How are enteroviral infections prevented?

Updated: Mar 01, 2018
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Hygienic measures such as hand washing and adequate disposal of infected secretions help prevent the spread of enteroviral infections.

Poliovirus vaccines have been instrumental in the effort to eradicate polio; the vaccine is available in 2 forms. Considerations are as follows:

  • The OPV is a live attenuated vaccine that contains all 3 serotypes. It was developed by Sabin. OPV administration decreases replication of the virus in the small intestine and increases production of high titers of IgA in the mucosa. The advantages of OPV include easy administration, stimulation of local and generalized immunity, and herd immunity. Adverse effects include vaccine-associated paralytic poliomyelitis [69] and seroconversion rates lower than those achieved with IPV. OPV should not be administered to immunocompromised patients or to household contacts of these patients.

  • OPV is used in developing nations because of it lower cost, ease of administration, and superior secretory immunity in the GI tract in comparison to IPV.

  • IPV was originally developed by Salk in 1955. Current formulations of IPV are more immunogenic than those available before 1987. This vaccine elicits higher IgG antibody titers and has few adverse effects but is inferior to OPV in providing secretory immunity in the GI tract. It is the recommended polio vaccine in United States when the risk of vaccine-associated paralytic polio disease due to OPV exceeds that of wild-type polio disease. Higher costs for production and supply and the delivery route, along with the lack of herd immunity, makes its use less desirable in developing countries.

  • Combined immunization with OPV and IPV provides the highest serum level of antibody response, with equivalent mucosal immunity to that produced by OPV alone. [70]

The spread of AHC is prevented by hand washing and using separate towels.

Intensified efforts to eradicate polio have led to the introduction of new monovalent OPV type 1 (mOPV1) and type 3 (mOPV3) vaccines to more rapidly eliminate the final strains of poliovirus in circulation.

Further efforts to simplify administration of the two monovalent vaccines have resulted in the development of a bivalent oral polio vaccine (bOPV). This vaccine consists of live-attenuated (weakened) poliovirus strains of type 1 and type 3, which simultaneously target the two remaining types of wild poliovirus (type 1 and type 3).

Recent trials demonstrated the superiority of bOPV over tOPV and noninferiority to the respective mOPVs in achieving seroconversion. [71]

As of 2009, the use of bOPV or mOPVs as supplementary immunization activity to complement tOPV is recommended. [30]


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