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首页> 外文期刊>Risk analysis >Oral Poliovirus Vaccine Evolution and Insights Relevant to Modeling the Risks of Circulating Vaccine-Derived Polioviruses (cVDPVs)
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Oral Poliovirus Vaccine Evolution and Insights Relevant to Modeling the Risks of Circulating Vaccine-Derived Polioviruses (cVDPVs)

机译：口服脊髓灰质炎病毒疫苗的演变和与模拟循环疫苗衍生脊髓灰质炎病毒（cVDPVs）的风险有关的见解

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摘要

The live, attenuated oral poliovirus vaccine (OPV) provides a powerful tool for controlling and stopping the transmission of wild polioviruses (WPVs), although the risks of vaccine-associated paralytic polio (VAPP) and circulating vaccine-derived poliovirus (cVDPV) outbreaks exist as long as OPV remains in use. Understanding the dynamics of cVDPV emergence and outbreaks as a function of population immunity and other risk factors may help to improve risk management and the development of strategies to respond to possible outbreaks. We performed a comprehensive review of the literature related to the process of OPV evolution and information available from actual experiences with cVDPV outbreaks. Only a relatively small fraction of poliovirus infections cause symptoms, which makes direct observation of the trajectory of OPV evolution within a population impractical and leads to significant uncertainty. Despite a large global surveillance system, the existing genetic sequence data largely provide information about transmitted virulent polioviruses that caused acute flaccid paralysis, and essentially no data track the changes that occur in OPV sequences as the viruses transmit largely asymptomatically through real populations with suboptimal immunity. We updated estimates of cVDPV risks based on actual experiences and identified the many limitations in the existing data on poliovirus transmission and immunity and OPV virus evolution that complicate modeling. Modelers should explore the space of potential model formulations and inputs consistent with the available evidence and future studies should seek to improve our understanding of the OPV virus evolution process to provide better information for policymakers working to manage cVDPV risks.
机译：减毒的口服口服脊髓灰质炎活疫苗（OPV）为控制和制止野生脊髓灰质炎病毒（WPV）的传播提供了强大的工具，尽管存在与疫苗相关的麻痹性脊髓灰质炎（VAPP）和循环源于疫苗的脊髓灰质炎病毒（cVDPV）爆发的风险只要OPV仍在使用中。了解作为人群免疫力和其他风险因素的函数的cVDPV出现和爆发的动态，可能有助于改善风险管理和制定应对可能爆发的策略。我们对与OPV进化过程相关的文献进行了全面回顾，并从cVDPV暴发的实际经验中获得了信息。仅一小部分脊髓灰质炎病毒感染会引起症状，这使得在人群中直接观察OPV进化的轨迹变得不切实际，并导致明显的不确定性。尽管有大型的全球监视系统，但现有的基因序列数据在很大程度上提供了有关导致急性弛缓性麻痹的强毒脊髓灰质炎病毒传播的信息，并且基本上没有数据追踪OPV序列中发生的变化，因为该病毒在无免疫力的情况下通过无症状的真实人群大量无症状地传播。我们根据实际经验更新了对cVDPV风险的估计，并确定了脊髓灰质炎病毒传播和免疫以及OPV病毒进化的现有数据存在许多局限性，使建模变得复杂。建模者应探索与可用证据相符的潜在模型制定和输入的空间，未来的研究应寻求加深我们对OPV病毒进化过程的了解，以便为致力于管理cVDPV风险的决策者提供更好的信息。

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  • 来源
    《Risk analysis》 |2013年第4期|680-702|共23页
  • 作者

    Radboud J. Duintjer Tebbens; Mark A. Pallansch; Jong-Hoon Kim; Cara C. Burns; Olen M. Kew; M. Steven Oberste; Ousmane M. Diop; Steven G.F. Wassilak; Stephen L. Cochi; Kimberly M. Thompson;

  • 作者单位

    Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, USA;

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

    Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, USA;

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

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

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

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

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

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

    Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, USA,University of Central Florida, College of Medicine, Orlando, FL, USA;

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  • 原文格式 PDF
  • 正文语种 eng
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  • 关键词

    dynamic modeling; outbreak risks; poliovirus;

    机译：动态建模爆发风险;脊髓灰质炎病毒;

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