Advertisement

Poliomyelitis Outbreak in China

Summary and Comment |
November 20, 2013

Poliomyelitis Outbreak in China

  1. Larry M. Baddour, MD

Forty-four cases of poliomyelitis occurred after importation of a wild-type strain into Xinjiang, China — an area previously certified as poliomyelitis-free.

  1. Larry M. Baddour, MD

China — the country with the world's largest population — was certified as poliomyelitis-free in 2000. A decade later, a poliomyelitis outbreak occurred in the province of Xinjiang. In response, the Chinese CDC initiated an investigation and a massive vaccination campaign.

In the investigation, poliomyelitis cases were defined as acute flaccid paralysis in children aged <15 years or paralytic illness in any person if poliomyelitis was suspected. Cases were considered laboratory-confirmed if wild-type virus was detected in stool samples, and clinically compatible if there was no stool confirmation of wild-type virus.

The index patient — a 16-month-old girl whose family had no history of travel outside Xinjiang — developed paralysis on July 3, 2011. By October 9, 2011, 44 cases (21 laboratory-confirmed and 23 clinically compatible) had been identified. Incidence was highest among children aged <1 year and was higher in males than in females. Sequence analysis performed on isolates from the index patient and three other patients implicated an imported wild-type virus that originated in Pakistan.

A “level 2” public health emergency response, the highest level that the China Ministry of Health was authorized to initiate, was launched. Between August 2011 (4 weeks after confirmation of the outbreak) and April 2012, 43.7 million doses of oral polio vaccine were administered in the province. The outbreak was stopped within 1.5 months after laboratory confirmation of the index case.

Comment

The Chinese government's prompt move to address this poliomyelitis outbreak was impressive. It serves as a reminder that aggressive action, including widespread vaccination of susceptible hosts, can truncate such outbreaks quickly, once they are identified. Although West Nile virus and enterovirus infections are more-common causes of an infectious polio-like flaccid quadriparesis, physicians should still consider poliomyelitis in patients who have recently traveled to regions with outbreaks.

  • Disclosures for Larry M. Baddour, MD at time of publication Editorial boards UpToDate Leadership positions in professional societies American Heart Association (Chairman, Rheumatic Fever, Endocarditis, Kawasaki Disease Committee)

Citation(s):

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.

Advertisement
Advertisement
Advertisement