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    321884
    Peer Reviewed

    Vaccine-derived poliomyelitis in Nigeria.

    Lancet. 2007 Oct 20; 370(9596):1394.

    Eradicating poliomyelitis presents many challenges. Financing essential activities can be difficult when donors fail to meet funding targets (a US$60 million funding gap currently exists for the fourth quarter of 2007). Security issues in two of the four polio-endemic countries-Afghanistan and Pakistan-make access to children difficult for immunisation teams. And in Nigeria, low vaccine coverage and an outbreak of disease from vaccine-derived poliovirus (VDPV) could set back global eradication efforts. Over the past 10 years there have been nine outbreaks of poliomyelitis derived from the oral vaccine in nine countries. Nigeria has seen the largest outbreak; 69 children have been paralysed this year. VDPVs are rare but occur when the live virus in an oral polio vaccine mutates and reverts to neurovirulence. This loss of attenuation does not matter so much in populations who are fully immunised with oral vaccine, since they will be protected from wild and vaccine-derived poliovirus, but in Nigeria,where vaccine coverage is 39% (and even lower in some northern states), it is a problem. (excerpt)
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