Search Results (270)

Background/Objectives: The World Health Organization (WHO) recommends the use of attenuated Sabin strains for the production of inactivated poliovirus vaccine (IPV), offering improved biosafety while retaining immunogenicity. To better characterize the antigenic composition of Sabin strain-based IPV (sIPV), including both the protective D-antigen and the non-protective H-antigen forms, we developed a method for purifying D- and H-antigens forms. Methods: D- and H-antigens of poliovirus Sabin strains types 1, 2, and 3 were purified using gradient ultracentrifugation and used to generate antigen-specific polyclonal antibodies. Results: The generated polyclonal antibodies demonstrated high specificity with neutralizing titers of antibodies against Sabin type 1 poliovirus—1:2048, against Sabin type 2 poliovirus—more than 1:2048, against Sabin type 3 poloivirus—1:2048. Conclusions: This antigen-specific antibody approach provides a valuable tool for routine quality control in sIPV manufacturing, enabling accurate quantification of immunogenic components and detection of potentially immunogenic degradation products during vaccine storage and distribution. Antibodies to the D-antigen allow assessment of immunogenic, neutralizing epitopes, while antibodies to the H-antigen provide a tool for detecting non-neutralizing components. This antigen-specific antibody approach offers a valuable tool for studying the antigenic structure of sIPV and for improving the accuracy of ELISA-based antigen quantification. Full article

Background: This study aimed to analyze the patterns and underlying reasons associated with population movement across Sindh, Pakistan. Methods: Cross-sectional surveys were conducted in response to the detection of WPV1 in various districts in Sindh province, where genetic linkages with poliovirus isolates in Karachi had been identified. The surveys targeted union councils (UCs) contributing sewage to the environmental sample collection sites where WPV1 was detected. Results: In the Karachi division a total of 1392 participants were interviewed, and outside Karachi 1471 participants were included. A significantly higher proportion of female participants were interviewed in Karachi (n = 72, 55.0%) compared to other divisions of Sindh (n = 794, 45.0%) (p < 0.001). Linguistic distribution varied significantly between regions, with Pashto speakers predominating in Karachi (n = 336, 86.4%), and Sindhi in other divisions (n = 501, 79.4%) (p < 0.001). OPV coverage exceeded 90% across all districts, and over 85% of children received RI vaccines. Travel patterns also differed significantly; participants from Karachi (n = 686, 44.2%) were less likely to report travel compared to other divisions (n = 865, 55.8%), who frequently traveled for family events, business, or employment (p < 0.001). Conclusions: It is critical to redefine high-risk populations annually based on updated mobility data, social survey analyses, and virus detection via surveillance to better identify and reach unvaccinated children in the Pakistan polio program. In addition, strategically placed PTPs along both formal and informal travel corridors based on an updated risk framework will enhance vaccination, thereby reducing the risk of virus spread. Full article

As part of the WHO’s Global Polio Eradication Initiative, acute flaccid paralysis (AFP) surveillance in children under 15 years old is crucial for monitoring the emergence of polioviruses and tracking Non-Polio Enteroviruses (NPEVs). This study outlines the past 17 years of AFP surveillance in Greece from 2008 to 2024, during which a total of 256 AFP cases were recorded. Stool samples from these cases were analyzed using virus isolation in cell cultures (RD/L20B) and sequencing of NPEV-positive samples. The Attica region reported the highest number of cases with 81 (31%), followed by Central Macedonia and Crete, each with 29 cases (11%). The overall analysis of fecal specimens identified the etiological agent in 18 (7%) specimens, with 13 (4.7%) classified as NPEVs, 4 (1.5%) as adenoviruses, and 1 (0.4%) as a parechovirus. Coxsackievirus A, Coxsackievirus B, and various Echoviruses were the most frequently detected NPEV types. Notably, more than half of these positive specimens (10/18) were from the Attica region, which has the highest population density. These findings highlight the ongoing relevance of AFP surveillance in polio-free settings for broader pathogen monitoring and public health preparedness. Continued vigilance and investment in AFP surveillance are critical to sustaining Greece’s polio-free status and detecting emerging viral threats. Full article

Pathogenic enteric viruses are a leading cause of gastroenteritis-related mortality worldwide. However, the architecture of this research field remains poorly quantified. This bibliometric analysis provides a comprehensive overview of 35 years of global scientific output on major enteric viruses, such as rotavirus, norovirus, astrovirus, sapovirus, and non-polio enteroviruses, to map trends, methodological developments, and geographic disparities. We conducted a systematic search of PubMed and Scopus (1990–2024), identifying 10,017 records. After deduplication and eligibility screening, a final corpus of 8320 publications was analyzed using Bibliometrix (Biblioshiny 5.0) in R (version 4.3.0) and VOSviewer (Version 1.6.20). We found that scientific production grew steadily (CAGR = 5.84%), reaching its peak in 2021. The field is characterized by profound thematic and geographic disparity: rotavirus dominated the literature (56.3% of publications), followed by norovirus (30.8%), while other viruses were severely underrepresented (<9% each). Geographically, output was highly concentrated, with the top five countries (the USA, China, Japan, India, and Brazil) producing 92.4% of the publications. In contrast, high-burden regions, such as sub-Saharan Africa and Latin America, contributed only 7.6%. Genomic sequencing gained prominence, being cited in over 26.2% of publications from 2020 to 2024, reflecting a methodological shift accelerated by the application of wastewater-based epidemiology during the COVID-19 pandemic. In conclusion, while genomic tools and environmental monitoring are transforming enteric virus research, its progress is hampered by deep and persistent inequalities. These include a narrow focus on rotavirus and a significant disparity between regions with high disease burdens and those with high research outputs. Closing this gap requires targeted investments in equitable collaboration, local genomic capacity, and integrated public health interventions combining vaccination, WASH, and One Health strategies. Full article

Background/Objectives: This study investigated susceptibility factors that may contribute to Post-Polio Syndrome (PPS) in elderly polio survivors. Methods: Serum immunoglobulin (Ig) levels, poliovirus neutralizing antibodies (PV NAb), and vitamin D status were evaluated in 80 PPS patients, 40 family members, and 89 healthy controls. Results: A significant number of PPS patients and their family members showed reduced levels of total IgG and/or IgA, and specific IgG subclasses, indicating a high prevalence of primary humoral immunodeficiencies within these groups. Despite these Ig deficits, PV NAb titers were similar across all groups, indicating high protection against poliovirus, likely due to vaccination campaigns with live virus in Italy and intense exposure to poliovirus, especially in long-term rehabilitation institutions. However, a small group of PPS subjects lacked neutralizing antibodies for specific poliovirus serotypes, suggesting more severe antibody deficiencies. Additionally, PPS subjects had a high prevalence of vitamin D deficiency, which likely increases their risk for osteoporosis/osteopenia and fractures. It is unclear if this deficiency was also present in their infancy, potentially enhancing their susceptibility to poliovirus. Conclusions: Overall, the findings indicate that genetic, immunological, or nutritional factors may increase individual susceptibility to the pathogenic effects of poliovirus. This study—limited to serum antibodies—highlights the complex relationship between immune status and long-term health in aging polio survivors. The results emphasize the need for potent poliovirus drugs and vaccines to help contain possible outbreaks but also—for poliomyelitis survivors—to avoid or mitigate the progression to PPS, the latest phase of this devastating disease. Full article

Enteroviruses, a diverse genus within the Picornaviridae family, are responsible for a wide range of human infections, including hand, foot, and mouth disease, respiratory disease, aseptic meningitis, encephalitis, myocarditis, and acute flaccid paralysis. Despite their substantial global health burden and the frequent emergence of outbreaks, no specific antiviral therapies are currently approved for clinical use against non-polio enteroviruses. This review provides a comprehensive overview of the current landscape of antiviral strategies targeting enteroviruses, including direct-acting antivirals such as capsid binders, protease inhibitors, and viral RNA polymerase inhibitors. We also examine the potential of host-targeting agents that interfere with virus–host interactions essential for replication. Emerging strategies such as immunotherapeutic approaches, RNA interference, CRISPR-based antivirals, and peptide-based antivirals are also explored. Furthermore, we address key challenges, including viral diversity, drug resistance, and limitations in preclinical models. By highlighting recent advances and ongoing efforts in antiviral development, this review aims to guide future research and accelerate the discovery of effective therapies against enterovirus infections. Full article

This study reviews the role of epidemiology in the United States in the late 19th and early 20th century, which led to recognition that poliomyelitis is an infectious disease and set the stage for subsequent developments in virology and immunology, the development of inactivated and live attenuated polio vaccines, and a dramatic worldwide decrease in poliomyelitis mortality and morbidity. Epidemiological studies in the United States were systematically reviewed from the mid-19th to early 20th centuries. Isolated cases and scattered small outbreaks of poliomyelitis in the mid-19th century led to epidemics of increasing size by the end of the century, causing public consternation, especially as the disease was considered “new” and had a predilection for young children. By the 1890s, the seasonal pattern of epidemics suggested that poliomyelitis might have an infectious etiology, but direct evidence of communicability or contagiousness was lacking, so an infectious etiology was not widely suspected until the early 20th century. Reports of bacterial isolations from spinal fluid and postmortem tissues suggested that poliomyelitis might be a bacterial disease, and simultaneous outbreaks of paralytic disease in humans and animals suggested a possible zoonotic basis. Although experimental studies showed that it was theoretically possible for flies to serve as vectors of poliovirus, and occasional cases of polio were likely caused by fly-borne transfer of poliovirus from human feces to human food, a fly abatement field trial showed convincingly that flies, whether biting or non-biting, could not explain the bulk of cases during polio epidemics. In conclusion, the early application of epidemiological evidence beginning in the late 19th century strongly suggested the infectious nature of the disease, distinct from previously identified conditions. Subsequent advances in virology and immunology from 1909 to 1954 proved that poliomyelitis was a viral disease with no natural animal host and made feasible the development of an inactivated trivalent poliovirus vaccine by Salk, and, subsequently, a live-attenuated trivalent poliovirus vaccine by Sabin. Full article

Background: Pakistan reported its first case of COVID-19 in February 2020 and joined other countries in activating a national emergency response following the declaration of the COVID-19 pandemic by the World Health Organization (WHO). Playing a vital role in the early phase of the country’s response was the National Stop Transmission of Polio (NSTOP) program, a highly trained cadre of polio workers who ordinarily support polio eradication efforts in the country. Methods: We developed a reporting tool using Microsoft Excel that tracked the activities of NSTOP officers to support the COVID-19 response. All NSTOP officers submitted their activity reports fortnightly using this reporting tool. Each provincial NSTOP officer reviewed and compiled their respective officers’ reports and sent them to the federal NSTOP Team. We present a summary of the reports for the period from 1 March 2020 to 31 July 2020. Results: A total of 71 officers of the NSTOP program supported various aspects of Pakistan’s COVID-19 response, including coordination, detection and response activities, surveillance, quarantine/isolation management, training and orientation sessions for healthcare personnel, data analysis, community engagement, and risk communication. They successfully investigated 32,729 suspected COVID-19 cases, of which about one-third were confirmed cases, and facilitated the collection and dispatch of >57,000 samples from these cases. Conclusions: This report details NSTOP contributions to the early phase of the COVID-19 response in Pakistan, demonstrating the value of polio investments beyond eradicating the disease to encompass having a workforce that is ready to respond to emergent disease threats and outbreaks. Such a workforce could also play a role in strengthening the capacity of existing immunization systems to help improve routine vaccination coverage in resource-limited settings. Full article

Introduction: Polio supplementary immunisation activities (SIA) are implemented to rapidly increase vaccination coverage and interrupt the transmission of poliovirus in a specified geographical area. Polio SIA complements routine immunisation and is crucial for the eradication of the disease by increasing population immunity. However, several contextual factors (i.e., implementation determinants) can influence the success or failure of polio SIA implementation; as such, understanding their dynamics can enhance proactive planning for practice improvement. This study aimed to explore and map the contextual factors of polio SIA implementation in the African region using a critical systems thinking approach. Methods: A rapid review of published and grey literature was conducted. The search included the Global Polio Eradication Initiative library for programmatic reports and two databases (PubMed and Google Scholar). Data extraction was performed using a structured tool. Thematic analysis was performed to categorise the identified contextual factors according to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR). Then, a causal loop diagram (CLD) was used to map the linkages between the identified factors. Results: A total of seventy-eight contextual factors across the five CFIR domains were identified: three for innovation, twenty for outer setting, sixteen for inner setting, twenty-six for individuals, and thirteen for the implementation process. A system map of all the factors using CLD revealed multiple contingent connections, with eleven reinforcing loops and four balancing loops. Conclusions: This study identified the multilevel nature of the contextual factors that influence polio SIA, including their dynamics. The integration of CLD and CFIR in this study offers critical insights into the potential feedback loops that exists between the contextual factors which can be used as leverage points for policy and practice improvements, including tailoring strategies to enhance polio campaign implementation effectiveness, especially with the expanded use of the novel Oral Polio Vaccine type 2 (nOPV2) across countries in the region. Full article

Non-polio enteroviruses continue to cause numerous epidemics world-wide that range from mild to severe disease, including acute flaccid paralysis, meningitis, severe respiratory infections and encephalitis. Using publicly available data we present a comprehensive global and regional temporal distribution of non-polio enteroviruses, with a focus on highly prevalent genotypes. We found that regional distribution did vary compared to global prevalence where the top prevalent genotypes included CVA6 and EV-A71 in Asia, EV-D68 in North America and CVA13 in Africa, while E-30 was prevalent in Europe, South America and Oceania. In 2020, the COVID-19 pandemic did interrupt non-polio enterovirus detections globally, and cases rebounded in subsequent years, albeit at lower prevalence and with decreased genotype diversity. Environmental surveillance for non-polio enteroviruses does occur and has been used in some regions as an early-warning system; however, further development is needed to effectively supplement potential gaps in clinical surveillance data. Overall, monitoring for non-polio enteroviruses is critical to identify true incidence, improve understanding of genotype circulation, provide an early warning system for emerging/re-emerging genotypes and allow for better outbreak control. Full article

Bacterial communities within the female upper genital tract may influence the risk of ovarian cancer. In this retrospective cohort pilot study, we aim to detect different communities of bacteria between ovarian cancer and normal controls using topic modeling, a natural language processing tool. RNA was extracted and analyzed using the VITCOMIC2 pipeline. Topic modeling assessed differences in bacterial communities. Idatuning identified an optimal latent topic number and Latent Dirichlet Allocation (LDA) assessed topic differences between high-grade serous ovarian cancer (HGSOC) and controls. Results were validated using The Cancer Genome Atlas (TCGA) HGSOC dataset. A total of 801 unique taxa were identified, with 13 bacteria significantly differing between HGSOC and normal controls. LDA modeling revealed a latent topic associated with HGSOC samples, containing bacteria Escherichia/Shigella and Corynebacterineae. Pathway analysis using KEGG databases suggest differences in several biologic pathways including oocyte meiosis, aldosterone-regulated sodium reabsorption, gastric acid secretion, and long-term potentiation. These findings support the hypothesis that bacterial communities in the upper female genital tract may influence the development of HGSOC by altering the local environment, with potential functional implications between HGSOC and normal controls. However, further validation is required to confirms these associations and determine mechanistic relevance. Full article

Objectives: Most antiviral vaccines are created by inactivating the virus using chemical methods. The inactivation and production of viral vaccine preparations after the irradiation of viruses with accelerated electrons has a number of significant advantages. Determining the integrity of the genome of the resulting viral particles is necessary to assess the quality and degree of inactivation after irradiation. Methods: This work was performed on the Sabin 2 model polio virus. To determine the most sensitive and most radiation-resistant part, the polio virus genome was divided into 20 segments. After irradiation at temperatures of 25 °C, 2–8 °C, −20 °C, or −70 °C, the amplification intensity of these segments was measured in real time. Results: The best correlation between the amplification cycle and the irradiation dose at all temperatures was observed for segment 3D, left. Consequently, this section of the poliovirus genome is the least resistant to the action of accelerated electrons and is the most representative for determining genome integrity. The worst dependence was observed for the VP1 right section, which, therefore, cannot be used to determine genome integrity during inactivation. The electrochemical approach was also employed for a comparative assessment of viral RNA integrity before and after irradiation. An increase in the irradiation dose was accompanied by an increase in signals indicating the electrooxidation of RNA heterocyclic bases. The increase in peak current intensity of viral RNA electrochemical signals confirmed the breaking of viral RNA strands during irradiation. The shorter the RNA fragments, the greater the peak current intensities. In turn, this made the heterocyclic bases more accessible to electrooxidation on the electrode. Conclusions: These results are necessary for characterizing the integrity of the viral genome for the purpose of creating of antiviral vaccines. Full article

Background: Acute respiratory distress syndrome (ARDS) secondary to tuberculosis (TB) is rare and associated with high mortality. Management is further complicated by comorbidities and ICU-related complications. Methods: We report a 43-year-old woman with post-polio sequelae and uncontrolled diabetes who developed ARDS due to pulmonary TB, complicated by recurrent nosocomial infections and gastrointestinal bleeding. Early bronchoscopy and GeneXpert MTB/RIF PCR were performed on ICU Day 2, enabling anti-TB therapy initiation by ICU Day 3. The patient received lung-protective ventilation, prone positioning, tailored antibiotics, and multidisciplinary care. Results: The patient’s clinical course was complicated by two episodes of ventilator-associated pneumonia and gastrointestinal bleeding, but with individualized management, she achieved ventilator weaning and functional recovery. Conclusions: Early TB recognition in ARDS is crucial. Multidisciplinary ICU management, including prudent steroid use, improves outcomes. Full article

The eradication of poliovirus remains a global health priority, with inactivated polio vaccines (IPVs) playing a pivotal role in immunization strategies. Over the past decades, advancements in IPV production have focused on optimizing safety, efficacy, and immunogenicity while addressing vaccine production and logistical challenges. This paper discusses a novel IPV candidate, ultraIPV^TM, which departs from conventional formalin inactivation and uses a modern ultraviolet C (UVC) inactivation technology that includes a powerful antioxidant that protects virus epitopes from damage during and after irradiation. The potential of UVC inactivation to maintain structural integrity and immunogenicity of viral antigens, while circumventing safety issues with conventional vaccines, could bolster global polio eradication efforts and holds promise for applications to numerous other viral pathogens. Wistar rats were immunized with three dosages of ultraIPV^TM, IPOL^R, or vehicle alone. Immune responses were analyzed by whole-virus ELISA and antiviral neutralizing responses. Toxicity was analyzed primarily by increases in body weight and cytokine ELISA. Tolerability was analyzed by gross pathological and histological examinations. ultraIPV^TM was determined to be immunogenic and non-toxic. No pathological or histological abnormalities related to the vaccine were observed. The data suggest that ultraIPV^TM is immunogenic and well-tolerated in rats. Full article