Strategies for the global eradication of poliomyelitis by the year 2000

Article Abstract:

In 1988, the eradication of poliomyelitis (polio) was adopted by the World Health Organization as a goal to be achieved by the year 2000. The successful eradication of smallpox serves as an important reminder that concerted efforts can completely eliminate a disease. However, there are serious obstacles that make eradicating polio more challenging than eliminating smallpox. The authors review the current state of polio around the world and the impediments to its eradication. One serious problem is that many cases of polio are asymptomatic, which makes it difficult to quarantine known cases. The difficulty in identifying all cases of polio also make it difficult to monitor the progress of any immunization program. More sophisticated health facilities will be necessary for evaluating the status of polio in developing countries than were needed for evaluating smallpox. Other problems involve the vaccine itself. The trivalent oral poliovirus vaccine (TOPV), a current version of the live virus Sabin vaccine, is much less stable than the smallpox vaccine. TOPV can lose much of its potency after only one day at 37 degrees centigrade. Furthermore, unlike the smallpox vaccine for which one dose can confer years of immunity, TOPV requires booster doses. While two doses are adequate in the US, at least four doses may be necessary in some developing countries to confer protective immunity. Obviously, this requires many small villages be visited more often, creating problems in both logistics and record-keeping. The eradication of smallpox cost about $300 million, but the elimination of this disease is estimated to save about $1 billion each year worldwide. Considering the greater difficulties, the eradication of polio is likely to be more costly. However, the eradication of polio would save $114 million each year in the US alone. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Planning, International aspects, World Health Organization. Expanded Programme on Immunization

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Candidate AIDS vaccines

Article Abstract:

Researchers are attempting to develop AIDS and HIV vaccines that will prevent infection by triggering an immune response that destroys the virus if it enters the body. Researchers are trying to develop vaccines that will stimulate the production of anti-HIV antibodies and the multiplication of T-cells that will kill HIV-infected cells. A challenge in vaccine development is the tremendous genetic variability in strains of HIV. Although some animal tests have shown some vaccines to be partially protective, vaccines that are effective in animals may not be applicable to humans. Vaccines that may have potential are those that include deactivated virus or mixtures of viral antigens produced by recombinant DNA. The possible risks of clinical trials include the development of an autoimmune reaction against the recipients' healthy cells or the development of antibodies that could accelerate HIV multiplication following a later infection. People in clinical trials may also experience discrimination because they will develop HIV-antibodies which are detected by the most common HIV test.

Research, AIDS vaccines

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Minimizing the risks associated with the prevention of poliomyelitis

Article Abstract:

Pediatricians and the public health community may need to be aware of the potential risk of intramuscular injections shortly after administration of the oral poliovirus vaccine (OPV) to provoke paralysis. A recent study of the high rate of vaccine-associated paralytic polio in Romania found that children who had received intramuscular injections of antibiotics shortly after receiving the OPV were at an increased risk of developing provocation paralysis. The risk of paralysis was found to be related to the administration of injections in the month between OPV administration and onset of paralysis, as well as to the number of injections received. Such findings may compel international public health officials to make sure the safest approaches are being followed to eradicate polio. The practice of giving intramuscular injections of antibiotics to young children is common in developing countries, as oral antibiotics may be hard to come by. Another factor that may increase the risk of polio in Romanian children is that they are immunized later than in other countries.

Editorial, Complications and side effects, Injections, Intramuscular, Intramuscular injections

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