Poliomyelitis outbreak in an unvaccinated community in the Netherlands, 1992-93

doi:10.1016/S0140-6736(94)92091-5

The Lancet

Volume 344, Issue 8923, 3 September 1994, Pages 665-670

https://doi.org/10.1016/S0140-6736(94)92091-5 Get rights and content

Abstract

Summary

An outbreak of poliomyelitis occurred in the Netherlands between September, 1992, and February, 1993, after 14 years without endemic cases. The outbreak was due to poliovirus type 3 and involved 71 patients, of whom 2 died and 59 had paralysis. The patients were aged between 10 days and 61 years (median 18 years).

None of the patients had been vaccinated, and all but 1 belonged to a socially and geographically clustered group of people who refuse vaccination for religious reasons. Control measures were taken within 5 days of notification of the first patient and included a wide offer of vaccination with the trivalent oral poliovirus vaccine to the population at risk. Sequence analysis of the viral genome showed closest similarity (96·7%) with a strain isolated in India in 1992, indicating that the virus probably originates from the Indian subcontinent. The difference, however, is still too large to assume direct import. Extensive outbreak investigation at schools, in the environment, at virus diagnostic laboratories, and in the general population showed no evidence of widespread circulation of the epidemic virus outside the groups at risk and area where these groups live.

As in the previous outbreak in 1978, the general population, including the majority of unvaccinated people who live dispersed in the population, seemed to be well-protected against poliomyelitis.

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Public healthPoliomyelitis outbreak in an unvaccinated community in the Netherlands, 1992-93

Abstract

Clin Diagn Virol

Virology

Lancet

Lancet

Lancet

Surveillance and control of poliomyelitis in the Netherlands

Rev Infect Dis

The national immunization program of the Netherlands

Pediatrics

Poliomyelitis in the Netherlands

Dev Biol Stand

The spread of wild poliovirus in the well-vaccinated Netherlands in connection with the 1978 epidemic

Prog Med Virol

Poliomyelitis in Nederland, 1979-1991: immuniteit en blootstelling

Ned Tijdschr Geneeskd

Intratypic serodifferentiation of poliomyelitis virus strains by strain-specific antisera

Intervirology

Public health
Poliomyelitis outbreak in an unvaccinated community in the Netherlands, 1992-93