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Wang HB, Yu WZ, Wang XQ, Wushouer F, Wang JP, Wang DY, Cui FQ, Zheng JS, Wen N, Ji YX, Fan CX, Wang HL, Ning GJ, Huang GH, Yan DM, Su QR, Liu DW, Zhang GM, Reilly KH, Ning J, Fu JP, Mi SS, Luo HM, Yang WZ. An outbreak following importation of wild poliovirus in Xinjiang Uyghur Autonomous Region, China, 2011. BMC Infect Dis 2015; 15:34. [PMID: 25636581 PMCID: PMC4336520 DOI: 10.1186/s12879-015-0761-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/15/2015] [Indexed: 11/24/2022] Open
Abstract
Background After more than 10 years without a case of wild poliovirus (WPV) in China, an outbreak occurred in 2011 in Xinjiang Uyghur Autonomous Region. Methods Acute flaccid paralysis (AFP) case surveillance was strengthened with epidemiological investigations and specimen collection and serological surveys were conducted among hospitalized patients. Results There were 21 WPV cases and 23 clinical compatible polio cases reported. WPV was isolated from 14 contacts of AFP cases and 13 in the healthy population. Incidence of WPV and clinical compatible polio cases were both highest among children <1 years, however, 24/44 (54.5%) polio cases were reported among adults aged 15–39 years. Conclusions High coverage of routine immunization should be maintained among children until WPV transmission is globally eradicated. Expansion of AFP case surveillance and use of serologic surveys to estimate population immunity should be conducted rapidly to guide preparedness and response planning for future WPV outbreaks.
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Affiliation(s)
- Hai-Bo Wang
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China. .,Peking University Clinical Research Institute, Xueyuan Rd 38#, Haidian District, Beijing, 100191, PR China.
| | - Wen-Zhou Yu
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Xin-Qi Wang
- Expanded Programme on Immunization, Xinjiang Uyghur autonomous region Center for Disease Control and Prevention, 138 Jianquanyi Street, Urumqi City, Xinjiang Uyghur autonomous region, 830001, PR China.
| | - Fuerhati Wushouer
- Expanded Programme on Immunization, Xinjiang Uyghur autonomous region Center for Disease Control and Prevention, 138 Jianquanyi Street, Urumqi City, Xinjiang Uyghur autonomous region, 830001, PR China.
| | - Jian-Ping Wang
- The Center for Disease Control and Prevention of the Xinjiang Production and Construction Corps, 344 Wuxingnanlu Street, Urumqi City, Xinjiang Uyghur autonomous region, 830002, PR China.
| | - Dong-Yan Wang
- WHO WPRO Regional Polio Reference Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, 102206, PR China.
| | - Fu-Qiang Cui
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Jing-Shan Zheng
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Ning Wen
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Yi-Xin Ji
- WHO WPRO Regional Polio Reference Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, 102206, PR China.
| | - Chun-Xiang Fan
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Hui-Ling Wang
- WHO WPRO Regional Polio Reference Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, 102206, PR China.
| | - Gui-Jun Ning
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Guo-Hong Huang
- WHO WPRO Regional Polio Reference Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, 102206, PR China.
| | - Dong-Mei Yan
- WHO WPRO Regional Polio Reference Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, 102206, PR China.
| | - Qi-Ru Su
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Da-Wei Liu
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Guo-Min Zhang
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | | | - Jing Ning
- Expanded Programme on Immunization, Xinjiang Uyghur autonomous region Center for Disease Control and Prevention, 138 Jianquanyi Street, Urumqi City, Xinjiang Uyghur autonomous region, 830001, PR China.
| | - Jian-Ping Fu
- The Center for Disease Control and Prevention of the Xinjiang Production and Construction Corps, 344 Wuxingnanlu Street, Urumqi City, Xinjiang Uyghur autonomous region, 830002, PR China.
| | - Sha-Sha Mi
- The Center for Disease Control and Prevention of the Xinjiang Production and Construction Corps, 344 Wuxingnanlu Street, Urumqi City, Xinjiang Uyghur autonomous region, 830002, PR China.
| | - Hui-Ming Luo
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
| | - Wei-Zhong Yang
- Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China.
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Wang HB, Zhu SL, Zheng JS, Gou AL, Cui H, Zhang Y, Ning GJ, Fan CX, Chen YS, Li KL, Yuan P, Ma C, Ma J, Zheng H, Fan XC, Li XL, Tang HS, Li XL, Zhang F, Yan DM, Wang DY, Cui ZQ, Ren LP, Zhu H, Wang HL, Jiang XH, An HQ, Liu Y, Li J, Xu WB, Wen N, Xu AQ, Luo HM. Sero-survey of polio antibodies during wild poliovirus outbreak in southern Xinjiang Uygur Autonomous Region, China. PLoS One 2014; 9:e80069. [PMID: 24991811 PMCID: PMC4081020 DOI: 10.1371/journal.pone.0080069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 09/29/2013] [Indexed: 12/17/2022] Open
Abstract
Background After being polio free for more than 10 years, an outbreak following importation of wild poliovirus (WPV) was confirmed in Xinjiang Uygur Autonomous Region, China, in 2011. Methods A cross-sectional study was conducted prior to supplementary immunization activities (SIAs), immediately after the confirmation of the WPV outbreak. In selected prefectures, participants aged ≤60 years old who visited hospitals at county-level or above to have their blood drawn for reasons not related to the study, were invited to participate in our study. Antibody titers ≥8 were considered positive. Results Among the 2,611 participants enrolled, 2,253 (86.3%), 2,283 (87.4%), and 1,989 (76.2%) were seropositive to P1, P2 and P3 respectively, and 1744 (66.8%) participants were seropositive to all the three serotypes. Lower antibody seropositivities and geometric mean titers were observed in children <1 year of age and in adults aged 15–39 years. Conclusion Serosurveys to estimate population immunity in districts at high risk of polio importation might be useful to gauge underlying population immunity gaps to polio and possibly to guide preparedness and response planning. Consideration should be given to older children and adults during polio risk assessment planning and outbreak response.
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Affiliation(s)
- Hai-Bo Wang
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuang-Li Zhu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing-Shan Zheng
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ai-Li Gou
- Expanded Program on Immunization, Xinjiang Uygur autonomous region Center for Disease Control and Prevention, Urumqi city, Xinjiang Uygur autonomous region, China
| | - Hui Cui
- Expanded Program on Immunization, Xinjiang Uygur autonomous region Center for Disease Control and Prevention, Urumqi city, Xinjiang Uygur autonomous region, China
| | - Yong Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gui-Jun Ning
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chun-Xiang Fan
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuan-Sheng Chen
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ke-Li Li
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ping Yuan
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chao Ma
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Ma
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Zheng
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin-Chun Fan
- Expanded Program on Immunization, Xinjiang Uygur autonomous region Center for Disease Control and Prevention, Urumqi city, Xinjiang Uygur autonomous region, China
| | - Xin-Lan Li
- Expanded Program on Immunization, Xinjiang Uygur autonomous region Center for Disease Control and Prevention, Urumqi city, Xinjiang Uygur autonomous region, China
| | - Hai-Shu Tang
- Expanded Program on Immunization, Xinjiang Uygur autonomous region Center for Disease Control and Prevention, Urumqi city, Xinjiang Uygur autonomous region, China
| | - Xiao-Lei Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fan Zhang
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Dong-Mei Yan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dong-Yan Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhi-Qiang Cui
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Li-Ping Ren
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Hui Zhu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui-Ling Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Hong Jiang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hong-Qiu An
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Liu
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Jing Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wen-Bo Xu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Wen
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (NW); (AQX); (HML)
| | - Ai-Qiang Xu
- Shandong University Institute for Prevention Medicine, Shandong Provincial Key Laboratory of Infectious Diseases Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan city, Shandong Province, China
- * E-mail: (NW); (AQX); (HML)
| | - Hui-Ming Luo
- Expanded Program on Immunization, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (NW); (AQX); (HML)
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Luo HM, Zhang Y, Wang XQ, Yu WZ, Wen N, Yan DM, Wang HQ, Wushouer F, Wang HB, Xu AQ, Zheng JS, Li DX, Cui H, Wang JP, Zhu SL, Feng ZJ, Cui FQ, Ning J, Hao LX, Fan CX, Ning GJ, Yu HJ, Wang SW, Liu DW, Wang DY, Fu JP, Gou AL, Zhang GM, Huang GH, Chen YS, Mi SS, Liu YM, Yin DP, Zhu H, Fan XC, Li XL, Ji YX, Li KL, Tang HS, Xu WB, Wang Y, Yang WZ. Identification and control of a poliomyelitis outbreak in Xinjiang, China. N Engl J Med 2013; 369:1981-90. [PMID: 24256377 DOI: 10.1056/nejmoa1303368] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The last case of infection with wild-type poliovirus indigenous to China was reported in 1994, and China was certified as a poliomyelitis-free region in 2000. In 2011, an outbreak of infection with imported wild-type poliovirus occurred in the province of Xinjiang. METHODS We conducted an investigation to guide the response to the outbreak, performed sequence analysis of the poliovirus type 1 capsid protein VP1 to determine the source, and carried out serologic and coverage surveys to assess the risk of viral propagation. Surveillance for acute flaccid paralysis was intensified to enhance case ascertainment. RESULTS Between July 3 and October 9, 2011, investigators identified 21 cases of infection with wild-type poliovirus and 23 clinically compatible cases in southern Xinjiang. Wild-type poliovirus type 1 was isolated from 14 of 673 contacts of patients with acute flaccid paralysis (2.1%) and from 13 of 491 healthy persons who were not in contact with affected persons (2.6%). Sequence analysis implicated an imported wild-type poliovirus that originated in Pakistan as the cause of the outbreak. A public health emergency was declared in Xinjiang after the outbreak was confirmed. Surveillance for acute flaccid paralysis was enhanced, with daily reporting from all public and private hospitals. Five rounds of vaccination with live, attenuated oral poliovirus vaccine (OPV) were conducted among children and adults, and 43 million doses of OPV were administered. Trivalent OPV was used in three rounds, and monovalent OPV type 1 was used in two rounds. The outbreak was stopped 1.5 months after laboratory confirmation of the index case. CONCLUSIONS The 2011 outbreak in China showed that poliomyelitis-free countries remain at risk for outbreaks while the poliovirus circulates anywhere in the world. Global eradication of poliomyelitis will benefit all countries, even those that are currently free of poliomyelitis.
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Affiliation(s)
- Hui-Ming Luo
- From the Chinese Center for Disease Control and Prevention, National Immunization Program (H.-M.L., W.-Z.Y., N.W., H.-Q.W., H.-B.W., J.-S.Z., F.-Q.C., L.-X.H., C.-X.F., G.-J.N., D.-W.L., G.-M.Z., Y.-S.C., Y.-M.L., D.-P.Y., K.-L.L., Y.W., W.-Z.Y.), the Ministry of Health Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention (Y.Z., D.-M.Y., D.-X.L., S.-L.Z., S.-W.W., D.-Y.W., G.-H.H., H.Z., Y.-X.J., W.-B.X.), the Health Emergency Control Center (Z.-J.F.), and the Division of Infectious Disease Control, Chinese Center for Disease Control and Prevention (H.-J.Y.) - all in Beijing; Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention (X.-Q.W., F.W., H.C., J.N., A.G., X.-C.F., X.-L.L., H.-S.T.) and the Center for Disease Control and Prevention of the Xinjiang Production and Construction Corps (J.-P.W., J.-P.F., S.-S.M.), Urumqi; and Shandong Center for Disease Control and Prevention, Jinan (A.-Q.X.) - all in China
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Li YX, Li MH, Fu SH, Chen WX, Liu QY, Zhang HL, Da W, Hu SL, Mu SDL, Bai J, Yin ZD, Jiang HY, Guo YH, Ji DZD, Xu HM, Li G, Mu GGC, Luo HM, Wang JL, Wang J, Ye XM, Jin ZMY, Zhang W, Ning GJ, Wang HY, Li GC, Yong J, Liang XF, Liang GD. Japanese encephalitis, Tibet, China. Emerg Infect Dis 2011; 17:934-6. [PMID: 21529419 PMCID: PMC3321773 DOI: 10.3201/eid1705.101417] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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