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Expert Review on Poliovirus Immunity and Transmission

机译:脊髓灰质炎病毒免疫和传播的专家评论

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摘要

Successfully managing risks to achieve wild polioviruses (WPVs) eradication and address the complexities of oral poliovirus vaccine (OPV) cessation to stop all cases of paralytic poliomyelitis depends strongly on our collective understanding of poliovirus immunity and transmission. With increased shifting from OPV to inactivated poliovirus vaccine (IPV). numerous risk management choices motivate the need to understand the tradeoffs and uncertainties and to develop models to help inform decisions. The U.S. Centers for Disease Control and Prevention hosted a meeting of international experts in April 2010 to review the available literature relevant to poliovirus immunity and transmission. This expert review evaluates 66 OPV challenge studies and other evidence to support the development of quantitative models of poliovirus transmission and potential outbreaks. This review focuses on characterization of immunity as a function of exposure history in terms of susceptibility to excretion, duration of excretion, and concentration of excreted virus. We also discuss the evidence of waning of host immunity to poliovirus transmission, the relationship between the concentration of poliovirus excreted and infectiousness, the importance of different transmission routes, and the differences in transmissibility between OPV and WPV. We discuss the limitations of the available evidence for use in polio risk models, and conclude that despite the relatively large number of studies on immunity, very limited data exist to directly support quantification of model inputs related to transmission. Given the limitations in the evidence, we identify the need for expert input to derive quantitative model inputs from the existing data.
机译:成功地控制风险以实现根除野生脊髓灰质炎病毒(WPV)并解决停止口服脊髓灰质炎病毒疫苗(OPV)的复杂性以制止所有麻痹性脊髓灰质炎病例在很大程度上取决于我们对脊髓灰质炎病毒免疫力和传播的集体理解。随着从OPV向灭活脊灰病毒疫苗(IPV)转移的增加。众多风险管理选择激发了理解权衡和不确定性并开发模型以帮助决策的需求。美国疾病预防控制中心于2010年4月召开了一次国际专家会议,以审查与脊髓灰质炎病毒免疫和传播有关的现有文献。该专家评估评估了66项OPV挑战研究和其他证据,以支持脊灰病毒传播和潜在暴发的定量模型的开发。这篇综述着重于根据对排泄的敏感性,排泄的持续时间和排泄的病毒浓度,将免疫力表征为暴露史的函数。我们还讨论了宿主对脊髓灰质炎病毒传播的免疫力减弱,脊髓灰质炎病毒排泄的浓度与传染性之间的关系,不同传播途径的重要性以及OPV和WPV之间的可传播性差异的证据。我们讨论了可用于脊髓灰质炎风险模型的现有证据的局限性,并得出结论,尽管对免疫力的研究相对较多,但仍然存在非常有限的数据来直接支持量化与传播相关的模型输入。鉴于证据的局限性,我们确定需要专家意见才能从现有数据中得出定量模型意见。

著录项

  • 来源
    《Risk analysis》 |2013年第4期|544-605|共62页
  • 作者单位

    Kid Risk, Inc., P.O. Box 590129, Newton, MA, USA;

    National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;

    Center for Biologies Evaluation and Research, Food and Drug Administration, Rockville, MD, USA;

    Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;

    National Institute for Health and Welfare (THL), Helsinki, Finland;

    National Institute of Biological Standards and Control, Health Protection Agency, South Mimms, Potters Bar, Hertfordshire, UK;

    Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA;

    Biologies Consulting Group, Inc., Bethesda, MD, USA;

    Polio Eradication Initiative, World Health Organization, Geneva, Switzerland;

    Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA;

    Global Immunization Division. Center for Global Health, Centers for Disease Control and Prevention. Atlanta, GA. USA;

    Global Immunization Division. Center for Global Health, Centers for Disease Control and Prevention. Atlanta, GA. USA;

    Kid Risk, Inc., P.O. Box 590129, Newton, MA, USA;

    Kid Risk, Inc., P.O. Box 590129, Newton, MA, USA;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

    dynamic modeling; polio eradication; risk management;

    机译:动态建模根除脊髓灰质炎风险管理;

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