{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T20:58:10Z","timestamp":1771102690432,"version":"3.50.1"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2016,2,2]],"date-time":"2016-02-02T00:00:00Z","timestamp":1454371200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Recent polio outbreaks in Syria and Ukraine, and isolation of poliovirus from asymptomatic carriers in Israel have raised concerns that polio might endanger Europe. We devised a model to calculate the time needed to detect the first case should the disease be imported into Europe, taking the effect of vaccine coverage \u2013 both from inactivated and oral polio vaccines, also considering their differences \u2013 on the length of silent transmission into account by deriving an \u2018effective\u2019 case\/infection ratio that is applicable for vaccinated populations. Using vaccine coverage data and the newly developed model, the relationship between this ratio and vaccine coverage is derived theoretically and is also numerically determined for European countries. This shows that unnoticed transmission is longer for countries with higher vaccine coverage and a higher proportion of IPV-vaccinated individuals among those vaccinated. Assuming borderline transmission (<jats:italic>R<\/jats:italic> = 1\u00b71), the expected time to detect the first case is between 326 days and 512 days in different countries, with the number of infected individuals between 235 and 1439. Imperfect surveillance further increases these numbers, especially the number of infected until detection. While longer silent transmission does not increase the number of clinical diseases, it can make the application of traditional outbreak response methods more complicated, among others.<\/jats:p>","DOI":"10.1017\/s0950268816000078","type":"journal-article","created":{"date-parts":[[2016,2,2]],"date-time":"2016-02-02T04:53:28Z","timestamp":1454388808000},"page":"1933-1942","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Effective case\/infection ratio of poliomyelitis in vaccinated populations"],"prefix":"10.1017","volume":"144","author":[{"given":"G.","family":"BENCSK\u00d3","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6791-3080","authenticated-orcid":false,"given":"T.","family":"FERENCI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,2,2]]},"reference":[{"key":"S0950268816000078_ref21","volume-title":"Global Sensitivity Analysis: the Primer","author":"Saltelli","year":"2008"},{"key":"S0950268816000078_ref18","unstructured":"Eurostat database. Population on 1 January by age and sex. Demo_pjan (http:\/\/appsso.eurostat.ec.europa.eu\/nui\/show.do?dataset=demo_pjan&lang=en). Accessed 30 January 2014)."},{"key":"S0950268816000078_ref16","unstructured":"WHO CISID database. Polio 3. % of infants vaccinated against (http:\/\/data.euro.who.int\/cisid\/). Accessed 30 January 2014)."},{"key":"S0950268816000078_ref13","first-page":"1055","article-title":"Field evaluation of vaccine efficacy","volume":"63","author":"Orenstein","year":"1985","journal-title":"Bulletin of the World Health Organization"},{"key":"S0950268816000078_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/175.Supplement_1.S141"},{"key":"S0950268816000078_ref3","author":"Plotkin","year":"2012","journal-title":"Vaccines"},{"key":"S0950268816000078_ref5","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.2105\/AJPH.90.10.1515","article-title":"When is a disease eradicable? 100 years of lessons learned","volume":"90","author":"Aylward","year":"2000","journal-title":"American Journal of Public Health"},{"key":"S0950268816000078_ref15","first-page":"1","article-title":"Poliomyelitis prevention in the United States: introduction of a sequential vaccination schedule of inactivated poliovirus vaccine followed by oral poliovirus vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"46","year":"1997","journal-title":"Morbidity and Mortality Weekly Report. Recommendations and Reports"},{"key":"S0950268816000078_ref26","volume-title":"Stochastic Processes in Epidemiology: HIV\/AIDS, Other Infectious Diseases, and Computers","author":"Mode","year":"2010"},{"key":"S0950268816000078_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-3324-9"},{"key":"S0950268816000078_ref19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1002599"},{"key":"S0950268816000078_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62220-5"},{"key":"S0950268816000078_ref9","unstructured":"European Centre for Disease Prevention and Control. Wild-type poliovirus 1 transmission in Israel \u2013 what is the risk to the EU\/EEA? (http:\/\/www.ecdc.europa.eu\/en\/publications\/Publications\/polio-risk-assessment-transmission-in-Israel.pdf). Accessed 30 January 2014)."},{"key":"S0950268816000078_ref25","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-162"},{"key":"S0950268816000078_ref10","unstructured":"European Centre for Disease Prevention and Control. Outbreak of circulating vaccine-derived poliovirus type 1 (cVDPV1) in Ukraine (http:\/\/ecdc.europa.eu\/en\/publications\/Publications\/Poliomyelitis-Ukraine-rapid-risk-assessment-September-2015.pdf). Accessed 23 September 2015)."},{"key":"S0950268816000078_ref23","unstructured":"Wolfram Research, Inc. Mathematica, version 9.0. Champaign, IL, 2012."},{"key":"S0950268816000078_ref17","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.053819"},{"key":"S0950268816000078_ref8","unstructured":"WHO. Polio eradication and endgame strategic plan 2013\u20132018. World Health Organization, 2013."},{"key":"S0950268816000078_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008820"},{"key":"S0950268816000078_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq320"},{"key":"S0950268816000078_ref6","first-page":"527","article-title":"Progress toward polio eradication \u2013 worldwide, 2014\u20132015","volume":"64","author":"Hagan","year":"2015","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268816000078_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1539-6924.2012.01864.x"},{"key":"S0950268816000078_ref2","volume-title":"Current Diagnosis and Treatment in Infectious Diseases","author":"Wilson","year":"2001"},{"key":"S0950268816000078_ref7","first-page":"941","article-title":"Polio-free certification and lessons learned\u2013South-East Asia Region, March 2014","volume":"63","author":"Bahl","year":"2014","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268816000078_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.08.059"},{"key":"S0950268816000078_ref1","volume-title":"Epidemiology and Prevention of Vaccine-preventable Diseases","author":"Atkinson","year":"2012"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268816000078","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T22:42:52Z","timestamp":1555627372000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268816000078\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,2]]},"references-count":26,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["S0950268816000078"],"URL":"https:\/\/doi.org\/10.1017\/s0950268816000078","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,2]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2016\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}