- Poliomyelitis: new challenges on the way to eradication
Poliomyelitis: new challenges on the way to eradication
SOVREMENNAYA PEDIATRIYA.2017.3(83):27-37; doi 10.15574/SP.2017.83.27
Tsyganchuk O. M.
SI «L.V. Gromashevsky Institute of Infectious Diseases and Immunology» of the National Academy of Sciences of Ukraine, Kyiv
Purpose. To assess the poliomyelitis epidemic situation in Ukraine and determine ways to maintain the status of a country as free from poliomyelitis.
Materials and methods. Findings of the epidemiological surveillance on acute flaccid paralyses (AFP)/ poliomyelitis, and statistical reports of the Ministry of Healthcare of Ukraine «Performance of Annual Immunization Plan» (Form 5) (from 2008 to 2015) were analyzed.
Findings and discussion. Since 2008 there has been a decrease of immunization coverage in Ukraine, as well as against poliomyelitis. Consequently, in 2012 pursuant to the conclusions of 7th Meeting of the Independent Monitoring Board of the Global Polio Eradication Initiative (October 29–31, 2012 London) Ukraine was listed as country at high risk of wild poliovirus transmission (alongside with the Horn of Africa, Kenya, Libya, Somalia, Uganda and Yemen). Despite the fact that polio immune prevention conditions in Ukraine were was rated as critical and the fact that this issue has been raised by the scientific community and up to the government levels, immunization coverage rates still remain extremely low (2008 — >98%, 2008 — 90.9%, 2009 — 80.6%, 2010 — 57.3%, 2011— 54.3%, 2012 — 73.7%, 2013 — 72.0%). Considering the required rate of 95%, the situation became particularly critical in 2014 (44.7%) and in the following year (as at 01.08.2015 — 17.3%). This resulted in vaccine-derived poliovirus (VDPV). Three strains of VDPV-2 were discovered in 2014, and in 2015 two polio outbreaks (2 cases) caused by circulating VDPV 1 were registered. Responding to the outbreak from October 2015 to February 2016 three immunization rounds to vaccinate children with oral polio vaccine (2 rounds for age groups from 2 months to 6 years; 3rd round — from 2 months to 10 years) with the respective coverage rates of 64.4%, 71.7% and 80.7%. This was followed by mop-up immunization campaign till 17.04.2016. Measures taken enabled some improvement of the immunization coverage conditions, namely in children under the age of 1 year had 3 vaccinations (inactivated + oral vaccine) the rate was 90.1%. At the same time, these figures were below 90% in 10 administrative areas. If immunization covers less than 90% the main goal of prophylactic immunization well not be accomplished, namely the formation of specific population immunity.
Conclusions. The following conditions are necessary for the preservation and maintenance in Ukraine of status as a polio-free territory: the routine immunization coverage should remain at 95%; mop-up immunization should be provided for children till the age of 10 years that missed scheduled vaccinations; proper epidemiological surveillance of AFP/ poliomyelitis and other enteroviral infections should be conducted; virological control of wastewater should be enhanced.
Key words: children, poliomyelitis, acute flaccid paralyses, eradication, immunization.
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