title: Silent reintroduction of wild-type poliovirus to Israel, 2013 - risk communication challenges in an argumentative atmosphere.
abstract: Israel has been certified as polio-free by the World Health Organization and its routine immunisation schedule consists of inactivated poliovirus vaccine (IPV) only. At the end of May 2013, the Israeli Ministry of Health (MOH) has confirmed the reintroduction of wild-type poliovirus 1 into the country. Documented ongoing human-to-human transmission necessitated a thorough risk assessment followed by a supplemental immunisation campaign using oral polio vaccine (OPV). The unusual situation in which ongoing poliovirus transmission was picked up through an early warning system of sewage monitoring without active polio cases, brought about significant challenges in risk communication. This paper reviews the challenges faced by the MOH and the communication strategy devised, in order to facilitate and optimise the various components of the public health response, particularly vaccination. Lessons learned from our recent experience may inform risk communication approaches in other countries that may face a similar situation as global polio eradication moves towards the 'End game'.
authors.affiliation: Public Health Services, Ministry of Health, Jerusalem, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Kaliner
authors.forename: J
authors.initials: J
authors.lastname: Moran-Gilad
authors.forename: I
authors.initials: I
authors.lastname: Grotto
authors.forename: E
authors.initials: E
authors.lastname: Somekh
authors.forename: E
authors.initials: E
authors.lastname: Kopel
authors.forename: M
authors.initials: M
authors.lastname: Gdalevich
authors.forename: E
authors.initials: E
authors.lastname: Shimron
authors.forename: Y
authors.initials: Y
authors.lastname: Amikam
authors.forename: A
authors.initials: A
authors.lastname: Leventhal
authors.forename: B
authors.initials: B
authors.lastname: Lev
authors.forename: R
authors.initials: R
authors.lastname: Gamzu
mesh_terms: D021821:Communicable Diseases, Emerging / Q000453:epidemiology; D003142:Communication; D004196:Disease Outbreaks / Q000517:prevention & control*; D004784:Environmental Monitoring; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008403:Mass Screening; D011051:Poliomyelitis / Q000175:diagnosis / Q000635:transmission / Q000821:virology*; D017955:Poliovirus / Q000145:classification / Q000276:immunology / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000276:immunology; D011159:Population Surveillance; D018570:Risk Assessment; D012722:Sewage / Q000821:virology*
chemical_list: D011055:Poliovirus Vaccine, Oral; D012722:Sewage