Hand hygiene, use of gowns and gloves, and enteric precautions (for 7 days after disease onset) prevent nosocomial transmission of enteroviruses during epidemics.
The availability of poliovirus vaccines and the implementation of polio eradication programs have largely eliminated disease due to wild-type poliovirus; of 293 cases in 2012, 85% were from Nigeria, Pakistan, and Afghanistan—the only countries where polio remains endemic. Outbreaks and sporadic disease due to vaccine-derived poliovirus occur.
Both oral poliovirus vaccine (OPV) and inactivated poliovirus vaccine (IPV) induce IgG and IgA antibodies that persist for at least 5 years.
Most developing countries, particularly those with persistent wild-type poliomyelitis, use OPV because of its lower cost and ease of administration. The suboptimal seroconversion rate among children in low-income countries, even after multiple OPV doses, contributes to difficulties in eradication.
Most industrialized countries have adopted all-IPV childhood vaccination programs.
- Unvaccinated adults in the United States do not need routine poliovirus vaccination but should receive three doses of IPV (the second dose 1-2 months after the first and the final dose 6-12 months later) if they are traveling to polio-endemic areas or might be exposed to wild-type poliovirus in their communities or workplaces.
- Adults at increased risk of exposure who have received their primary vaccination series should receive a single dose of IPV.
For a more detailed discussion, see Cohen JI: Enterovirus, Parechovirus, and Reovirus Infections, Chap. 228, p. 1289, in HPIM-19.