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Figure 1 | BMC Infectious Diseases

Figure 1

From: Modeling undetected live poliovirus circulation after apparent interruption of transmission: implications for surveillance and vaccination

Figure 1

Schematic of poliovirus surveillance. (a). Overview and sources of LPV infections detected by each component of surveillance indicated in a box (with full schematic Figure location indicated as 1b-1d). (b). AFP surveillance system details. (c). Supplemental human surveillance system details. (d). Environmental surveillance system details. Notes: blue arrows show the direction of the influence; hash marks (double horizontal parallel lines) in the arrow indicate a delay of (d) time i (di); d1, time from onset of infection to onset of paralysis (incubation period); d2, time to detect AFP case in the field; d3, time to collect sample and ship sample to laboratory; d4,time to confirm WPV in specimen; d5, time to confirm VDPV in specimen; d6, time to confirm Sabin-like virus in specimen; d7, time to confirm the absence ofpoliovirus in specimen; d8, time of clinical follow-up; d9, time of VDPV follow-up investigation (varies such that d9a < d9b << d9c); d10, time for non-polioAFP reporting and averaging; d11, time of effective surveillance intensity ramp-up (if confirmed cases increase) or decrease (in the absence of confirmed cases);d12, time to recover from infection; d13; dilution time; d14, time between sample collection; APF, acute flaccid paralysis; IPV, inactivated poliovirus vaccine;LPV, live poliovirus; OPV, oral poliovirus vaccine; VDPV, vaccine-derived poliovirus (preceded by “c” to specify circulating VDPV, “i” to specify virus froman immunocompromised long-term excretor, or “a” to indicate an ambiguous source (i.e., not classifiable as “c” or “i”); WPV, wild poliovirus

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