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Polio and Its Epidemiology

  • Lester M. ShulmanEmail author
Chapter

Abstract

The word “polio ” has been used to describe both a disease and the disease agent. Among current methods to measure the importance of or interest in a topic is to run a general web search for the term and to search the scientific literature in PubMed. A Google web search of the word “polio” in Aug 2010 yielded 31,100,000 hits, while a search in PubMed yielded 22,000 articles and 826 review articles. This review will concentrate on those aspects of the epidemiology of polio as it relates to disease eradication and the sustainability of this effort. The terms “polio” and “poliomyelitis ” will be used when describing the disease and “poliovirus” and related terms such as “polio vaccine ” will be used to describe the agent that causes the disease.

Keywords

Internal Ribosome Entry Site Acute Flaccid Paralysis Polio Eradication Environmental Surveillance Inactivate Poliovirus Vaccine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Glossary

ACPE

The Advisory Committee on Polio Eradication

AFP

Acute flaccid paralysis.

AFP surveillance

Characterization of enteroviruses in stool samples from all AFP cases especially in individuals under 15 years of age to rule-in or rule-out etiology by polioviruses.

aVDPV

A vaccine-derived poliovirus isolate whose evolutionary path is unknown or ambiguous.

bOPV

Bivalent oral polio vaccine (usually containing serotypes 1 and 3).

BSL

Biosafety standard level.

Capsid

The protein shell that surrounds a virus particle.

Capsomere

One of the individual morphological units that make up the viral capsid.

CDC

US Centers for Disease Control and Prevention

CD155 or PVr

The human encoded cell receptor for poliovirus, a member of the immunoglobulin superfamily.

Codon

A sequence of three adjacent nucleotides on a strand of DNA or RNA that specifies which specific amino acid will be incorporated into a protein.

Codon bias

Unequal usage of synonymous codons (different codons that specify the same amino acid)

CPE

Cytopathic effect.

cVDPV

A circulating vaccine-derived poliovirus, that is, a poliovirus that has evolved from vaccine during person-to-person transmission.

eIPV

Enhanced inactivated polio vaccine.

Emergence

The appearance of a pathogen in a previously pathogen-free area.

Endemic

The constant presence of a disease to a greater or lesser extent in a particular locality.

Enteroviruses

Any of >80 different species of polioviruses, coxsackie viruses, echoviruses, and enteroviruses belonging to the genus Enterovirus in the family Picornaviridae.

Environmental surveillance (as related to polioviruses)

Investigation of sewage and recreational water for the presence of poliovirus as an indication of the presence of poliovirus-infected individuals in a community.

EPI

Expanded Program on Immunization.

Epidemic

A rapid spread of disease into a disease-free area or spread of a disease to more than the usual number of persons affected in a region with disease.

Epitopes

The component of an antigen that is recognized by and binds to an antibody.

Eradication

The complete elimination of all incidence of disease and/or the presence of the agent that causes the disease.

Evolution

Change in the genetic composition of a population or the genome of a given organism during successive generations.

GAP

Global action plan for laboratory containment.

GAP I

GAP phase I – plan for identifying all known and potential sources of poliovirus especially wild polioviruses within each country.

GAP II

GAP phase II – plan for laboratory containment of wild polioviruses.

GAP III

GAP phase III – plan to minimize post-eradication poliovirus facility-associated risks.

GAVI

Global alliance for vaccines and immunization

Genetic recombination (of polioviruses)

A situation where one portion of the genome of a poliovirus is replaced through a covalent linkage with the equivalent segment from another poliovirus or non-polio enterovirus.

Genotype

He genetic makeup of an organism as distinguished from its physical characteristics.

GMT

Geometric mean titer, usually calculated according to Karber.

GOARN

Global Outbreak Alert and Response Network.

GPEI or GEI

The Global Poliomyelitis Eradication Initiative of the WHO, adopted in 1988.

GPLN

Global Polio Laboratory Network.

Hydrophobic pocket

A hydrophobic space located under the binding site for the host encoded viral receptor that is located on the bottom of the canyon surrounding the fivefold axis of symmetry of the enteroviral capsid.

Hydrophobic pocket factors

Small hydrophobic molecules that occupy the hydrophobic pocket and that may regulate the host receptor viral capsid interaction.

Immunodeficient

Lacking one of the components of the immune system.

Immunogenicity

The relative ability of a molecule to elicit an immune response.

i.d.

Intradermal or under the skin.

i.m.

Intramuscular.

i.n.

Intranasal.

i.p.

Intraperitoneal.

i.t.

Intrathecal.

Infection

Establishment and growth of an infectious agent in the body.

IPV

Inactivated poliovirus vaccine.

IRES

Internal ribosome entry site.

ITD

Intratypic differentiation (determination if a virus isolate is vaccine, vaccine-derived, or wild).

iVDPV

A vaccine-derived poliovirus that has diverged from its respective oral poliovirus serotype during persistent infection of an immunodeficient host.

Lineages

A group of organisms that are closely related genetically.

MAPREC

Mutant analysis by PCR and restriction fragment enzyme cleavage to measure reversion of attenuation sites in vaccine strains.

MNVT

Monkey neurovirulence test, an in vivo neurovirulence test in monkeys.

mOPV

Monovalent OPV.

Neurovirulence

The ability of the poliovirus to infect and damage nerve cells causing disease of the nervous system.

Neurovirulence attenuation sites

Specific nucleotide positions along the poliovirus genome where the specific nucleotide present at that site will influence whether or not an individual polioviral isolate will be neurovirulent.

Neutralizing antigenic sites

Epitopes of the poliovirus that induce neutralizing antibodies.

NID

National immunization day.

NSL

Non-Sabin-like (wild) virus of vaccine-derived poliovirus (based on results of certain ITD tests).

Major disease

Poliomyelitis, AFP, or cases of infection with polio that involves invasion and permanent damage to the nervous system.

Microarray

A technology used to study many genes at once using thousands of different short molecular sequences at known position on solid support to hybridize to complementary nucleic acid sequences from different sources.

Minor disease

Nonspecific illness caused by poliovirus that may include upper respiratory tract symptoms (sore throat and fever), gastroenteritis (nausea vomiting, abdominal pain, constipation or diarrhea), and influenza-like illness.

NCCs

National Certification Committees.

NGOs

Nongovernmental organizations.

NIDs

National immunization days.

NPEV

Non-polio enteroviruses.

Nonstructural genes

Viral genes encoding proteins that are not incorporated into the structure of the capsid.

Oligonucleotide

A short sequence of nucleotides frequently synthetic.

OPV

Live attenuated oral poliovirus vaccine.

Outbreaks

(Under eradication conditions) even the presence of a single case of paralytic poliomyelitis.

Persistent poliovirus infection

An infection associated with an immunodeficient host where virus is not cleared but continues to replicate for an indefinite period of time.

Phylogenetic tree

A diagram with branches showing the inferred evolutionary relationships among various biological entities.

Picornaviridae

A viral family made up of the small (18–30nm) ether-sensitive single stranded, positive-sense RNA viruses that lack an envelope.

Poliomyelitis

The infectious disease caused by poliovirus involving inflammation of motor neurons of the spinal cord and brainstem that leads to acute paralysis followed by atrophy of the muscles enervated by the infected motor neurons.

Poliovirus

One of three serotypes of picornaviruses that can cause acute flaccid paralysis and whose cell receptor is CD155.

Polypeptide

A small molecule constructed from linked amino acids.

Postpolio syndrome

Slow progressive muscle pain and weakness that reappears 30 or 40 years after paralysis caused by a poliovirus infection affecting muscles previously affected by polio as well as muscles that may not have been affected.

Posttranslational processing

Any modification of a protein after it has been translated.

Provoked poliomyelitis

Poliomyelitis resulting from physical trauma during infection with poliovirus.

Proofreading

An enzymatic process that checks whether a newly incorporated nucleotide in a nascent chain is the correct compliment of its corresponding nucleotide in the template.

PVR

The poliovirus receptor, CD155.

PVR Tg21 transgenic mouse

A mouse that has been genetically modified to express the human poliovirus receptor.

Quasispecies

A term used to describe a cluster, cloud, or swarm of viruses with minor differences in nucleotide sequence that arise during replication as a consequence of polymerase incorporation errors.

Rearrangement (in relation to polioviruses)

A structural alteration in the genomic sequence occurring during coinfection with two or more viruses resulting in a new genome in which parts are from different parental polio or non-polio enteroviruses

Reemergence

Emergence after an absence.

RCC

Regional Certification Committees.

RCT

Reproductive capacity temperature, the temperature at which viruses can replicate.

RNA-dependent RNA polymerase

A viral encoded polymerase that synthesizes a complimentary RNA strand from an RNA template.

RRL

Regional Reference Laboratory of the Global Polio Laboratory Network.

SAGE

Strategic Advisory Group of Experts on Immunization.

Serotype

A group of closely related virus expressing a common set of antigens.

Seroconversion

Appearance of antibodies following exposure to antigen in seronegative person, or ≥4-fold increase in titer of previously immune person.

Seroconversion index

The mean seroconversion rate against all three poliovirus serotypes.

SL

Sabin-like poliovirus (based on result from some ITD tests).

SIA

Supplemental immunization activities (such as NIDs, SNIDS, and mop-ups).

Silent circulation

Person-to-person transmission of virus in a community in the absence of cases of AFP.

Silent infection

Asymptomatic infection.

Silent presence

The presence of a virus in the absence of clinical cases and the absence of person-to-person transmission.

SNIDS

Sub-national Immunization Days.

Stakeholders

All governmental and nongovernmental agencies involved in the GPEI.

Structural genes (in relation to polio)

Genes encoding viral capsid proteins.

Synonymous nucleotide substitutions

Changes in the nucleotide sequence that do not result in a change in encoded amino acid.

TAG

Technical Advisory Group.

TD

Typic differentiation (determination of the serotype of a poliovirus isolate).

TOPV

Trivalent oral polio vaccine containing all three serotypes of attenuated poliovirus.

Transition

The substitution of a purine nucleotide with the other purine, or a pyrimidine nucleotide with the other pyrimidine.

Transversions

The substitution of a pyrimidine nucleotide by a purine nucleotide or vice versa.

UNICEF

United Nations Children’s Fund.

Vaccine strains

Poliovirus strains approved by the WHO for production of live and inactivated polio vaccines.

VAPP

Vaccine-associated paralytic poliomyelitis.

VDPV

A vaccine-derived poliovirus that has diverged through evolution from its respective live poliovirus vaccine strain serotype by more than 1% (serotypes 1 and 3) or more than 0.6% (serotype 2) of its respective VP1 capsid protein.

Viremia

The presence of virus in the bloodstream during an infection.

VPg

Viral protein genome linked – 22 amino acid protein covalently linked to genome and complimentary negative strand.

VP1

Viral capsid protein 1.

VP2

Viral capsid protein 2.

VP3

Viral capsid protein 3.

VP4

Viral capsid protein 4.

WHA

World Health Assembly.

WHO

World Health Organization.

WPV or wild poliovirus

Any poliovirus that is not derived from attenuated oral polio vaccine strains

3’UTR

The untranslated region of the polioviral genome that is located 3′ of the open reading frame that encodes the viral polyprotein.

3Dpol

Viral encoded RNA-dependent RNA polymerase.

5’UTR

A highly structured, untranslated area of the polioviral genome located 5′ to the open reading frame that encodes the viral polyprotein. The 5’UTR is covalently linked on its 5′ base to viral protein VPg.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Central Virology Laboratory, Laboratory of Environmental Virology at Sheba Medical CenterPublic Health Services, Israel Ministry of HealthTel HaShomerIsrael
  2. 2.Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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