title: Persistence of vaccine-derived poliovirus following a mass vaccination campaign in Cuba: implications for stopping polio vaccination after global eradication.
abstract: BACKGROUND
  With substantial progress made toward polio eradication, developing the appropriate strategy for discontinuing global oral poliovirus vaccine (OPV) after global eradication becomes increasingly important. At issue is the theoretical risk of independent circulation of potentially virulent OPV-derived strains. Because Cuba uses OPV only in mass campaigns, it represents an ideal site to assess vaccine-derived poliovirus persistence.
  
  
  METHODS
  Infants born after the 1997 biannual mass campaigns were evaluated for past (neutralizing antibody) or current (virus excretion) evidence of vaccine-derived poliovirus exposure. We obtained sera and/or stool specimens from 861 infants; a second serum from 218 infants.
  
  
  RESULTS
  All stool specimens were poliovirus negative. Of 762 infants, 113 (14.8%) had initially detectable poliovirus type 1 antibody, 193 (25.3%) type 2, and 94 (12.3%) type 3. A precipitous antibody decline occurred in initially positive sera.
  
  
  CONCLUSIONS
  Our results suggest that in a country with high population immunity, vaccine-derived virus is unlikely to establish ongoing circulation.
authors.affiliation: Pedro Kouri Institute for Tropical Medicine, Havana, Cuba. pmasl@ipk.sld.cu
authors.forename: P
authors.initials: P
authors.lastname: Más Lago
authors.forename: V M
authors.initials: VM
authors.lastname: Cáceres
authors.forename: M A
authors.initials: MA
authors.lastname: Galindo
authors.forename: H E
authors.initials: HE
authors.lastname: Gary
authors.forename: M
authors.initials: M
authors.lastname: Valcarcel
authors.forename: J
authors.initials: J
authors.lastname: Barrios
authors.forename: L
authors.initials: L
authors.lastname: Sarmiento
authors.forename: I
authors.initials: I
authors.lastname: Avalos
authors.forename: J A
authors.initials: JA
authors.lastname: Bravo
authors.forename: R
authors.initials: R
authors.lastname: Palomera
authors.forename: M
authors.initials: M
authors.lastname: Bello
authors.forename: R W
authors.initials: RW
authors.lastname: Sutter
authors.forename: M A
authors.initials: MA
authors.lastname: Pallansch
authors.forename: C A
authors.initials: CA
authors.lastname: de Quadros
mesh_terms: D003462:Cuba / Q000453:epidemiology; D014943:Global Health; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D011051:Poliomyelitis / Q000453:epidemiology / Q000517:prevention & control*; D011055:Poliovirus Vaccine, Oral
chemical_list: D011055:Poliovirus Vaccine, Oral