2/04/2011

Circulating vaccine-derived poliovirus (cVDPV) 2000-2011



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Circulating vaccine-derived poliovirus (cVDPV) 2000-2011


*Circulating Vaccine-derived poliovirus (cVDPV) is associated with 2 or more cases of AFP. 
Cases with less than 10 nt genetically related to these outbreaks and cases of ambiguous Vaccine-derived Poliovirus (aVDPV) are not reported here. 
Figures exclude VDPV from non-AFP source. Figures may include different chains of transmission. 

Data in WHO/HQ as of 01 February 2011
Related



Implications of a Circulating Vaccine-Derived Poliovirus in Nigeria

Helen E. Jenkins, M.Sc., R. Bruce Aylward, M.D., Alex Gasasira, M.B., Ch.B., Christl A. Donnelly, Sc.D., Michael Mwanza, B.Comm., Jukka Corander, Ph.D., Sandra Garnier, B.Sc., Claire Chauvin, R.N., M.P.H., Emmanuel Abanida, M.P.H., Muhammad Ali Pate, M.D., Festus Adu, D.V.M., Ph.D., Marycelin Baba, Ph.D., and Nicholas C. Grassly, D.Phil.
N Engl J Med 2010; 362:2360-2369June 24, 2010
Abstract
Article
References
Citing Articles (2)
Letters

BACKGROUND

The largest recorded outbreak of a circulating vaccine-derived poliovirus (cVDPV), detected in Nigeria, provides a unique opportunity to analyze the pathogenicity of the virus, the clinical severity of the disease, and the effectiveness of control measures fo
r cVDPVs as compared with wild-type poliovirus (WPV).



New bivalent vaccine the eradication ‘game-changer’


SCIENTISTS believed that the new bivalent oral polio vaccine (bOPV) was going to be effective. However, no one expected it to be this effective. And scientists and epidemiologists concur that despite bOPV’s stunning success in the field, we are yet to understand this vaccine’s true potential.

Since bOPV’s introduction, for the first time ever there has been concurrent drops in the number of both type 1 and 3 cases in the key reservoir areas of Nigeria (total cases down 98%) and India (down 95%). Type 3 cases have fallen to their lowest number in the history of the GPEI (76 WPV3 cases, as of 17 November, compared with 946 cases at this time last year). In the past six months, just 22 cases of WPV3 have been recorded, reflecting the role that bOPV is playing and providing a real opportunity to eradicate type 3 poliovirus globally.

Since November 2009, four manufacturers have pre-qualified bOPV (GlaxoSmithKline, Panacea, Haffkine and BioFarma, with three more producers planning to come on board early in 2011) have produced more than 700
 million doses of bOPV (out of 2 billion doses used annually), but demand continues to outstrip supply.

Ian Lewis, Contract Officer for the UNICEF Supply Division in Copenhagen, has overseen the roll-out of several vaccines, including both monovalent oral polio vaccine types 1 and 3 (mOPV1 and mOPV3), but said he had never witnessed such a high demand for a new product.

Mr Lewis said that although more than 700 million doses of bOPV had been distributed in 2010, suppliers still could not keep pace. “It’s been challenging, balancing the capacity of the manufacturers with the high demand from the countries and the programmatic side,” Mr Lewis said. “Literally as soon as bOPV is coming off the production line it’s going on a plane and to the countries.”

WHO Technical Officer Jackie Fournier-Caruana paid tribute to the unprecedented collaboration between UNICEF, the World Health Organization (WHO), vaccine suppliers, national
 regulatory authorities and other development partners, which saw the vaccine developed and rolled out in record time. “It was extremely good cooperation between all - that’s the only way you could get a vaccine out so quickly,” she said. “It was a lot of hard work - we put all our effort in this one - but it has been worth it.” 

In October, medical journal 
The Lancet released the results of the first head-to-head study of bOPV against mOPV1, mOPV3 and tOPV, which found that bOPV induced a significantly higher immune response than tOPV and a similar response to the monovalent vaccines, but in a unique package that tackled both remaining serotypes 1 and 3 at once. 

Co-author of the study, Dr Roland Sutter, said bOPV appeared to be the “game-changer” in eradication. “This (new) vaccine could get us over the top and get us to the finish line for eradication,” Dr Sutter said. “The effect has been greater than expected.” 
- Rod Curtis/WHO 
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