Strategies and lessons learned from a type 1 circulating vaccine-derived poliovirus (cVDPV) outbreak affecting adult population: Madagascar, 2020–2023
Vaccine·
- DOI
- 10.1016/j.vaccine.2026.128987
- PMID
- 42556297
- PMCID
- —
- OpenAlex
- W7172535766
- Study type
- Journal article
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings demonstrate that polio outbreaks can involve significant adult populations with high mortality, supporting the need for inclusive vaccination strategies that target all age groups rather than exclusively children.
Structured evidence summary
Research question
This study examined a cVDPV1 outbreak in Madagascar between September 2020 and September 2023, which exhibited an atypical pattern of affecting adults with high mortality among paralytic cases, and documented the adapted surveillance approaches and tailored outbreak response strategies employed.
Study design
The investigation employed a descriptive analysis of epidemiological data on confirmed and polio-compatible cases, reviewing age distribution, clinical presentation, and outcomes while documenting vaccination campaigns and operational innovations.
Population and setting
The outbreak occurred in Madagascar over a three-year period from September 2020 to September 2023, with cases identified in multiple regions and particular focus on adult populations.
Main findings
Fifty-four confirmed cVDPV1 paralytic cases were reported, including two adults presenting with fever and paralysis. An additional fifteen adult acute flaccid paralysis cases were classified as polio-compatible due to missing or negative laboratory specimens (86%), with a mortality rate of 56% among these compatible adult cases. Vaccination campaigns using bivalent oral polio vaccine achieved high coverage among adults in 2023, attributed to strong country leadership, strategic mobilization, and effective community communication.
Public-health relevance
The findings demonstrate that polio outbreaks can involve significant adult populations with high mortality, supporting the need for inclusive vaccination strategies that target all age groups rather than exclusively children.
Important limitations
This summary is limited to the supplied single-article abstract and metadata. The original paper would be required for decision-grade interpretation of study limitations, methodological details, and complete statistical findings.
GIDS interpretation
This article documents a completed historical outbreak response (2020-2023) and does not represent current surveillance data. It provides retrospective insights into outbreak management strategies and adult involvement in cVDPV transmission, serving as a reference for understanding epidemiological patterns and response effectiveness in similar settings.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 10 auditable classifier relationships to diseases, places, topics, and study design.