Poliovirus, the etiologic agent of paralytic poliomyelitis (hereinafter referred to as polio), is a positive-sensed single-stranded RNA virus, which belongs to the genus
Enterovirus. Enteroviruses in turn are a species of small, pathogenic, icosahedral viruses belonging to the family
Picornaviridae. Polioviruses are subdivided in three immunologically different serotypes: poliovirus type 1, 2 and 3 (hereinafter referred to as PV1, 2, 3). Since 1960, polio has been controlled by the use of live oral polio vaccine (OPV) or inactivated polio vaccine (IPV). The latter poses no risk of vaccine-associated paralytic polio and has been used in Germany since 1998 [
1,
2]. Polio usually affects children under the age of 5 years: paralytic polio has been seen in one of 200 cases, fatal cases are seen in about 5-10% of paralytic polio in developing countries [
3]. The number of polio cases has been reduced by > 99%, from an estimated number of 350,000 cases worldwide in 1988 [
4] to 1,606 cases in 2009 [
4] and 1,294 cases in 2010 [
5]. While Germany was deemed to be polio-free by WHO on June, 21
st in 2002 [
6], circulating wild polioviruses remain endemic in four major locations: Nigeria, Pakistan, Afghanistan and India [
4,
7,
8]. The occurrence of polio outbreaks, such those reported in Tajikistan, Turkmenistan and Kazakhstan in 2010 [
9,
10] or Angola in 2007/2008 [
11] underlines the necessity of vaccination campaigns for polio prevention. Epidemiological surveillance is also crucial to document polio-absence in polio-free countries. Between 1997 and 2010 Germany has taken part in the acute flaccid paralysis (AFP)-program, which was initiated to exclude a PV-infection by a two-time stool investigation in cases of AFP in children younger than 15 years. Because of low participation rates an alternative surveillance-program was initiated in Germany by the
National Commission for Polio-Eradication in the Federal Republic of Germany (
Nationale Kommission für die Polioeradikation in der Bundesrepublik Deutschland) and the Robert Koch-Institut (RKI), Berlin, Germany, in 2005. It is the so called
Enterovirus-Surveillance, which bases on laboratory diagnostic clarification of viral meningitis or encephalitis by stool or cerebrospinal fluid (CSF). By
Enterovirus-Surveillance Germany fulfils the obligation to prove to be and remain polio-free, as required by WHO. Up to date, no polio-caused AFP case has been detected in Germany [
12]. The objective of our study was to describe the immunity status to PV1, 2, 3 of a German urban cohort 13 years after introduction of IPV and 9 years after elimination of polio in Germany. Therefore, we retrospectively evaluated the seroprevalence of neutralizing antibodies (NA) to PV1, 2, 3 using microneutralization assay (MNA) in 1,632 routinely collected serum samples in the university-hospital of Frankfurt am Main, Germany. Furthermore, we quantitatively analyzed and evaluated the level of immunity to PV1, 2, 3 by titres on average.