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Arya SC. Vaccine-associated poliomyelitis. Lancet. 1994 Mar 5;343(8897):610-1. No abstract available.PMID: 7906372; UI: 94150215.
Arlazoroff A, et al. Vaccine-associated contact paralytic poliomyelitis with atypical neurological presentation. Acta Neurol Scand. 1987 Sep;76(3):210-4. PMID: 3687370; UI: 88073121.
Basa, SN, "Paralytic Poliomyelitis Following Inoculation With Combined DTP Prophylactic. A review of Sixteen cases with Special Reference to Immunization Schedules in Infancy", J Indian Med Assoc, Feb 1, 1973, 60:97-99.
Chitsike I, et al. Paralytic poliomyelitis associated with live oral poliomyelitis vaccine in child with HIV infection in Zimbabwe: case report. BMJ. 1999 Mar 27;318(7187):841-3. PMID: 10092261; UI: 99192485.
Groom SN, et al. Vaccine-associated poliomyelitis. Lancet. 1994 Mar 5;343(8897):609-10. No abstract available.PMID: 7906370; UI: 94150213.
Mermel L, et al. Vaccine-associated paralytic poliomyelitis. N Engl J Med. 1993 Sep 9;329(11):810-1. No abstract available. PMID: 8350905; UI: 93354422.
Neurologic diseases are common manifestations in enteroviral infections, and most common is aseptic meningitis in children. Only a few percents of poliovirus infected children may result in aseptic meningitis or paralytic poliomyelitis. VAPP (Vaccine Associated Paralytic Poliomyelitis) should be considered among patients with a recent history of receiving OPV (oral polio vaccine). Recently PCR analysis has been used in order to differentiate vaccine-strain from wild-strain poliovirus. There are no specific laboratory findings about enterovirus infections in CNS, however CSF (cerebrospinal fluid) in acute phase may show elevated, predominant polymorphonuclear cells and mean-while shift to mononuclear cell dominance. The G-CSF concentration in CSF with enteroviral meningitis is elevated, which indicates that induced G-CSF is responsible for neutrophil predominance in CSF.
Strebel PM, et al. Epidemiology of poliomyelitis in the United States one decade after the last reported case of indigenous wild virus-associated disease. Clin Infect Dis. 1992 Feb;14(2):568-79. Review. PMID: 1554844; UI: 92208140.
Strebel PM, et al. Paralytic poliomyelitis in Romania, 1984-1992.
Evidence for a high risk of vaccine-associated disease and
reintroduction of wild-virus infection. Am J Epidemiol. 1994 Dec
15;140(12):1111-24. PMID: 7998593; UI: 95091240.
BACKGROUND. In Romania the rate of vaccine-associated paralytic
poliomyelitis is for unexplained reasons 5 to 17 times higher than in
other countries. Long ago it was noted that intramuscular injections
administered during the incubation period of wild-type poliovirus
infection increased the risk of paralytic disease (a phenomenon known as
"provocation" poliomyelitis). We conducted a case-control study to
explore the association between intramuscular injections and
vaccine-associated poliomyelitis in Romania. ...RESULTS. Of the 31
children with vaccine-associated disease, 27 (87 percent) had received
one or more intramuscular injections within 30 days before the onset of
paralysis, as compared with 77 of the 151 controls (51 percent) (matched
odds ratio, 31.2; 95 percent confidence interval, 4.0 to 244.2).
Nearly all the intramuscular injections were of antibiotics,
and the association was strongest for the patients who received 10 or
more injections (matched odds ratio for > or = 10 injections as compared
with no injections, 182.1; 95 percent confidence interval, 15.2 to
2186.4). The risk of paralytic disease was strongly associated with
injections given after the oral polio virus vaccine, but not with
injections given before or at the same time as the vaccine (matched odds
ratio, 56.7; 95 percent confidence interval, 8.9 to infinity). The
attributable risk in the population for intramuscular injections given
in the 30 days before the onset of paralysis was 86 percent (95 percent
confidence interval, 66 to 95 percent); that is, we estimate that 86
percent of the cases of vaccine-associated paralytic poliomyelitis in
this population might have been prevented by the elimination of
intramuscular injections within 30 days after exposure to oral
poliovirus vaccine. CONCLUSIONS. Provocation paralysis, previously
described only for wild-type poliovirus infection, may rarely occur in a
child who receives multiple intramuscular injections shortly after
exposure to oral poliovirus vaccine, either as a vaccine recipient or
through contact with a recent recipient. This phenomenon may explain the
high rate of vaccine-associated paralytic poliomyelitis in Romania,
where the use of intramuscular injections of antibiotics in infants with
febrile illness is common.
Sen S, et al. Poliomyelitis in vaccinated children. Indian
Pediatr. 1989 May;26(5):423-9. PMID: 2599609; UI: 90093396.
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