Prevalence of Asymptomatic Poliovirus Infection in Older Children and Adults in Northern India: Analysis of Contact and Enhanced Community Surveillance, 2009

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  Mach, Ondrej ; Verma, Harish ; Khandait, Devendra W. ; Sutter, Roland W. ; O'Connor, Patrick M. ; Pallansch, Mark A. ; Cochi, Stephen L. ; Linkins, Robert W. ; Chu, Susan Y. ; Wolff, Chris ; Jafari, Hamid S.
• Description:
  Background
  
  In 2009, enhanced poliovirus surveillance was established in polio-endemic areas of Uttar Pradesh and Bihar, India, to assess poliovirus infection in older individuals.
  
  Methods
  
  In Uttar Pradesh, stool specimens from asymptomatic household and neighborhood contacts of patients with laboratory-confirmed polio were tested for polioviruses. In Bihar, in community-based surveillance, children and adults from 250 randomly selected households in the Kosi River area provided stool and pharyngeal swab samples that were tested for polioviruses. A descriptive analysis of surveillance data was performed.
  
  Results
  
  In Uttar Pradesh, 89 of 1842 healthy contacts of case patients with polio (4.8%) were shedding wild poliovirus (WPV); 54 of 85 (63.5%) were ≥5 years of age. Shedding was significantly higher in index households than in neighborhood households (P < .05). In Bihar, 11 of 451 healthy persons (2.4%) were shedding WPV in their stool; 6 of 11 (54.5%) were ≥5 years of age. Mean viral titer was similar in older and younger children.
  
  Conclusions
  
  A high proportion of persons ≥5 years of age were asymptomatically shedding polioviruses. These findings provide indirect evidence that older individuals could have contributed to community transmission of WPV in India. Polio vaccination campaigns generally target children <5 years of age. Expanding this target age group in polio-endemic areas could accelerate polio eradication.
  
  
• Subjects:
  Adolescent Adult Aged Age Factors Article Asymptomatic Diseases Child Child, Preschool Community Transmission Enhanced Surveillance Epidemiological Monitoring Feces Female Humans India Infant Infant, Newborn Male Middle Aged Pharynx Poliomyelitis Poliovirus Prevalence Virus Shedding Young Adult

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• Source:
  J Infect Dis. 210(0 1):S252-S258.
• Pubmed ID:
  25316843
• Pubmed Central ID:
  PMC4663665
• Document Type:
  Journal Article
• Funding:
  001/World Health Organization/International ; CC999999/Intramural CDC HHS/United States
• Volume:
  210
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2154e607d4be99caab24ca4b77deece0c1c78bc65746922658745b8c5044290c
• Download URL:
  https://stacks.cdc.gov/view/cdc/36711/cdc_36711_DS1.pdf
• File Type:
  [PDF - 288.53 KB ]