Poliomyelitis poliovirus

Vaccine diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated poliovirus combined Pediarix Active immunization against diphtheria, tetanus, pertussis and all known subtypes of hepatitis B virus, and poliomyelitis immunization Sfee adverse reactions against individual vaccines. Primary immunization series 3 doses of 0.5 mLat 6-to 8-week intervals IM (first dose is 2 months of age, but may be given as early as 6 weeks of age)... 

Picomaviruses Poliovirus Naked icosahedral particles 28 nm in diameter One of a group of enteroviruses common in the gut of humans. The primary site of multiplication is the lymphoid tissue of the alimentary tract. Only rarely do they cause systemic infections or serious neurological conditions like encephalitis or poliomyelitis... 

Poliomyelitis (inactivated)t (Salktype) Human diploid cell cultures infected with each of the three serotypes of poliovirus 1 Clarification 2 Inactivation with formalin 3 Concentration 4 Blending of virus of each serotype Induction of antibodies to polioviruses in chicks or guinea-pigs Inoculation of cell cultures and monkey spinal cords to exclude live virus... 

Poliomyelitis (live or oral) (Sabin type) Cell cultures infected with attenuated poliovirus of each of the three serotypes 1 Clarification 2 Blending of virus of three serotypes in stabilizing medium Infectivity titration of each of three virus serotypes Test for attenuation by Inoculation of spinal cords of monkeys and comparison of lesions with those produced by a reference vaccine... 

Viral vaccines present problems of safety testing far more complex than those experienced with bacterial vaccines. With killed viral vaccines the potential hazards are those due to incomplete virus inactivation and the consequent presence of residual live virus in the preparation. The tests used to detect such live virus consist of the inoculation of susceptible tissue cultures and of susceptible animals. The cultures are examined for cytopathic effects and the animals for symptoms of disease and histological evidence of infection at autopsy. This test is of particular importance in inactivated poliomyelitis vaccine, the vaccine being injected intraspinally into monkeys. At autopsy, sections of brain and spinal cord are examined microscopically for the histological lesions indicative of proliferating poliovirus. 

Polio is the only disease, at present, for which both hve and killed vaccines compete. Since the introduction of the killed vims (Salk) in 1956 and the live attenuated virus (Sabin) in 1962 there has been a remaikable decline in the incidence of poliomyelitis (Fig. 16.1). The inactivated polio vaccine (TPV) contains formalin-killed poliovirus of all three serotypes. On injection, the vaccine stimulates the production of antibodies of the IgM and IgG class which neutrahze the vims in the second stage of infection. A course of three injections at monthly intervals produces long-lasting immunity to all three poliovirus types. 

Poliomyelitis is a highly contagious disease that is often asymptomatic however, approximately 1 in every 100 to 1000 cases will develop a rapidly progressive paralytic disease. Polio is caused by poliovirus which has three serotypes type 1 is most frequently associated with paralytic disease. Poliovirus replicates in the oropharynx and intestinal tract and is excreted in oral secretions and feces, which can infect others. As a result, more than 90% of unvaccinated individuals will become infected with poliovirus following household exposure to wild-type poliovirus. Since the introduction of the first poliovirus vaccine, there has been a significant reduction in the number of polio cases. Today, polio caused by wild-type poliovirus has been eradicated from the Western Hemisphere with the goal of eradicating it from the world.11... 

The first inactivated poliovirus vaccine was introduced in the 1950s in an injectable formulation, and replaced in the 1960s by a live oral poliovirus vaccine. The oral poliovirus vaccine not only elicits systemic immunogenicity but also a localized immune response in the intestinal tract. Unfortunately, the oral poliovirus vaccine has the risk of vaccine-associated paralytic poliomyelitis occurring in approximately 1 case of every 2.4 million doses distributed. The risk with the first dose of oral poliovirus vaccine is 1 case in 750,000 doses.11... 

The last reported case of indigenous wild-type poliovirus in the United States was in 1979 subsequent cases were all vaccine-associated. In 1997, a transition period to the inactivated poliovirus vaccine was begun to reduce the risk of vac-cine-associated paralytic poliomyelitis. By January 2000, the oral vaccine was no longer recommended for routine use. Currently, the inactivated poliovirus vaccine is recommended for routine use in the United States. The oral poliovirus vaccine is still widely used in some countries where poliovirus eradication has been more difficult. 

Poliomyelitis (polio) IPV (Inactivated poliovirus vaccine) OPV (Oral polio vaccine) Cell based... 

The tobacco mosaic virus (center right), a plant pathogen, has a structure similar to that of MB, but contains ssRNA instead of DNA. The poliovirus, which causes poliomyelitis, is also an RNA virus. In the influenza virus, the pathogen that causes viral flu, the nucleocapsid is additionally surrounded by a coat derived from the plasma membrane of the host cell (C). The coat carries viral proteins that are involved in the infection process. 

Poliovirus. A virus of the genus Enterovirus that is the etiological agent of poliomyelitis, separable on the basis of specificity of neutralizing antibody into three serotypes, designated types 1, 2, and 3. 

Sabin, A.B., Oral poliovirus vaccine. History of its development and prospects for eradication of poliomyelitis. Jama, 1965. 194(8) 872-6. 

Inoculation of these mice with poliovirus resulted in viral replication in the central nervous system and in the development of a disease analogous to paralytic poliomyelitis. 

Picornaviridae Hepatitis A virus Polioviruses Rhinovirus, types 1-89 Hepatitis A Poliomyelitis Common cold... 

Sutter RW, Prevots DR, Cochi SL (2000) Poliovirus vaccines - progress toward global poliomyelitis eradication and changing routine immunization recommendations in the United States. Pediatr Clin North Am 47(2) 287-308 Therien HM, Lair D, Shahum E (1990) Liposomal vaccine - influence of antigen association on the kinetics of the humoral response. Vaccine 8(6) 558-562 Thones N, Muller M (2007) Oral immunization with different assembly forms of the HPV 16 major capsid protein LI induces neutralizing antibodies and cytotoxic T-lymphocytes. Virol 369(2) 375-388... 

Two types of trivalent poliovirus vaccines are currently licensed for distribution in the United States an enhanced inactivated vaccine (IPV) and a live attenuated, oral vaccine (OPV). IPV is the recommended vaccine for the primary series and booster dose for children in the United States, whereas OPV is recommended in areas of the world that have circulating pohovirus. IPV is given to children aged 2, 4, and 6 to 18 months and 4 to 6 years. Primary poliomyelitis immunization is recommended for all children and young adults up to age 18 years. Allergies to any component of IPV, including streptomycin, polymyxin B, and neomycin, are contraindications to vaccine use. 

Nathanson, N. Langmuir, A.D. The cutter incident. Poliomyelitis following formaldehyde-inactivated poliovirus vaccination in the United States during the spring of 1955. I. Background. Am. J. Hygiene 1963, 78, 16-28. 

There are two types of pohomyelitis vaccines available. One is prepared from pohoviruses that as a rule have been inactivated by formaldehyde. Inactivated poliomyelitis vaccine (IPV) is given parenterally. The second group of polio vaccines comprises attenuated strains of live polioviruses (oral poliomyelitis vaccine, OPV), which are given orally these live vaccines are the most widely used. 

Poliomyelitis caused by vaccine-derived polioviruses Between 12 July and 18 November 2000, a total of 19 people (aged between 9 months and 21 years) with acute flaccid paralysis were identified in the Dominican Republic one case occurred in Haiti (August 2000) (26). The case in Haiti and three of the cases in the Dominican Republic were laboratory-confirmed with poliovirus type... 

The molecular biological findings connected with the occurrence of vaccine-associated poliomyelitis have been summarized (29). There is convincing evidence that the Sabin 2 and 3 viruses themselves can revert to a neuro-virulent phenotjrpe on passage in man. The authors report that a point mutation in the 5 -non-coding region of the genome of the poliovirus type 3 vaccine consistently reverts to the wild type in viruses isolated from cases of vaccine-associated pohomyehtis. 

In the early days of vaccine development the majority of untoward effects after immunization were associated with faulty production, and the control of biological products as they exist today has been developed largely as a result of major accidents. For example, the Cutter incident in the USA in 1955, in which a batch of inactivated poliomyelitis vaccine containing live poliovirus was inadvertently released, had devastating consequences. The World Health Organization (WHO) subsequently took over the responsibility for international biological standardization. Currently, more than 50 WHO requirements for the manufacture and control of biological substances have been adopted and updated. As a result of the incorporation of WHO requirements, and their strict observance by manufacturers and control authorities, accidents due to faulty production of vaccines have become rare (SEDA-13, 271). 

An example from virus vaccine manufacture is the titration, prior to inactivation, of the infectivity of the pools of live poliovirus used to make inactivated poliomyelitis vaccine. Adequate infectivity of the virus from the tissue cultures is an indicator of the adequate virus content of the starting material... 

Poliomyelitis is a contagious viral infection that usually causes asymptomatic infection but in its serious form causes acute flaccid paralysis. Poliovirus is spread via the fecal-oral route. The virus replicates in the upper respiratory tract, gastrointestinal tract, and local lymphatics. The vast majority of polio infections are subclinical and asymptomatic. Indigenous polio has been absent from the United States since 1979, and the last case in the Americas was reported in 1991. Global eradication efforts are entering the final stages, and the eradication of polio should be accomplished in the next few years. 

Centers for Disease Control and Prevention. Prolonged poliovirus excretion in an immunodeflcient person with vaccine-associated paralytic poliomyelitis. MMWR 1997 46 641-643. 

Poliomyelitis is not the scourge that it once was, thanks to improved hygienic practices which have effectively blocked the spread of wild-type polioviruses, especially in developed countries, and thanks to the widespread use of vaccines. The viruses, like other enteroviruses, are transmitted by the fecal-oral route, following ingestion, they replicate in various cell types in the pharynx and small intestine (they are quite stable to stomach acids) and gain access to the circulation. From there, they disseminate and occasionally gain access to the central nervous system, where they may produce the characteristic lesions leading to poliomyelitis. 

Although the vaccine strains of polioviruses are very safe, the use of all polioviruses will soon be phased out in view of the anticipated eradication of poliomyelitis whereas a cox-sackie- or echovirus may be used instead, their safety will be a concern. 

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