title: Deficiency of immunity to poliovirus type 3: a lurking danger?
abstract: BACKGROUND
  Europe was certified to be polio-free in 2002 by the WHO. However, wild polioviruses remain endemic in India, Pakistan, Afghanistan, and Nigeria, occasionally causing polio outbreaks, as in Tajikistan in 2010. Therefore, effective surveillance measures and vaccination campaigns remain important. To determine the poliovirus immune status of a German study population, we retrospectively evaluated the seroprevalence of neutralizing antibodies (NA) to the poliovirus types 1, 2 and 3 (PV1, 2, 3) in serum samples collected from 1,632 patients admitted the University Hospital of Frankfurt am Main, Germany, in 2001, 2005 and 2010.
  
  
  METHODS
  Testing was done by using a standardized microneutralization assay.
  
  
  RESULTS
  Level of immunity to PV1 ranged between 84.2% (95%CI: 80.3-87.5), 90.4% (88.3-92.3) and 87.5% (85.4-88.8) in 2001, 2005 and 2010. For PV2, we found 90.8% (87.5-90.6), 91.3% (89.3-93.1) and 89.8% (88.7-90.9), in the same period. Seroprevalence to PV3 was 76.6% (72.2-80.6), 69.8% (66.6-72.8) and 72.9% (67.8-77.5) in 2001 and 2005 and 2010, respectively. In 2005 and 2010 significant lower levels of immunity to PV3 in comparison to PV1 and 2 were observed. Since 2001, immunity to PV3 is gradually, but not significantly decreasing.
  
  
  CONCLUSIONS
  Immunity to PV3 is insufficient in our cohort. Due to increasing globalization and worldwide tourism, the danger of polio-outbreaks is not averted - even not in developed countries, such as Germany. Therefore, vaccination remains necessary.
authors.affiliation: Institute for Medical Virology, University Hospital Frankfurt am Main, Germany. claudia.reinheimer@kgu.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Reinheimer
authors.forename: Imke
authors.initials: I
authors.lastname: Friedrichs
authors.forename: Holger F
authors.initials: HF
authors.lastname: Rabenau
authors.forename: Hans W
authors.initials: HW
authors.lastname: Doerr
mesh_terms: D000293:Adolescent; D000328:Adult; D057134:Antibodies, Neutralizing / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009500:Neutralization Tests; D011051:Poliomyelitis / Q000517:prevention & control*; D017955:Poliovirus / Q000276:immunology*; D023321:Poliovirus Vaccines / Q000276:immunology*; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D023321:Poliovirus Vaccines