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    Global polio eradication efforts face challenges from vaccine-derived poliovirus outbreaks, particularly type 2. Maintaining high population immunity is crucial to prevent the emergence of circulating vaccine-derived poliovirus (cVDPV) and control outbreaks.

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    Area of Science:

    • Epidemiology
    • Public Health
    • Vaccinology

    Background:

    • Wild poliovirus cases have decreased by over 99.99% since the Global Polio Eradication Initiative (GPEI) began in 1988.
    • Genetically divergent vaccine-derived poliovirus (VDPV) strains can emerge and cause outbreaks in under-immunized populations.
    • A switch from trivalent OPV to bivalent OPV occurred in 2016, with monovalent type 2 OPV used for outbreak response.

    Purpose of the Study:

    • To report on circulating VDPV (cVDPV) outbreaks detected between January 2018 and June 2019.
    • To analyze trends in cVDPV outbreaks, with a focus on type 2 strains.

    Main Methods:

    • Analysis of reported cVDPV outbreak data from January 2018 to June 2019.
    • Comparison of outbreak numbers with the previous period (January 2017-June 2018).

    Main Results:

    • The number of reported cVDPV outbreaks more than tripled, increasing from nine to 29.
    • The majority of outbreaks (86%) were caused by VDPV type 2 (VDPV2).
    • The rise in outbreaks was attributed to VDPV2 emergence both within and outside of response areas.

    Conclusions:

    • Increased VDPV2 outbreaks highlight the ongoing challenge of controlling vaccine-derived poliovirus.
    • Maintaining high population immunity is essential to mitigate the risk of cVDPV emergence.
    • Future strategies include using a novel, stabilized type 2 OPV and eventual cessation of all OPV use.