Poliovirus circulation among schoolchildren during the early phase of the 1992-1993 poliomyelitis outbreak in The Netherlands.

During the 1992-1993 outbreak of poliomyelitis in The Netherlands, we examined 866 childrenat 7 schools for evidence of infection with the outbreak virus, poliovirus type 3(PV3), to determine the extent of the outbreak and the protection of the herd immunity. Seventy-seven children (8.9%) showed evidence of recent wild-type PV3 infection, as determined by virus isolation and/or poliovirus type-specific IgM assay. Most infected children lived in the same area as the index case patient, attended an orthodox-reformed (OR) primary school, and had not been vaccinated. At the OR school, as many as 22% of children immunized with inactive poliovirus vaccine were found to have evidence of recent infection, which is a significantly lower rate than that among unvaccinated children (59.5%). No evidence of vaccination was seen in 25.5%-43.1% of children at OR schools. Seroprevalence of antibodies against the 3 types of poliovirus suggested that no poliovirus circulation had occurred between the 1978 and 1992-1993 outbreaks.