학술논문
Modeling undetected poliovirus circulation following the 2022 outbreak in the United States.
Document Type
Academic Journal
Author
Kalkowska DA; Kid Risk, Inc, Orlando, FL, USA.; Badizadegan K; Kid Risk, Inc, Orlando, FL, USA.; Routh JA; Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.; Burns CC; Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.; Rosenberg ES; Office of Public Health, New York State Department of Health, Albany, NY, USA.; Department of Epidemiology and Biostatistics, State University of New York at Albany, Albany, NY, USA.; Brenner IR; Office of Public Health, New York State Department of Health, Albany, NY, USA.; Zucker JR; New York City Department of Health and Mental Hygiene, New York, NY, USA.; Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.; Langdon-Embry M; New York City Department of Health and Mental Hygiene, New York, NY, USA.; Thompson KM; Kid Risk, Inc, Orlando, FL, USA.; Department of Public Health, Syracuse University, Syracuse, NY, USA.
Source
Publisher: Taylor & Francis Country of Publication: England NLM ID: 101155475 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-8395 (Electronic) Linking ISSN: 14760584 NLM ISO Abbreviation: Expert Rev Vaccines Subsets: MEDLINE
Subject
Language
English
Abstract
Background: New York State (NYS) reported a polio case (June 2022) and outbreak of imported type 2 circulating vaccine-derived poliovirus (cVDPV2) (last positive wastewater detection in February 2023), for which uncertainty remains about potential ongoing undetected transmission.
Research Design and Methods: Extending a prior deterministic model, we apply an established stochastic modeling approach to characterize the confidence about no circulation (CNC) of cVDPV2 as a function of time since the last detected signal of transmission (i.e. poliovirus positive acute flaccid myelitis case or wastewater sample).
Results: With the surveillance coverage for the NYS population majority and its focus on outbreak counties, modeling suggests a high CNC (95%) within 3-10 months of the last positive surveillance signal, depending on surveillance sensitivity and population mixing patterns. Uncertainty about surveillance sensitivity implies longer durations required to achieve higher CNC.
Conclusions: In populations that maintain high overall immunization coverage with inactivated poliovirus vaccine (IPV), rare polio cases may occur in un(der)-vaccinated individuals. Modeling demonstrates the unlikeliness of type 2 outbreaks reestablishing endemic transmission or resulting in large absolute numbers of paralytic cases. Achieving and maintaining high immunization coverage with IPV remains the most effective measure to prevent outbreaks and shorten the duration of imported poliovirus transmission.
Research Design and Methods: Extending a prior deterministic model, we apply an established stochastic modeling approach to characterize the confidence about no circulation (CNC) of cVDPV2 as a function of time since the last detected signal of transmission (i.e. poliovirus positive acute flaccid myelitis case or wastewater sample).
Results: With the surveillance coverage for the NYS population majority and its focus on outbreak counties, modeling suggests a high CNC (95%) within 3-10 months of the last positive surveillance signal, depending on surveillance sensitivity and population mixing patterns. Uncertainty about surveillance sensitivity implies longer durations required to achieve higher CNC.
Conclusions: In populations that maintain high overall immunization coverage with inactivated poliovirus vaccine (IPV), rare polio cases may occur in un(der)-vaccinated individuals. Modeling demonstrates the unlikeliness of type 2 outbreaks reestablishing endemic transmission or resulting in large absolute numbers of paralytic cases. Achieving and maintaining high immunization coverage with IPV remains the most effective measure to prevent outbreaks and shorten the duration of imported poliovirus transmission.