Stopping a polio outbreak in the midst of war: Lessons from Syria. Issue 28 (23rd June 2021)
- Record Type:
- Journal Article
- Title:
- Stopping a polio outbreak in the midst of war: Lessons from Syria. Issue 28 (23rd June 2021)
- Main Title:
- Stopping a polio outbreak in the midst of war: Lessons from Syria
- Authors:
- Mbaeyi, Chukwuma
Moran, Thomas
Wadood, Zubair
Ather, Fazal
Sykes, Emma
Nikulin, Joanna
Al Safadi, Mohammad
Stehling-Ariza, Tasha
Zomahoun, Laurel
Ismaili, Abdelkarim
Abourshaid, Nidal
Asghar, Humayun
Korukluoglu, Gulay
Duizer, Erwin
Ehrhardt, Derek
Burns, Cara C.
Sharaf, Magdi - Abstract:
- Abstract: Background: Outbreaks of circulating vaccine-derived polioviruses (cVDPVs) pose a threat to the eventual eradication of all polioviruses. In 2017, an outbreak of cVDPV type 2 (cVDPV2) occurred in the midst of a war in Syria. We describe vaccination-based risk factors for and the successful response to the outbreak. Methods: We performed a descriptive analysis of cVDPV2 cases and key indicators of poliovirus surveillance and vaccination activities during 2016–2018. In the absence of reliable subnational coverage data, we used the caregiver-reported vaccination status of children with non-polio acute flaccid paralysis (AFP) as a proxy for vaccination coverage. We then estimated the relative odds of being unvaccinated against polio, comparing children in areas affected by the outbreak to children in other parts of Syria in order to establish the presence of poliovirus immunity gaps in outbreak affected areas. Findings: A total of 74 cVDPV2 cases were reported, with paralysis onset ranging from 3 March to 21 September 2017. All but three cases were reported from Deir-ez-Zor governorate and 84% had received < 3 doses of oral poliovirus vaccine (OPV). After adjusting for age and sex, non-polio AFP case-patients aged 6–59 months in outbreak-affected areas had 2.5 (95% CI: 1.1–5.7) increased odds of being unvaccinated with OPV compared with non-polio AFP case-patients in the same age group in other parts of Syria. Three outbreak response rounds of monovalent OPV type 2Abstract: Background: Outbreaks of circulating vaccine-derived polioviruses (cVDPVs) pose a threat to the eventual eradication of all polioviruses. In 2017, an outbreak of cVDPV type 2 (cVDPV2) occurred in the midst of a war in Syria. We describe vaccination-based risk factors for and the successful response to the outbreak. Methods: We performed a descriptive analysis of cVDPV2 cases and key indicators of poliovirus surveillance and vaccination activities during 2016–2018. In the absence of reliable subnational coverage data, we used the caregiver-reported vaccination status of children with non-polio acute flaccid paralysis (AFP) as a proxy for vaccination coverage. We then estimated the relative odds of being unvaccinated against polio, comparing children in areas affected by the outbreak to children in other parts of Syria in order to establish the presence of poliovirus immunity gaps in outbreak affected areas. Findings: A total of 74 cVDPV2 cases were reported, with paralysis onset ranging from 3 March to 21 September 2017. All but three cases were reported from Deir-ez-Zor governorate and 84% had received < 3 doses of oral poliovirus vaccine (OPV). After adjusting for age and sex, non-polio AFP case-patients aged 6–59 months in outbreak-affected areas had 2.5 (95% CI: 1.1–5.7) increased odds of being unvaccinated with OPV compared with non-polio AFP case-patients in the same age group in other parts of Syria. Three outbreak response rounds of monovalent OPV type 2 (mOPV2) vaccination were conducted, with governorate-level coverage mostly exceeding 80%. Interpretation: Significant declines in both national and subnational polio vaccination coverage, precipitated by war and a humanitarian crisis, led to a cVDPV2 outbreak in Syria that was successfully contained following three rounds of mOPV2 vaccination. … (more)
- Is Part Of:
- Vaccine. Volume 39:Issue 28(2021)
- Journal:
- Vaccine
- Issue:
- Volume 39:Issue 28(2021)
- Issue Display:
- Volume 39, Issue 28 (2021)
- Year:
- 2021
- Volume:
- 39
- Issue:
- 28
- Issue Sort Value:
- 2021-0039-0028-0000
- Page Start:
- 3717
- Page End:
- 3723
- Publication Date:
- 2021-06-23
- Subjects:
- Polio -- Outbreaks -- Vaccine-derived polioviruses -- Oral poliovirus vaccine -- Syria -- Conflict
Vaccines -- Periodicals
615.372 - Journal URLs:
- http://www.sciencedirect.com/science/journal/0264410X ↗
http://www.clinicalkey.com/dura/browse/journalIssue/0264410X ↗
http://www.clinicalkey.com.au/dura/browse/journalIssue/0264410X ↗
http://www.elsevier.com/journals ↗ - DOI:
- 10.1016/j.vaccine.2021.05.045 ↗
- Languages:
- English
- ISSNs:
- 0264-410X
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 9138.628000
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 17264.xml