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Poliomyelitis is a current challenge: long-term sequelae and circulating vaccine-derived poliovirus

Journal

GEROSCIENCE
Volume 45, Issue 2, Pages 707-717

Publisher

SPRINGER
DOI: 10.1007/s11357-022-00672-7

Keywords

Poliovirus; OPV; Vaccine-derived poliovirus; Poliomyelitis; Post-polio syndrome; Aging

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The World Health Organization Western Pacific Region has been free of polio for over 20 years, but two challenges remain. Firstly, elderly polio survivors experience late polio sequelae that greatly affect their daily lives and quality of life. Secondly, vaccine-derived poliovirus strains are circulating and pose a significant obstacle to polio elimination. Maintaining high vaccination rates and improving living conditions in poorer nations are crucial for eradicating polio.
For more than 20 years, the World Health Organization Western Pacific Region (WPR) has been polio-free. However, two current challenges are still polio-related. First, around half of poliomyelitis elderly survivors suffer late poliomyelitis sequelae with a substantial impact on daily activities and quality of life, experiencing varying degrees of residual weakness as they age. The post-polio syndrome as well as accelerated aging may be involved. Second, after the worldwide Sabin oral poliovirus (OPV) vaccination, the recent reappearance of strains of vaccine-derived poliovirus (VDPV) circulating in the environment is worrisome and able to persistent person-to-person transmission. Such VDPV strains exhibit atypical genetic characteristics and reversed neurovirulence that can cause paralysis similarly to wild poliovirus, posing a significant obstacle to the elimination of polio. Immunization is essential for preventing paralysis in those who are exposed to the poliovirus. Stress the necessity of maintaining high vaccination rates because declining immunity increases the likelihood of reemergence. If mankind wants to eradicate polio in the near future, measures to raise immunization rates and living conditions in poorer nations are needed, along with strict observation. New oral polio vaccine candidates offer a promissory tool for this goal.

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