BACKGROUND: In 2009, enhanced poliovirus surveillance was established in polio-endemic areas of Uttar Pradesh and Bihar, India, to assess poliovirus infection in older individuals. METHODS: In Uttar Pradesh, stool specimens from asymptomatic household and neighborhood contacts of patients with laboratory-confirmed polio were tested for polioviruses. In Bihar, in community-based surveillance, children and adults from 250 randomly selected households in the Kosi River area provided stool and pharyngeal swab samples that were tested for polioviruses. A descriptive analysis of surveillance data was performed. RESULTS: In Uttar Pradesh, 89 of 1842 healthy contacts of case patients with polio (4.8%) were shedding wild poliovirus (WPV); 54 of 85 (63.5%) were ≥5 years of age. Shedding was significantly higher in index households than in neighborhood households (P<.05). In Bihar, 11 of 451 healthy persons (2.4%) were shedding WPV in their stool; 6 of 11 (54.5%) were ≥5 years of age. Mean viral titer was similar in older and younger children. CONCLUSIONS: A high proportion of persons≥5 years of age were asymptomatically shedding polioviruses. These findings provide indirect evidence that older individuals could have contributed to community transmission of WPV in India. Polio vaccination campaigns generally target children<5 years of age. Expanding this target age group in polio-endemic areas could accelerate polio eradication.
BACKGROUND: In 2009, enhanced poliovirus surveillance was established in polio-endemic areas of Uttar Pradesh and Bihar, India, to assess poliovirus infection in older individuals. METHODS: In Uttar Pradesh, stool specimens from asymptomatic household and neighborhood contacts of patients with laboratory-confirmed polio were tested for polioviruses. In Bihar, in community-based surveillance, children and adults from 250 randomly selected households in the Kosi River area provided stool and pharyngeal swab samples that were tested for polioviruses. A descriptive analysis of surveillance data was performed. RESULTS: In Uttar Pradesh, 89 of 1842 healthy contacts of case patients with polio (4.8%) were shedding wild poliovirus (WPV); 54 of 85 (63.5%) were ≥5 years of age. Shedding was significantly higher in index households than in neighborhood households (P<.05). In Bihar, 11 of 451 healthy persons (2.4%) were shedding WPV in their stool; 6 of 11 (54.5%) were ≥5 years of age. Mean viral titer was similar in older and younger children. CONCLUSIONS: A high proportion of persons≥5 years of age were asymptomatically shedding polioviruses. These findings provide indirect evidence that older individuals could have contributed to community transmission of WPV in India. Polio vaccination campaigns generally target children<5 years of age. Expanding this target age group in polio-endemic areas could accelerate polio eradication.
Authors: Concepción F Estívariz; Hamid Jafari; Roland W Sutter; T Jacob John; Vibhor Jain; Ashutosh Agarwal; Harish Verma; Mark A Pallansch; Ajit P Singh; Sherine Guirguis; Jitendra Awale; Anthony Burton; Sunil Bahl; Arani Chatterjee; R Bruce Aylward Journal: Lancet Infect Dis Date: 2011-11-07 Impact factor: 25.071
Authors: Nicholas C Grassly; Christophe Fraser; Jay Wenger; Jagadish M Deshpande; Roland W Sutter; David L Heymann; R Bruce Aylward Journal: Science Date: 2006-11-17 Impact factor: 47.728
Authors: Nicholas C Grassly; Jay Wenger; Sunita Durrani; Sunil Bahl; Jagadish M Deshpande; Roland W Sutter; David L Heymann; R Bruce Aylward Journal: Lancet Date: 2007-04-21 Impact factor: 79.321
Authors: George Shirreff; Mufti Zubair Wadood; Rui Gama Vaz; Roland W Sutter; Nicholas C Grassly Journal: Emerg Infect Dis Date: 2017-02-15 Impact factor: 6.883
Authors: Maria Melissa Ann Jiao; Lea Necitas Apostol; Maricel de Quiroz-Castro; Youngmee Jee; Vito Roque; Manuel Mapue; Frances Marsha Navarro; Cleo Fe Tabada; Amado Tandoc Journal: BMC Public Health Date: 2020-02-03 Impact factor: 3.295