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Epidemiologic Notes and Reports Poliomyelitis Update -- Jamaica

As of June 23, 1982, a total of 54 suspected cases of paralytic poliomyelitis, including 1 death, had been reported from Jamaica. Onset of the first case occurred in late March 1982. Type I poliovirus has been isolated in 8 cases. Forty-eight persons were from Cornwall County; of these, 44 were from St. James Parish. Eighty-three percent (42) occurred in the 15-year age group. Of 37 suspect cases from whom previous vaccination status could be elicited, 29 had never received any polio vaccine; three had had 1 dose; two, 2 doses, and three, 3 doses. Cases have occurred predominantly among children living in crowded households with limited access to water and with substandard or absent sanitation facilities. Immunization status data suggest that 45% of Jamaican children who reached age 1 during 1981 had received a primary series of 3 doses of trivalent oral poliovirus vaccine (OPV) compared with 25% in 1980 and 20% in 1979.

Onset of illness for 35 patients was before June 1, 1982, the date when an island-wide immunization program began. In 13 parishes the program delivered 1 dose of OPV each to an estimated 70%-80% of children 6 weeks through 4 years of age and to 80%-90% of the 5-14 year age group by June 21, 1982. In addition, an estimated 40%-55% of the population 15 years and older each received a dose of OPV. The second round of OPV immunization, targeted to the most susceptible age group, 6 weeks through 14 years of age, is planned to begin during the first week of July. Between June 1 and June 23 an average of 6 cases occurred each week; no cases of poliomyelitis in travelers to Jamaica have been reported. Reported by Ministry of Health, Jamaica; Viral Diseases Div, Center for Infectious Diseases, Immunization Div, Quarantine Div, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note: The last outbreak of poliomyelitis in Jamaica occurred in 1964 and was associated with type I poliovirus. Since then no cases had been reported to the Ministry of Health.

In the present outbreak, the occurrence of cases following the immunization campaign is not unexpected because the incubation period for poliomyelitis may range up to 21 days and because of the time period required for the campaign. Prompt recognition of poliomyelitis outbreaks and intense immunization programs with OPV that have achieved high coverage in a short period of time (as in Jamaica) have been successful in markedly decreasing transmission of the wild poliovirus and in controlling poliomyelitis outbreaks (1,2).

Proof of diphtheria, measles, rubella, and poliomyelitis immunization is not required for international travel to or from any country. However, travelers to any country in which these diseases are endemic or epidemic should be protected. For travel to any country with poliomyelitis, adequate protection in unvaccinated or partially vaccinated travelers can be achieved by completion of a primary series with poliomyelitis vaccine as detailed in the ACIP recommendations published in MMWR Vol. 31, January 29, 1982. Travelers who have previously completed a primary series may wish to receive another dose of OPV or inactivated poliovirus vaccine (IPV).

References

  1. Sabin AB. Poliomyelitis in the tropics. Increasing incidence and prospects for control. Trop Geogr Med 1963;15:38-44.

  2. Witte JJ, Page MI, Gelfand HM. Control of type 1 poliomyelitis epidemic in British Guiana, 1962-1963, with trivalent oral poliovirus vaccine. 1. Epidemiological aspects. Bull WHO 1965;33:1-11.

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