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Originally published in Science Express on 14 March 2002
Science 12 April 2002:
Vol. 296. no. 5566, pp. 356 - 359
DOI: 10.1126/science.1068284
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Reports

Outbreak of Poliomyelitis in Hispaniola Associated with Circulating Type 1 Vaccine-Derived Poliovirus

Olen Kew,1* Victoria Morris-Glasgow,2 Mauricio Landaverde,3 Cara Burns,1 Jing Shaw,1 Zacarías Garib,4 Jean André,5 Elizabeth Blackman,2 C. Jason Freeman,1 Jaume Jorba,1 Roland Sutter,6 Gina Tambini,3 Linda Venczel,3 Cristina Pedreira,7 Fernando Laender,8 Hiroyuki Shimizu,9 Tetsuo Yoneyama,9 Tatsuo Miyamura,9 Harrie van der Avoort,10 M. Steven Oberste,1 David Kilpatrick,1 Stephen Cochi,6 Mark Pallansch,1 Ciro de Quadros3

An outbreak of paralytic poliomyelitis occurred in the Dominican Republic (13 confirmed cases) and Haiti (8 confirmed cases, including 2 fatal cases) during 2000-2001. All but one of the patients were either unvaccinated or incompletely vaccinated children, and cases occurred in communities with very low (7 to 40%) rates of coverage with oral poliovirus vaccine (OPV). The outbreak was associated with the circulation of a derivative of the type 1 OPV strain, probably originating from a single OPV dose given in 1998-1999. The vaccine-derived poliovirus associated with the outbreak had biological properties indistinguishable from those of wild poliovirus.

1 Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30333, USA.
2 Caribbean Epidemiology Centre (CAREC) Laboratory, Pan American Health Organization (PAHO), 16-18 Jamaica Boulevard, Federation Park, Port-of-Spain, Trinidad and Tobago.
3 Division of Vaccines and Immunization, PAHO, 525 Twenty-Third Street, N.W., Washington, DC 20037, USA.
4 Ministry of Health, Avenida San Cristóbal esquina Tiradentes, Santo Domingo, Dominican Republic.
5 Ministry of Public Health, Port-au-Prince, Haiti.
6 Vaccine Preventable Disease Eradication Division, National Immunization Program, CDC, 1600 Clifton Road, Atlanta, GA 30333, USA.
7 PAHO, Calle Pepillo Salcedo, Plaza de la Salud, Santo Domingo, Dominican Republic.
8 PAHO, Number 295 Avenue John Brown, Port-au-Prince, Haiti.
9 Department of Virology II, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162, Japan.
10 Polio Laboratory, National Institute of Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3720 BA, Bilthoven, Netherlands.
*   To whom correspondence should be addressed. E-mail: okew{at}cdc.gov

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