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Trying to get accurate info on Syrian Polio outbreak. - Page 2

post #21 of 40
Edited.
Edited by teacozy - 12/29/13 at 7:57am
post #22 of 40
edited. 

Edited by kathymuggle - 12/29/13 at 9:38am
post #23 of 40

Trollin at the highest level.

post #24 of 40
Quote:
Originally Posted by cwill View Post
 

It looks like the next update is scheduled for December 26 so hopefully we'll get more information then.

 

As to why the vaccination campaign... Coverage has dropped significantly for one. It's something like 65% now. So we have a new population of susceptible individuals - mostly children - that warrant protecting.

 

Secondly, Syria had been polio-free since 1999. They had switched to the IPV. So the reason they want to revaccinate with OPV is for all the reasons pers talked about in her post. IPV is great for preventing disease in an individual, but not so great at preventing transmission. Given the living conditions in Syria right now, it's believable that the wild type polio could again become endemic. Reducing transmission will help avoid that.

actually that is not what I am really talking about - yes, coverage has dropped BUT if you re-vacanate the whole population,  those who have already been FULLY vaccinated and also require all those going into the country (as I had posted in the other threat this - http://wwwnc.cdc.gov/travel/notices/alert/polio-syria ) - you (be it the CDC or WHO) is saying the vaccine (s) don't work - IF they did you would not re-vaccinate those who have been FULLY vacated and received the required dose…………..are we to be lead to believe should a infrastructure breakdown occurs here we must re-vaccanted for polio? 

 

Given the numbers of doses they plan (as of the last news I read) the numbers are not just for children that have been born since the "conflict" and have not been dosed  - this is a re-bolstering/re-vaccinating for the masses 

 

 

http://wwwnc.cdc.gov/travel/notices/alert/polio-syria

Because of the risk of cross-border transmission, CDC recommends a one-time booster dose of polio vaccine for fully vaccinated adults who are traveling to Egypt, Iraq, Jordan, Lebanon, and Turkey to work in health care facilities, refugee camps, or other humanitarian aid settings.

 

in other words you are NOT fully vaccinated if you have to get a one-time booster 

post #25 of 40
Quote:
Originally Posted by serenbat View Post
 

actually that is not what I am really talking about - yes, coverage has dropped BUT if you re-vacanate the whole population,  those who have already been FULLY vaccinated and also require all those going into the country (as I had posted in the other threat this - http://wwwnc.cdc.gov/travel/notices/alert/polio-syria ) - you (be it the CDC or WHO) is saying the vaccine (s) don't work - IF they did you would not re-vaccinate those who have been FULLY vacated and received the required dose…………..are we to be lead to believe should a infrastructure breakdown occurs here we must re-vaccanted for polio? 

 

I addressed this in the second part of my post.  There is a difference between IPV and OPV and the level of protection needed in a country that has eliminated endemic polio, which Syria had as of 1999, vs. the level of protection needed in a country where polio is endemic or in outbreak status, which Syria is as of a couple months ago.  WHO is saying that IPV provides very good individual-level protection, but not very good transmission-level protection.

 

I'm curious to know if you read pers post because I think she explained very well why OPV is being recommended for everyone in Syria.  I don't think I can do a better job. 

post #26 of 40
Quote:
Originally Posted by cwill View Post
 

 

I addressed this in the second part of my post.  There is a difference between IPV and OPV and the level of protection needed in a country that has eliminated endemic polio, which Syria had as of 1999, vs. the level of protection needed in a country where polio is endemic or in outbreak status, which Syria is as of a couple months ago.  WHO is saying that IPV provides very good individual-level protection, but not very good transmission-level protection.

 

I'm curious to know if you read pers post because I think she explained very well why OPV is being recommended for everyone in Syria.  I don't think I can do a better job. 

bit snippy?

 

did you read my post?  

 

I'm well aware of the difference between IPV and OPV.

 

 

http://wwwnc.cdc.gov/travel/notices/alert/polio-syria

Because of the risk of cross-border transmission, CDC recommends a one-time booster dose of polio vaccine for fully vaccinated adults who are traveling to Egypt, Iraq, Jordan, Lebanon, and Turkey to work in health care facilities, refugee camps, or other humanitarian aid settings.

 

in other words you are NOT fully vaccinated if you have to get a one-time booster 

 

FULLY vaccinated is a joke!:bgbounce …………there is no FULLY vaccinated!

post #27 of 40
How do you define fully vaccinated? Do you think it's the same way the CDC defines it?
post #28 of 40
Quote:
Originally Posted by cwill View Post

How do you define fully vaccinated? Do you think it's the same way the CDC defines it?

IF you (or your child) has received what is on the US schedule according to the CDC and WHO for the dose for the polio vaccine.

 

http://www.cdc.gov/VACCINES/vpd-vac/polio/default.htm

Children get 4 doses of IPV at these ages: 2 months, 4 months, 6-18 months, and a booster dose at 4-6 years. OPV has not been used in the United States since 2000 but is still used in many parts of the world.

 

If you (again or your child) have been vaccinated and in this country (US) there are many that have only had OVP, you travel to a country listed--- you re-booster. I know several that started with OVP and also got IVP because of the change date, my DD is one of them. 

 

So, there is no such thing as FULLY vaccinated and this should concern those here who vaccinate and feel they are protected, you are ONLY until they say you need to re-booster when FULLY vaccinated-----there is no such thing and FULLY vaccinated.

 

Just when does the ONE time only re-booster start in the US for everyone?

post #29 of 40

When polio comes back.

post #30 of 40
It's true that policies change given the prevalence of a disease. If you choose to consider that as meaning there is no such thing as fully vaccinated... well, OK.
post #31 of 40
Quote:
Originally Posted by serenbat View Post

 

http://wwwnc.cdc.gov/travel/notices/alert/polio-syria

Because of the risk of cross-border transmission, CDC recommends a one-time booster dose of polio vaccine for fully vaccinated adults who are traveling to Egypt, Iraq, Jordan, Lebanon, and Turkey to work in health care facilities, refugee camps, or other humanitarian aid settings.

 

in other words you are NOT fully vaccinated if you have to get a one-time booster 

 

The vaccine schedule is different for different level of risk.  This is why health care workers or other at higher risk of exposure to certain diseases are supposed to get extra vaccine that are not recommended for the rest of us. 

 

I'm up to date on vaccines. My last polio vaccine was over thirty year ago.  It is probably still protecting me, but even if it isn't there is an extremely low risk of polio exposure here right now.  No vaccine is 100% though, so if there was an outbreak here or I was to travel to somewhere with a higher risk of polio exposure, while I would probably be protected by my thirty year old vaccine, I would go ahead and get the booster on the basis of better safe than sorry.  

 

Most fully vaccinated people will be protected from polio.  A very small number will not.  Giving an extra booster will cut that small number down to an even smaller number. 

 

Vaccines are not perfect protection, but they are far, far, far better than no protection.  

post #32 of 40
Quote:
Originally Posted by pers View Post
 

 

The vaccine schedule is different for different level of risk.  This is why health care workers or other at higher risk of exposure to certain diseases are supposed to get extra vaccine that are not recommended for the rest of us. 

 

I'm up to date on vaccines. My last polio vaccine was over thirty year ago.  It is probably still protecting me, but even if it isn't there is an extremely low risk of polio exposure here right now.  No vaccine is 100% though, so if there was an outbreak here or I was to travel to somewhere with a higher risk of polio exposure, while I would probably be protected by my thirty year old vaccine, I would go ahead and get the booster on the basis of better safe than sorry.  

 

Most fully vaccinated people will be protected from polio.  A very small number will not.  Giving an extra booster will cut that small number down to an even smaller number. 

 

Vaccines are not perfect protection, but they are far, far, far better than no protection.  they certainly are not!

you are simply not eradicating something you have to re-booster and re-boozer for since some countries want you to do it every 10 years

 

the long term plan is to not use OVP if you really want eradication

post #33 of 40
Quote:
Originally Posted by serenbat View Post
 

you are simply not eradicating something you have to re-booster and re-boozer for since some countries want you to do it every 10 years

 

the long term plan is to not use OVP if you really want eradication

 

The long term plan is to use OPV partly because it is cheaper and easier to administer but mostly because it is more effective and prevents transmission better than IPV.  It also has the benefit of being able to indirectly immunize people who were not given the vaccine - if Suzy is immunized with OPV and Billy is is not but then when they play together, Suzy passes the oral polio virus to Billy, they are both now immune.  This only becomes a problem when it is not just Suzy and Billy, but Billy passes it to someone else who passes it to someone else through a long enough chain of people that the virus has a chance to mutate, which is why it is important for as many people as possible to be vaccinated directly so as to prevent long chains from happening.  

 

Oral polio vaccine worked quite well in ridding the Americas and most other countries of the disease.  

 

You are eradicating something if you are moving toward the point where it will be gone completely, however many boosters you must give in the meantime.  Polio virus does not have an animal reservoir, and it does not live long in the environment. The virus must be able to infect people in order to survive.  Successful eradication would eventually lead to no longer vaccinating for polio just as we no longer vaccinate for smallpox 

post #34 of 40
Quote:
Originally Posted by pers View Post
 

 

The long term plan is to use OPV partly because it is cheaper and easier to administer but mostly because it is more effective and prevents transmission better than IPV. 

OPV is the short term plan, not for the long term plan.

 

 

http://www.polioeradication.org/content/publications/OPVCessationFrameworkEnglish.pdf

post #35 of 40
Quote:
Originally Posted by serenbat View Post
 

OPV is the short term plan, not for the long term plan.

 

 

http://www.polioeradication.org/content/publications/OPVCessationFrameworkEnglish.pdf

 

I would have thought it was a little optimistic to call it a short term plan, but now I'm reading that they hope to get rid of all wild polio by the end of 2014 (hope recent outbreaks haven't put a dent in that) and all polio by 2018, so perhaps we are talking short   

 

Short or long term, the plan is to use oral polio to eradicate wild polio virus because it is a far better choice for doing that then to switch to IPV everywhere once wild polio is gone (which will require having a cheaper IPV to use in developing nations) for however long is deemed necessary to eradicate any lingering virus strain polio. 

post #36 of 40
There's something I don't understand.

If there are only 3 identified stereotypes of poliovirus, and if oral polio vaccine is still used in many countries, how are they able to determine that "wild polio virus" is in the sewage? If people given oral polio vaccine shed live polio virus in their stools, wouldn't you EXPECT to find live polio virus in the sewage?
post #37 of 40
Quote:
Originally Posted by Taximom5 View Post

There's something I don't understand.

If there are only 3 identified stereotypes of poliovirus, and if oral polio vaccine is still used in many countries, how are they able to determine that "wild polio virus" is in the sewage? If people given oral polio vaccine shed live polio virus in their stools, wouldn't you EXPECT to find live polio virus in the sewage?

 

By testing it to see which strain it is.  By PCR assay, I believe, because the genetic code is a little different for each of the wild strains and each of the vaccine strains.  Don't ask me to explain exactly how the test works though as it's been close to twenty years since I learned about them in biology and that was just the basics, but they have been able to identify different strains of virus for a long time.  

 

This is the same way that they knew that the polio spreading in Nigeria for about six years was oral polio 2 virus that had regained virulence rather than wild polio virus, and why they believe that actual wild polio type 2 has already been wiped out since they haven't fount it in anyone or any sewage samples in a while. 

post #38 of 40
Thanks, pers. I'm still confused, though.

A lot of good info here http://www.polioeradication.org/Polioandprevention.aspx, but there's still something I'm not getting.

Every source of info I can find says that there are only 3 serotypes. Both the oral vaccine and the inactivated shot provide protection against all 3 strains.

The oral vaccine can cause shedding of all 3 strains.

Only types 1 and 3 "wild" polio viruses continue to circulate in endemic areas, according to this site.

So how do they tell what is "wild" type 1 or 3 in the sewage, and what is shed or originally transmitted by someone who received the OPV?
Edited by Taximom5 - 12/24/13 at 7:06am
post #39 of 40

(disclaimer: this is my layman's understanding of things, so take it with a grain of salt. Plenty of books on biology or anyone who actually works in bio-tech or medicine could probably explain it better/with more accuracy)

 

When they attenuate a virus, they are basically creating a new sub-strain of the virus, one that can't reproduce very well in human cells, but is still close enough to the original that when your immune system encounters it it recognizes it as something it has encountered before and uses the ways to fight it that it developed in response to the vaccine virus.  The attenuated vaccine is genetically different from the parent virus, so by looking for certain genetic sequences that are known to be different between the two, they can tell which one is which. 

 

They can actually tell a lot more than that.  When DNA or RNA replicates, it does not make a perfect copy of itself.  There will be little bits where the genetic sequence has a letter different.  These are called transcription errors and are the basis of random mutation.   Some things are better at copying themselves than others  Flu virus tends to have a lot of these errors, and thus it mutates very quickly and there are many strains.  Polio does not mutate as quickly as flu, thankfully, but it still does mutate.   Also, there can be a fair amount of these transcription errors without changing the basic nature of what it is.  There can be genetic differences between two samples of polio virus and yet have them still be close enough to be the same strain of polio.     

 

So imagine for a second that there was still polio in South America and there was an ongoing outbreak of the same strain as was circulating in Brazil as there as in Pakistan (it could be wild or vaccine derived, just so long as it is the same in both places).  If these were allowed to circulate uncontrolled in these separate places for long enough, you could potentially see them diverging enough to be entirely separate strains, which is probably how we came to have three separate strains from one parent virus long ago. This would be expected to take a very, very long time though. On the shorter term though, the virus will be mutating in very small ways each time it replicates, and so the virus circulating in Brazil while still basically the same disease will come to have genetic differences from the virus circulating in Pakistan (just like you and I have obvious genetic differences, but we are both human).  

 

So now imagine polio shows up in someone in Chicago.  They can test it to determine not only what strain it is and if it is a wild strain or a vaccine strain, but after determining it is the same strain that is circulating in Brazil an Pakistan, but by comparing it genetically to samples from those places to see which one it is more similar too, they can determine which one it came from. 

 

Here is a page which talk about some of this in more detail http://www.who.int/vaccines/en/poliolab/webhelp/Chapter_01/1_4_Transmission_of_polio_virus.htm

post #40 of 40
ack.  Meant to edit and hit reply….Must.have.coffee

 

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