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首页> 外文期刊>Morbidity and mortality weekly report >Update on vaccine-derived polioviruses.
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Update on vaccine-derived polioviruses.

机译：关于疫苗衍生的脊髓灰质炎病毒的更新。

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In 1988, the World Health Assembly resolved to eradicate polio worldwide. The Global Polio Eradication Initiative (PEI) of the World Health Organization (WHO) has led to a decline in global polio incidence, from an estimated 350,000 cases in 1988 to fewer than 2,000 reported cases in 2005, and polio remains endemic to only four countries (Afghanistan, India, Nigeria, and Pakistan). However, two additional obstacles to global eradication involve vaccine-derived polioviruses (VDPVs). Polio outbreaks continue to be associated with circulating vaccine-derived polioviruses (cVDPVs) in areas with low oral poliovirus vaccine (OPV) coverage. In addition, long-term excretion of neurovirulent immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) can lead to poliovirus spread to contacts. Overcoming these obstacles is challenging. High rates of OPV coverage will prevent all poliovirus spread, including spread of VDPVs, but will not prevent establishment of prolonged VDPV infections in certain persons with B-cell immunodeficiencies (i.e., having defects in antibody production). Inevitable gaps in vaccination coverage will give rise to cVDPVs as long as OPV use continues. This report updates a previous report on VDPVs and describes the potential implications of VDPVs in the final stages of global polio eradication. The findings underscore the critical need to strengthen strategies to prevent emergence of VDPVs and to stop all OPV use once wild polioviruses (WPVs) are eradicated.
机译：1988年，世界卫生大会决心在世界范围内根除脊髓灰质炎。世界卫生组织（WHO）的全球根除脊髓灰质炎行动（PEI）导致全球脊髓灰质炎发病率下降，从1988年的估计350,000例下降到2005年报告的不足2,000例，并且脊髓灰质炎仍然仅在四个国家流行（阿富汗，印度，尼日利亚和巴基斯坦）。但是，全球根除的另外两个障碍涉及疫苗衍生的脊髓灰质炎病毒（VDPV）。脊髓灰质炎暴发继续与口服脊髓灰质炎疫苗覆盖率低的地区的循环疫苗衍生脊髓灰质炎病毒（cVDPV）相关。此外，长期排泄神经毒性免疫缺陷相关疫苗衍生的脊髓灰质炎病毒（iVDPV）可能导致脊髓灰质炎病毒传播到接触者。克服这些障碍具有挑战性。高水平的OPV覆盖率将阻止所有脊髓灰质炎病毒的传播，包括VDPV的传播，但不会阻止某些B细胞免疫缺陷（即抗体生产有缺陷）的人长期感染VDPV。只要继续使用OPV，疫苗接种覆盖率中不可避免的缺口就会产生cVDPV。本报告更新了有关VDPV的先前报告，并描述了VDPV在全球根除脊髓灰质炎最后阶段的潜在影响。研究结果强调，一旦根除野生脊髓灰质炎病毒（WPV），就必须加强策略以防止VDPV出现并停止所有OPV的使用。

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