Feb 11, 2012

Despite WHO's recommendation to switch the poliomyelitis vaccine from oral polio vaccine (OPV) to inactivated polio vaccine (IPV) in countries

Vaccine-associated paralytic poliomyelitis in Japan
Despite WHO's recommendation to switch the poliomyelitis vaccine from oral polio vaccine (OPV) to inactivated polio vaccine (IPV) in countries where polio elimination has been achieved, Japan has continued to use OPV. In Japan, OPV is given twice to children aged from 3 to 18 months.1 More than 10 years after the elimination of wild polio virus, tragic cases of vaccine-associated paralytic poliomyelitis (VAPP) continue to be reported every year—most recently in May, 2011. The Ministry of Health, Labour and Welfare claims that IPV is still being developed by Japanese vaccine companies and that it will not be available until the end of 2012 at the earliest. The growing tension between the Government, which persists with domestically produced OPV, and the parents, who request IPV to avoid VAPP, has evoked huge media attention.
To understand OPV perceptions and practices among parents, we did a survey of 260 parents whose children attend day care or one of two nursery schools in Kanagawa Prefecture. 50 parents (19%) thought that OPV was dangerous and 81 (31%) wanted their children to take IPV. Because of the growing fear of OPV, the coverage of OPV has been decreasing. According to the Ministry, OPV coverage from April to June, 2011, was 17·5% lower than in the previous year.2 A paediatrician in the urban area of Tokyo has said that the inoculation rate is only about 50% there, which indicates an increased risk of retransmission of poliovirus once it is imported.3
Despite such concerns, the Japan Pediatric Society recommends that people should take OPV until domestically produced IPV becomes available.4 However, some paediatricians have begun to import IPV and administer it if parents are willing to pay out-of-pocket expenses of US$160—240. The Governor of Kanagawa Prefecture also announced the establishment of a system to provide IPV to respond to the needs of residents, despite strong opposition from the Government.
Japan has been a major driver of the Global Polio Eradication Initiative,5 but the lack of consistency between its domestic and global health policies is harming its own people. How long will the Japanese people need to wait for safe IPV to become available?
This study was reviewed by the Office of Human Research Administration of the Harvard School of Public Health. Protocol number 21402-101: “Polio vaccination status and parents' perception on polio vaccine.” We declare that we have no conflicts of interest.


1 Ministry of HealthLabour and WelfareBasic information on polio and poliomyelitis vaccine.http://www.mhlw.go.jp/bunya/kenkou/polio/qa.html#q6(accessed Dec 5, 2011).
2 AnonGovernment should introduce IPV immediately. Akita Sakigake Nov 18, 2011.http://www.sakigake.jp/p/editorial/news.jsp?kc=20111118az(accessed Dec 5, 2011).
3 Horigome KRecord of polio information session for the National Diet Members: November 15, 2011.http://lohasmedical.jp/blog/2011/11/post_2509.php(accessed Jan 31, 2012).
4 Japan Pediatric SocietyCommittee of Immunization and Communicative DiseasePolicy statement on polio vaccine.http://www.jpeds.or.jp/saisin/saisin_111114.pdf(accessed Dec 5, 2011).
5 AnonJapan to provide 900 million yen to fight polio. Asahi Shimbun Oct 26, 2011.http://ajw.asahi.com/article/behind_news/politics/AJ2011102615766(accessed Dec 5, 2011).

México Post Polio a la vanguardia en el Síndrome de Post Polio

Feb 6, 2012

But polio stubbornly persists in pockets of poverty in Africa and Asia.

How we will eradicate the next polio

Recently, in San Diego, Microsoft Chairman Bill Gates and Rotary International announced a massive infusion of new money to finally eradicate polio worldwide. Polio is given little attention in American media today because it is no longer a public health issue in this country.
Decades ago, the deadly paralytic viral disease was purged from developed countries. But polio stubbornly persists in pockets of poverty in Africa and Asia.
Today the challenges to globally eliminating polio are largely political and cultural – overcoming local fears about vaccine safety, reaching people in war-torn areas, tracking people who are constantly moving and adequately strengthening the polio-fighting infrastructure.
We applaud Gates, Rotary and others for their enduring commitment to eradicating this viral menace that jeopardizes the health of poor children unlucky enough to be born in the slums of India, Afghanistan, Pakistan or Nigeria.
Of course, here at the Salk Institute we paid particular attention to the Gates/Rotary announcement because the original polio vaccine that halted the spread of the vicious disease was developed by our founder, Dr. Jonas Salk. Indeed, our highly regarded research institution owes its very existence to Salk's genius and persistence in conquering the poliovirus, and to the vision of the March of Dimes, which provided institute seed funding and continues to support our work.
For Americans too young to remember: Polio was once a public health terror, frightening families coast to coast. Each year thousands of children and teenagers died from polio outright. Many more, including President Franklin Delano Roosevelt, were severely crippled by it. Iron lungs, massive leg braces and wheelchairs were stark symbols of polio's life-altering effects.
The polio story deserves recalling because it is a shining example of innovation, dedication and resourcefulness in post-war America. Working under a mandate from FDR with public and private support and a great sense of urgency, scientists probed the biological properties of the polio virus. In 1948, the first breakthrough: Scientists in Boston successfully grew the virus in laboratory human tissue, facilitating vaccine research. Then, in Pittsburgh in 1952, Jonas Salk and his colleagues devised the first vaccine to boost immunity and show promise for large-scale use.
Our country then embarked on what, to this day, must be the most massive clinical testing ever. Some 1.8 million American children and teens were part of field trials in 44 states – from Maine to California. The study participants were dubbed “Polio Pioneers” and, whether they received the real vaccine, a placebo or were in the control group for comparison, each child was awarded a certificate attesting to his or her national contribution.
With testing on such an enormous scale, it rapidly became clear that the vaccine was both safe and effective. The trial was stopped in 1955 and the vaccine made available to the public.
Decades later Dr. Salk met an elderly man and his grandson in the Salk Institute courtyard. “There's the man who killed polio,” the grandfather told the boy. “What's polio?” the boy replied. Salk later described that moment as one of his proudest.

 “Polio Pioneers”

México a la vanguardia en el Síndrome de Post Polio

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