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