New strategies for the elimination of polio from India
New strategies for the elimination of polio from India
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DOI：
10.1126/science.1130388
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发表时间：
2006-11-17
期刊：
影响因子：
56.9
通讯作者：
Aylward, R. Bruce
中科院分区：
文献类型：
--
作者：
Grassly, Nicholas C.;Fraser, Christophe;Aylward, R. Bruce
由于在少数几个地方继续传播，成为其他地方暴发的源头，全球根除小儿麻痹症的可行性受到质疑。也许最大的挑战是在印度，尽管多剂疫苗的覆盖率很高，但在北方邦和比哈尔邦，传播仍在持续。我们估计了控制这些地区季节性流行病的关键参数，并表明人口密度高和卫生条件差不仅促进脊髓灰质炎病毒的传播，而且严重影响三价疫苗的有效性，从而导致持续性。我们分析了应对这种情况的策略，并表明改用单价疫苗最终可能会中断病毒传播。
The feasibility of global polio eradication is being questioned as a result of continued transmission in a few localities that act as sources for outbreaks elsewhere. Perhaps the greatest challenge is in India, where transmission has persisted in Uttar Pradesh and Bihar despite high coverage with multiple doses of vaccine. We estimate key parameters governing the seasonal epidemics in these areas and show that high population density and poor sanitation cause persistence by not only facilitating transmission of poliovirus but also severely compromising the efficacy of the trivalent vaccine. We analyze strategies to counteract this and show that switching to monovalent vaccine may finally interrupt virus transmission.