Characterization of Household and Community Shedding and Transmission of Oral Polio Vaccine in Mexican Communities With Varying Vaccination Coverage

被引：9

作者：

Altamirano, Jonathan ^{[1
]}

Purington, Natasha ^{[1
]}

Behl, Rasika ^{[1
]}

Sarnquist, Clea ^{[1
]}

Holubar, Marisa ^{[1
]}

Garcia-Garcia, Lourdes ^{[2
]}

Ferreyra-Reyes, Leticia ^{[2
]}

Montero-Campos, Rogelio ^{[2
]}

Pablo Cruz-Hervert, Luis ^{[2
,4
]}

Boyle, Shanda ^{[3
]}

Modlin, John ^{[3
]}

van Hoorebeke, Christopher ^{[1
]}

Leary, Sean ^{[1
]}

Huang, ChunHong ^{[1
]}

Sommer, Marvin ^{[1
]}

Ferreira-Guerrero, Elizabeth ^{[2
]}

Delgado-Sanchez, Guadalupe ^{[2
]}

Canizales-Quintero, Sergio ^{[2
]}

Diaz Ortega, Jose Luis ^{[2
]}

Desai, Manisha ^{[1
]}

Maldonado, Yvonne A. ^{[1
]}

机构：

[1] Stanford Univ, Sch Med, Stanford, CA 94305 USA

[2] Inst Nacl Salud Publ, Cuernavaca, Morelos, Mexico

[3] Bill & Melinda Gates Fdn, Seattle, WA USA

[4] Univ Nacl Autonoma Mexico, Mexico City, DF, Mexico

来源：

CLINICAL INFECTIOUS DISEASES | 2018年 / 67卷

基金：

比尔及梅琳达.盖茨基金会;

关键词：

OPV; shedding; oral poliovirus vaccine; poliovirus transmission; longitudinal virus surveillance; Mexico; ATTENUATED STRAINS; POLIOMYELITIS; IMMUNIZATION; INFECTION; CESSATION; IMMUNITY; CHILDREN; SPREAD; TRIAL;

D O I：

10.1093/cid/ciy650

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. The World Health Assembly 2012 Polio Eradication and Endgame Strategic Plan calls for the eventual cessation of all oral polio vaccines (OPVs), to be replaced with inactivated polio vaccine (IPV); however, IPV induces less robust mucosal immunity than OPV. This study characterized household and community OPV shedding and transmission after OPV vaccination within primarily IPV-vaccinated communities. Methods. Households in 3 IPV-vaccinated Mexican communities were randomized to receive 3 levels of OPV vaccination coverage (70%, 30%, or 10%). Ten stool samples were collected from all household members over 71 days. Analysis compared vaccinated subjects, household contacts of vaccinated subjects, and subjects in unvaccinated households. Logistic and Cox regression models were fitted to characterize transmission of OPV by coverage and household vaccination status. Results. Among 148 vaccinated children, 380 household contacts, and 1124 unvaccinated community contacts, 78%, 18%, and 7%, respectively, shed OPV. Community and household contacts showed no differences in transmission (odds ratio [OR], 0.67; 95% confidence interval [CI], .37-1.20), in shedding trajectory (OR, 0.61; 95% CI, .35-1.07), or in time to shedding (hazard ratio, 0.68; 95% CI, .39-1.19). Transmission began as quickly as 1 day after vaccination and persisted as long as 71 days after vaccination. Transmission within unvaccinated households differed significantly across vaccination coverage communities, with the 70% community experiencing the most transmissions (15%), and the 10% community experiencing the least (4%). These trends persisted over time and in the time to first shedding analyses. Conclusions. Transmission did not differ between household contacts of vaccinees and unvaccinated households. Understanding poliovirus transmission dynamics is important for postcertification control.

引用

页码：S4 / S17

页数：14

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