Poliomyelitis, London, New York and Israel

All children aged 1 to 9 in London to be offered a dose of polio vaccine

Last UK case, 1984

8,000 people developed paralysis every year

https://www.gov.uk/government/....organisations/uk-hea

https://www.gov.uk/government/....news/all-children-ag

Vaccine-derived poliovirus in sewage in north and east London

Genetic diversity (RNA virus)

Most are vaccine-like virus

A few have sufficient mutations to be classified as vaccine derived poliovirus (VDPV2),

behaves more like naturally occurring ‘wild’ polio

Joint Committee on Vaccination and Immunisation (JCVI)

Targeted inactivated polio vaccine (IPV) booster dose,

offered to all children between the ages of 1 and 9 in all London boroughs

This will ensure a high level of protection from paralysis and help reduce further spread of the virus.

The programme will start with the areas affected,

where the poliovirus has been detected and vaccination rates are low

It’s important all children aged 1 to 9 – even if up to date with their vaccinations – accept this vaccine when offered

Beckton sewage treatment works first

Now also,

Barnet, Brent, Camden, Enfield, Hackney, Haringey, Islington, Waltham Forest

A total of 116 PV2 isolates identified in 19 sewage samples


Poliomyelitis

https://assets.publishing.serv....ice.gov.uk/governmen

https://www.cdc.gov/vaccines/v....pd/polio/public/inde

An acute illness

Follows invasion through the gastro intestinal tract by polio virus

Virus replicates in the gut

Has a high affinity for nervous tissue

Spread occurs via the bloodstream

Retrograde axonal transport to the central nervous system

Often infection is clinically inapparent

Symptoms may range in severity

Fever to

Headache,

Gastrointestinal disturbance,

Malaise

Stiffness of the neck and back

Aseptic meningitis

Paralysis.

Ratio of inapparent to paralytic infections

1000 to 1 in children

75 to 1 in adults

Transmission

Contact with the faeces or pharyngeal secretions

Polio virus replicates long periods in GI tract

Can be excreted for three to six weeks in faeces

Can be excreted for two weeks in saliva

Incubation period

Three to 21 days

When the infection was endemic

Paralytic disease is caused by naturally occurring ‘wild virus’

Live attenuated vaccine, (OPV – Sabin)
Virus retains the potential to revert to a virulent form,

that can rarely cause paralytic disease

Vaccine-associated paralytic polio (VAPP)

VAPP cases can occur rarely where live attenuated vaccines are used

OPV not used in UK since 2004

(US, not since 2000)

Inactivated polio vaccine (i.m. injected) for routine immunisation

tetanus/diphtheria/inactivated polio vaccine

diphtheria/tetanus/pertussis/inactivated polio vaccine

Recommended at two, three and four months of age,

can be given at any stage from two months up to ten years of age