WPR) has maintained a polio-free status for more than two decades. At the global level, there were only six confirmed polio cases due to wild type 1 poliovirus in Pakistan, Afghanistan, and Malawi in 2021; therefore, the risk of wild poliovirus importation from endemic countries to the WPR is considerably lower than that in the past. However, the risk of polio outbreaks associated with circulating vaccine-derived polioviruses (cVDPVs) cannot be ignored even in the WPR. Since the late 2010s, cVDPV outbreaks in the WPR have increased in frequency and magnitude. Moreover, the emergence of concomitant polio outbreaks of type 1 and type 2 cVDPVs in the Philippines and Malaysia during 2019-2020 highlighted the potential risk of cVDPV outbreaks in high-risk areas and/or communities in the WPR. Previous cVDPV outbreaks in the WPR have been rapidly and effectively controlled. However, future polio outbreak risks associated with cVDPVs must be reconsidered, and polio immunization and surveillance strategies should be updated accordingly.
世界卫生组织西太平洋区域（WPR）已经保持了二十多年的无脊髓灰质炎状态。在全球范围内，2021 年仅在巴基斯坦、阿富汗和马拉维发现了六例由野生 1 型脊灰病毒引起的确诊脊灰病例；因此，野生脊灰病毒从流行国家输入 WPR 的风险比过去大大降低。然而，即使在 WPR，与循环疫苗衍生脊灰病毒（cVDPV）有关的脊灰暴发风险也不容忽视。自 2010 年代末以来，WPR 的 cVDPV 暴发频率和规模不断增加。此外，2019-2020 年期间，菲律宾和马来西亚同时发生 1 型和 2 型 cVDPV 脊灰暴发，突显了 WPR 高风险地区和/或社区发生 cVDPV 暴发的潜在风险。WPR 以前的 cVDPV 暴发已经得到了迅速和有效的控制。然而，必须重新考虑与 cVDPV 相关的未来脊灰暴发风险，并相应更新脊灰免疫和监测策略。
