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Global Transmission of Live Polioviruses: Updated Dynamic Modeling of the Polio Endgame

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  • Dominika A. Kalkowska
  • Mark A. Pallansch
  • Steven G. F. Wassilak
  • Stephen L. Cochi
  • Kimberly M. Thompson

Abstract

Nearly 20 years after the year 2000 target for global wild poliovirus (WPV) eradication, live polioviruses continue to circulate with all three serotypes posing challenges for the polio endgame. We updated a global differential equation‐based poliovirus transmission and stochastic risk model to include programmatic and epidemiological experience through January 2020. We used the model to explore the likely dynamics of poliovirus transmission for 2019–2023, which coincides with a new Global Polio Eradication Initiative Strategic Plan. The model stratifies the global population into 72 blocks, each containing 10 subpopulations of approximately 10.7 million people. Exported viruses go into subpopulations within the same block and within groups of blocks that represent large preferentially mixing geographical areas (e.g., continents). We assign representative World Bank income levels to the blocks along with polio immunization and transmission assumptions, which capture some of the heterogeneity across countries while still focusing on global poliovirus transmission dynamics. We also updated estimates of reintroduction risks using available evidence. The updated model characterizes transmission dynamics and resulting polio cases consistent with the evidence through 2019. Based on recent epidemiological experience and prospective immunization assumptions for the 2019–2023 Strategic Plan, the updated model does not show successful eradication of serotype 1 WPV by 2023 or successful cessation of oral poliovirus vaccine serotype 2‐related viruses.

Suggested Citation

  • Dominika A. Kalkowska & Mark A. Pallansch & Steven G. F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2021. "Global Transmission of Live Polioviruses: Updated Dynamic Modeling of the Polio Endgame," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 248-265, February.
    • Handle: RePEc:wly:riskan:v:41:y:2021:i:2:p:248-265
    DOI: 10.1111/risa.13447
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    1. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Dominika A. Kalkowska & Steven G. F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Characterizing Poliovirus Transmission and Evolution: Insights from Modeling Experiences with Wild and Vaccine‐Related Polioviruses," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 703-749, April.
    2. Kimberly M. Thompson & Mark A. Pallansch & Radboud J. Duintjer Tebbens & Steve G. Wassilak & Jong‐Hoon Kim & Stephen L. Cochi, 2013. "Preeradication Vaccine Policy Options for Poliovirus Infection and Disease Control," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 516-543, April.
    3. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Jong‐Hoon Kim & Cara C. Burns & Olen M. Kew & M. Steven Oberste & Ousmane M. Diop & Steven G.F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Oral Poliovirus Vaccine Evolution and Insights Relevant to Modeling the Risks of Circulating Vaccine‐Derived Polioviruses (cVDPVs)," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 680-702, April.
    4. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Olen M. Kew & Victor M. Cáceres & Hamid Jafari & Stephen L. Cochi & Roland W. Sutter & R. Bruce Aylward & Kimberly M. Thompson, 2006. "Risks of Paralytic Disease Due to Wild or Vaccine‐Derived Poliovirus After Eradication," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1471-1505, December.
    5. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Review and Assessment of Poliovirus Immunity and Transmission: Synthesis of Knowledge Gaps and Identification of Research Needs," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 606-646, April.
    6. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Expert Review on Poliovirus Immunity and Transmission," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 544-605, April.
    7. Dominika A. Kalkowska & Radboud J. Duintjer Tebbens & Mark A. Pallansch & Kimberly M. Thompson, 2019. "Modeling Undetected Live Poliovirus Circulation After Apparent Interruption of Transmission: Pakistan and Afghanistan," Risk Analysis, John Wiley & Sons, vol. 39(2), pages 402-413, February.
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    1. Kamran Badizadegan & Dominika A. Kalkowska & Kimberly M. Thompson, 2023. "Health Economic Analysis of Antiviral Drugs in the Global Polio Eradication Endgame," Medical Decision Making, , vol. 43(7-8), pages 850-862, October.

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