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At least 19 recordsLinked to original sources
PubMed1992

Predictors of poliomyelitis case confirmation at initial clinical evaluation: implications for poliomyelitis eradication in the Americas.

In 1985, the Pan American Health Organization adopted the goal of eradication of poliomyelitis from the Americas by 1990. Strategies to accomplish this included high vaccination coverage, aggressive outbreak control, and active surveillance for acute flaccid paralysis (AFP). Although the sensitivity of AFP surveillance for detecting paralytic poliomyelitis cases is high, studies have shown the specificity to be low. In 1990, 2497 notified cases of AFP were investigated in the Americas of which 2146 had stool specimens collected. However, only 18 were confirmed as poliomyelitis by isolation of wild poliovirus from stool specimens, 71 were classified as being compatible with poliomyelitis. Cases of AFP due to causes other than poliomyelitis result in extensive but unnecessary outbreak control measures. To predict, at initial clinical evaluation, the likelihood of future confirmation as a case of poliomyelitis, likelihood ratios (LR) were calculated for different combinations of clinical characteristics of AFP cases (249) from Mexico in 1989 and 1990. The best predictors in a child with AFP were proximal muscle involvement which progressed '4 days together with fever at onset of paralysis, and proximal and unilateral involvement with either fever at onset or paralysis which progressed '4 days. The odds would increase by 12 that the child would eventually be confirmed as poliomyelitis (19), based on a stool culture positive for wild poliovirus (95% confidence interval (CI) 2.6-55.9). A guide for use in the field is proposed whereby local health officials, often with little training in neurological evaluation, can predict at initial clinical examination the likelihood that an AFP case will subsequently be confirmed as poliomyelitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1951

An epidemic of paralytic poliomyelitis characterized by dual infections with poliomyelitis and Coxsackie viruses.

The first known epidemic of poliomyelitis in Easton, Pennsylvania, occurred in 1949, and was unusual in the high proportion of paralytic to non-paralytic cases. Both poliomyelitis and Cosxackie, or C, viruses were isolated from more than half the patients studied during the acute stage of the disease. One month later C virus was only occasionally recovered. Classification of the 28 strains of C virus which were isolated revealed that 24 belonged to one antigenic type, Easton-2 (related to Albany type 1 virus). Patients from whom C virus was isolated showed a rise during convalescence to the Easton-2 or homologous type antibody. Two patients with paralytic poliomyelitis were studied for the quantitative development of antibodies to the poliomyelitis virus and to the C virus found in their stools. Using the neutralization test in monkeys and in newborn mice, respectively, a simultaneous rise in antibodies to both agents was observed. The situation at present can be summarized as follows:-Poliomyelitis virus or C virus may produce infection in man, with a specific antibody response. Both agents may be carried, particularly in the intestines, without causing any serious illness and healthy carrier states have been observed for each. Both viruses can be found in nature in flies and in sewage. However there has been no evidence to suggest that these two viruses bear a relationship to each other, even when isolated from the same patient. Thus, when both viruses are found in a patient with paralysis, it is not yet possible to say with any degree of accuracy to what extent each is responsible in the over-all pattern of the disease. How frequently dual infections of this nature may occur remains for future investigations to determine. Certainly all cases of poliomyelitis are not complicated by a superimposed infection with a C virus. However, this will have to be one more item to consider in epidemic poliomyelitis.

Animals↗
PubMed1997

[Oral vaccines against poliomyelitis and vaccination-related paralytic poliomyelitis in Germany. Do we need a new immunization strategy?].

Oral vaccination against poliomyelitis, which was carried out worldwide, lead to eradication of poliomyelitis in the United States, in South America and parts of Europe; in other parts of the world, paralytic poliomyelitis is still a severe risk of health. In those countries where poliomyelitis has been eradicated, it is presently discussed whether the vaccination schedules should be changed to an inactivated polio vaccine (IPV), as in polio-free countries only cases of paralytic poliomyelitis after vaccinations have been reported. Behringwerke's data from a 30-year period of analysing adverse drug reaction reveal the following: using the trivalent oral polio vaccine (OPV), based on WHO case definition, the risk for vaccine-associated paralytic poliomyelitis with permanent damage is approximately 1 case for 4.5 million vaccinations (0.22 per million) in vaccinees, and approximately 1 case for 11 million (0.09 per million) in contact persons. This low risk is in line with the data ascertained worldwide.

Adolescent↗
PubMed2003

Provocation poliomyelitis: vaccine associated paralytic poliomyelitis related to a rectal abscess in an infant.

OBJECTIVE: . To describe a case of vaccine associated paralytic poliomyelitis (VAPP) and relate this to current UK immunization policy. METHOD: A case report in which the clinical course and factors leading to the diagnosis are described and then related to reports of paralytic poliomyelitis in the literature. RESULTS: The child in this case was left severely disabled by paralytic poliomyelitis. The pathological process was related to a pararectal abscess needing urgent drainage shortly after immunisation. CONCLUSION: The skeletal muscle damage due to the presence of the pararectal abscess may have acted as the 'provocation' in the development of poliomyelitis. Adoption of a policy of initial vaccination by the parenteral route as in the USA and European countries has been shown to greatly reduce this risk. The UK could adopt this policy which would minimise the risk of VAPP, as all recorded paralytic poliomyelitis in the UK in the last decade has been vaccine related.

Abscess↗
PubMedDate not supplied

[An outbreak of poliomyelitis in Tajikistan in 1991 caused by the poliomyelitis virus type 1 in concomitant echovirus 19 infection].

In 1991 in Tajikistan 36 cases of acute poliomyelitis were recorded (spinal form 27, bulbospinal 3, pontospinal 6 cases) in children ranging in ages from 6 months to 6 years. The outcome of the disease was fatal in 4 cases and with crude residual effects in 32 children. Out of 23 children examined, poliomyelitis virus type I was isolated from 13, antibodies to poliovirus type I in titres 1:16 to 1:1024 were detected in 21 children, ECHO 19 virus was isolated from 5 children and antibodies to this virus in titres 1:16 to 1:8192 were demonstrated in 13 children. The fresh isolates of poliomyelitis virus type I had rct+, DS+ and N+ markers. The strains of ECHO 19 virus were highly pathogenic for monkeys causing deaths of the animals within 3-4 days. It is assumed that the main causative agent of the Tajikistan outbreak of poliomyelitis was a virulent "wild" variant of poliovirus type I. The preceding or concomitant infection with ECHO 19 virus (considering the data from the literature and the demonstrated high virulence of this agent for monkeys) could exert an aggravating effect on the course of poliomyelitis or, in some cases, be an independent cause of the disease and, possibly, death of the children.

Acute Disease↗
PubMedDate not supplied

[Possibility of occurrence of mild spinal forms of poliomyelitis in subjects immunized repeatedly with live poliomyelitis vaccine].

The results of clinical, epidemiological, serological and virological examinations of patients with mild spinal forms of poliomyelitis occurring under conditions of mass immunization with oral live poliomyelitis vaccine are presented. The etiological role of poliomyelitis virus types I and III in these diseases has been established. It has been shown that multiple vaccination does not always prevent diseases but in these cases they are milder. Serological examination of patients and normal subjects suggests inadequacy of seroconversion to poliomyelitis viruses under conditions of mass vaccination of the population against poliomyelitis.

Child, Preschool↗
PubMedDate not supplied

Surveillance of suspected poliomyelitis in Albania, 1980-1995: suggestion of increased risk of vaccine associated poliomyelitis.

Surveillance of suspected poliomyelitis cases was conducted in Albania from 1980 through 1995. A total of 93 cases were reported, 11 of which were clinically defined as poliomyelitis cases according to WHO criteria. Poliovirus was isolated from six subjects who were defined as contact vaccine-associated cases. Characterization of isolates by both antigenic and molecular methods showed that, in all cases, the disease was associated with type 2 or 3 polioviruses of vaccine origin with retromutations known to be associated with loss of Sabin attenuated phenotype. Infection occurred despite the fact that all patients had records of previous immunization with oral polio vaccine (OPV), suggesting a failure of vaccination. Four of the five patients from which poliovirus could not be isolated were classified as possible recipient vaccine-associated poliomyelitis on the basis of serology data (presence of antibodies against all three polioviruses) and the temporal association between the latest dose of vaccine received and onset of paralysis. Virological investigation on healthy contacts of the poliomyelitic patients yielded the isolation of a further 12 Sabin-like polio revertant viruses, mostly type 2 and 3. A detailed study of the non-polio acute flaccid paralysis (AFP) cases and their healthy contacts revealed the presence of several enteroviruses, namely Echo, coxsackie and, in three cases type 2 or 3 Sabin-like polioviruses. Overall, these data suggest the absence of circulation of wild-type poliovirus in Albania from 1980 to 1995, before the recent outbreak of poliomyelitis in 1996, and emphasize the need for active surveillance of AFP and laboratory characterization of virus isolates to monitor vaccination efficacy.

Adolescent↗
PubMed2000

Widespread paralytic poliomyelitis in Pakistan: A case-control study to determine risk factors and implications for poliomyelitis eradication.

Despite substantial efforts to eradicate poliomyelitis by administering oral poliovirus vaccine through routine immunization and annual national immunization days (NIDs), Pakistan reported 22% (1147) of the worldwide cases in 1997. Reasons for continued high poliomyelitis incidence include failure to vaccinate, vaccine failure, or inadequate immunization strategies. A case-control study was conducted to measure vaccination status and reasons for undervaccination among 66 poliomyelitis cases and 130 age- and neighborhood-matched controls. Cases were undervaccinated through routine immunization (matched odds ratio [MOR], 0.3; 95% confidence interval [CI], 0.1-0.5); however, NID immunization was similar for cases and controls (MOR, 0.6; 95% CI, 0.3-1.2). Reasons for undervaccination included not being informed, considering vaccination unimportant, and long distances to vaccination sites. Failure to vaccinate through routine immunization was a major risk factor for poliomyelitis in Pakistan. Successful NIDs alone will not interrupt poliovirus circulation in Pakistan, and children remain at risk unless routine immunization is strengthened or additional supplementary immunization is provided.

Case-Control Studies↗
PubMed1999

Paralytic poliomyelitis associated with live oral poliomyelitis vaccine in child with HIV infection in Zimbabwe: case report.

OBJECTIVE: To describe a complication of oral vaccination with live, attenuated poliomyelitis virus in a child infected with HIV. DESIGN: Case report. SETTING: Teaching hospital in Harare, Zimbabwe. SUBJECTS: A boy of 41/2 years and his mother. MAIN OUTCOME MEASURES: Results of clinical and laboratory investigations. RESULTS: Two weeks after receiving the second dose of oral poliomyelitis vaccine during national immunisation days the child developed paralysis of the right leg. He had a high titre of antibodies against poliovirus type 2, as well as antibodies against HIV-1, a low CD4 count, a ratio of CD4 to CD8 count of 0.47, and hypergammaglobulinaemia. He did not have any antibodies against diphtheria, tetanus, or poliovirus types 1 and 3, although he had been given diphtheria, tetanus, and pertussis and oral polio vaccines during his first year and a booster of the diphtheria, tetanus, and pertussis vaccine at 24 months. He had no clinical symptoms of AIDS, but his mother had AIDS and tuberculosis. CONCLUSION: Paralytic poliomyelitis in this child with HIV infection was caused by poliovirus type 2 after oral poliomyelitis vaccine.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Poliomyelitis--not an extinct disease. Outbreak of poliomyelitis in Vestlandet 1950-54].

The last epidemic outbreak of poliomyelitis in Norway lasted from 1950 to 1954. The article describes the occurrence of poliomyelitis in Western Norway on the basis of 243 medical records from this period. The epidemic reached its peak in Western Norway in 1952, while the highest number of new cases of poliomyelitis in Norway as a whole occurred in 1951. We found equal representation of both sexes. Most cases were recorded in late summer and autumn. Most patients (96%) had general symptoms, most frequently headache. The fever was moderate. Meningeal irritation (neck stiffness) was recorded in 56% of the cases. The most frequent neurological symptom was asymmetric limb paralysis. 6% of the patients died. High fever, extensive paralysis and inadequate respiration had a negative effect on the prognosis. 57 patients had aparalytic poliomyelitis and were hospitalized for a short time.

Adult↗
PubMed1952

Studies on the propagation in vitro of poliomyelitis viruses. III. The propagation of poliomyelitis viruses in tissue cultures devoid of nerve cells.

Cells like fibroblasts, having no resemblance whatever to nerve cells were obtained in morphologically pure cultures from monkey testicular tissue and were found to support the growth in vitro of poliomyelitis virus, Type 2, Yale-SK strain. Moreover, these cells were destroyed as a result of the multiplication of this virus within them. Similarly, "fibroblasts" propagated in primary explant cultures of testicle were destroyed by poliomyelitis viruses, Types 1 and 2. Type specific antibodies neutralized the pathogenic effect of poliomyelitis virus on monkey testicular fibroblasts.

Fibroblasts↗
PubMed1992

Epidemic poliomyelitis in The Gambia following the control of poliomyelitis as an endemic disease. II. Clinical efficacy of trivalent oral polio vaccine.

An epidemic of poliomyelitis caused by poliovirus type 1 occurred in The Gambia from May to November 1986. Descriptive findings and vaccination coverage levels are reported in part I. This article (part II) describes a case-control study to estimate the clinical efficacy of three or more doses of trivalent oral polio vaccine compared with zero doses. "Cases" were 1- to 7-year-old children paralyzed during the epidemic who were diagnosed as having poliomyelitis by designated referral physicians. They were identified by reports from referral physicians during the epidemic and by a nationwide village-to-village search after the epidemic. Up to five controls were randomly selected for each case from among children of the same age and sex living in neighboring households. In a matched analysis of 195 cases and 839 controls, the efficacy of three or more doses of trivalent oral polio vaccine was 72% (95% confidence interval 57-82) when children without vaccination cards were considered unvaccinated. The efficacy of three or more doses in 1- to 2-year-old children, in whom the determination of vaccination status was considered to be more accurate than in older children, was 81% (95% confidence interval 66-90). Vaccine failure was not associated with short intervals between doses. Higher levels of vaccination coverage and efficacy than those achieved in The Gambia may be needed in African countries to prevent the return of poliomyelitis as an epidemic disease after it has been controlled as an endemic disease.

Age Factors↗