LIVE POLIO IRUS VACCINES

26. VACCINATION WITH ATTENUATED POLIOVIRUSES IN
COSTA RICA. SECOND PROGRESS REPORT
Section I. Vaccination Program
J. NÚÑEZ, O. VARGAS-MÉNDEZ, E. C. GUEVARA, J. M. QUIRCE,
J. A. MONTOYA, H. DOANY, AND M. MARTINS DA SILVA
Section II: Surveillance Program
J. M. QUIRCE, J. NÚÑEZ, E. C. GUEVARA, J. A. MONTOYA,
H. DOANY, AND A. SHELOKOV
Dr. VARGAS-MÉNDEZ (presenting Section I of
the paper): Poliomyelitis is a problem of increasing
importance in Costa Rica. The number
of reported cases of the disease has varied from
year to year, ranging from as few as four in 1949
to more than 1,000 cases in the major epidemic
in 1954, during which approximately 80 per cent
were children under five years of age. Costa
Rica's poliomyelitis experience of the past few
years is illustrated in Table 1. As you can see
the First Conference. This communication is a
progress report on the nationwide program begun
on 17 March 1959. The surveillance aspects
of this program will be discussed separately, in
Section II.
ORGANIZATION OF THE PROGRAM
1. Monovalent vaccine. Originally the plan
was to vaccinate all children under the age of
TABLE 1. COSTA RICA-POLIOMYELITIS BY AGE 1954-1960
AGE IN YEARS
YEARS
CASES
15
UNK.
1954
1955
1956
1957
1958
1959
1960t
1,081
45
170
51
62
41*
31
198 673
4 28
31 112
8 29
14 34
7 29
12 14
101
7
16
8
7
5
4
37
6
10
4
4
0
1
5
O
1
2
3
O
O
* Includes cases occurring before initiation of program.
t Up to April.
from the table, the high percentage of the cases
fell within the age group up to five years of age.
Since attempts to control the disease with
Salk vaccine have involved relatively high costs
for vaccine, syringes, personnel, etc., the public
health authorities welcomed the opportunity to
employ live virus oral vaccine, which held the
promise of longer immunity and greater ease of
application-advantages of prime importance in
public health administration.
The preliminary plans for mass application
of the oral vaccine were described last year at
561
11, throughout the country, with monovalent
vaccine. The campaign was initiated in the
national capital and extended to five of the six
provincial capitals and 10 of the larger cities.
In San José, a house-to-house campaign was
conducted by teams of public health and auxiliary
nurses. Records were kept by name and
location for all vaccinated children, and from
some of them, randomly selected, pre-vaccination
blood samples were collected. In the
larger cities, similar personnel vaccinated the
children at local health centers.