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. 2014 Nov 1;210 Suppl 1(Suppl 1):S353-60.
doi: 10.1093/infdis/jiu069.

Outbreak of type 1 wild poliovirus infection in adults, Namibia, 2006

Nasir Yusuf  1 , Rosalina de Wee  2 , Norbert Foster  2 , Margaret A Watkins  3 , Desta Tiruneh  4 , Claire Chauvin  5 , Robert Bossarte  3 , Custodia Mandlhate  4 , Abdoulie Jack  1 , Nicksy Gumede  6 , Alfred Mawela  6 , Cara C Burns  7 , Mark A Pallansch  7 , Tina Allies  2 , Jeannette Rainey  3 , Noah Mataruse  1 , Deo Nshimirimana  8
Affiliations

Outbreak of type 1 wild poliovirus infection in adults, Namibia, 2006

Nasir Yusuf et al. J Infect Dis. .

Abstract

A paralytic poliomyelitis outbreak occurred in Namibia in 2006, almost exclusively among adults. Nineteen cases were virologically confirmed as due to wild poliovirus type 1 (WPV1), and 26 were classified as polio compatible. Eleven deaths occurred among confirmed and compatible cases (24%). Of the confirmed cases, 97% were aged 15-45 years, 89% were male, and 71% lived in settlement areas in Windhoek. The virus was genetically related to a virus detected in 2005 in Angola, which had been imported earlier from India. The outbreak is likely due to immunity gaps among adults who were inadequately vaccinated during childhood. This outbreak underscores the ongoing risks posed by poliovirus importations, the importance of maintaining strong acute flaccid paralysis surveillance even in adults, and the need to maintain high population immunity to avoid polio outbreaks in the preeradication period and outbreaks due to vaccine-derived polioviruses in the posteradication era.

Keywords: Namibia; disease outbreak; paralysis; poliomyelitis; type 1 wild poliovirus.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Laboratory-confirmed wild poliovirus type 1 (WPV1) cases, polio-compatible cases, and “discarded” cases (non-polio acute flaccid paralysis [AFP] cases), by month of onset, Namibia, 2006.
Figure 2.
Figure 2.
Laboratory-confirmed wild poliovirus type 1 (WPV1) cases and polio-compatible cases, Namibia, 2006.
Figure 3.
Figure 3.
VP1 phylogenetic relationships among wild poliovirus type 1 isolated from 19 cases in Namibia, based on analysis of the 906-nucleotide VP1 sequences. The tree was generated by the neighbor-joining algorithm, using the Kimura 2-parameter nucleotide substitution model [18] implemented in MEGA 4 [17].
See this image and copyright information in PMC

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