1 The WHO European Region has been free of autochthonous polio cases from 1998, and certification by the WHO in 2002 of this condition led to a modification in vaccine administration. The oral polio vaccine (OPV) has gradually been replaced with the enhanced potency inactivated polio vaccine (IPV), safer than GDC-0199 in vivo OPV because it is not associated with the rare

risk of vaccine-associated paralytic poliomyelitis (VAPP).3 In Italy, there is an increased and continuous inflow of refugees from countries where poliomyelitis is still present and this may represent a risk of the wild poliovirus strains being introduced. The Italian region of Puglia (Southern Italy) can be deemed a “border region” because, due to its geographic position, it has to face daily arrivals of refugees. The aim of this study was to evaluate the poliomyelitis immunization level, by titration PFT�� of the neutralizing antibody, in a sample of refugees of various nationalities

residing in the Asylum Seeker Center in Bari Palese in Puglia. The study was carried out during 2008 and involved 573 refugees, 520 (90.8%; 95% CI = 88–92.9) males and 53 (9.2%; 95% CI = 7.1 − 12) females. Of these, 546 (95.3%; 95% CI = 93.1 − 96.8) were from Africa and 27 (4.7%; 95% CI = 3.2 − 6.9) from Asia. In particular, 20 residents (3.5%; 95% CI = 2.2 − 5.4) were from Afghanistan and 67 (11.7%; 95% CI = 9.2 − 14.7) from Nigeria. The average age of the population sample was 24.3 (SD = 5.4; range 1–50). Signed informed consent to the study was BCKDHB obtained from each participant. A 10 mL blood sample was obtained by venipuncture and the serum was separated by centrifugation. Each serum sample was coded and stored at −20°C. The immunity against poliomyelitis was evaluated as described previously.4 Demographic data from the Asylum Center database and the laboratory exam results were analyzed with the statistical software Epi-Info 6.00. Fisher’s exact test was used in the analysis of the difference between proportions. A value of p < 0.05 was considered as significant. An

antibody titer ≥1:8 was found in 571 subjects (99.6%) for poliovirus type 1, in 572 subjects (99.8%) for poliovirus type 2, and in 570 subjects (99.5%) for poliovirus type 3 (Table 1). All the subjects with an antibody titer less than 1:8 were males from Africa: specifically, a 20-year-old Nigerian with antibody titer less than 1:4 for the three types of poliovirus; two Somalis, aged 26 and 20, had antibody titers of 1:4 and 1:8, respectively. The levels of antibody titer did not significantly differ between Africans and Asians (Table 1). Our survey results revealed excellent immunization levels in the immigrants, in line with other studies in Europe in the last 15 years.5,6 However, we cannot exclude the existence of low-immunity pockets in the immigrant population just because they were not detected in our study.