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Poliovirus
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== Cross-immunity == It is theorized that exposure to one enterovirus may confer partial immunity or improved immune response to another enteroviruses. One study compared schoolchildren in [[Estonia]], who were inoculated with the Sabin, live attenuated virus polio vaccine, to [[Finland|Finnish]] schoolchildren, who were inoculated with the Salk, inactivated vaccine.<ref>{{Cite journal | last= Juhela | first = S | date = July 1999| title = Comparison of enterovirus-specific cellular immunity in two populations of young children vaccinated with inactivated or live poliovirus vaccines|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905481/|journal=Clinical & Experimental Immunology|volume=117|pages=100–105|via=}}</ref> Estonian children had stronger [[T cell]] responses to [[coxsackievirus B4]] and poliovirus type 1, and stronger expression of [[IFN-γ]] when exposed to poliovirus challenge as compared to Finnish children. Finnish children have weaker cellular immunity against enteroviruses at the age of 9 months compared with Estonian children at the same age. (Finland has a rate of [[diabetes#Type_1|type 1 diabetes]] three times the rate of Estonia. Coxsackie B4 has been associated with Type 1 diabetes.) An unintended consequence of widespread polio vaccination may have been impaired immunity to other enteroviruses, such as [[Coxsackievirus|Coxsackie]] and [[echoviruses]]. There is indirect evidence of cross-immunity between [[poliovirus]] and the unidentified virus or viruses in epidemic myalgic encephalomyelitis outbreaks. After the 1948-1949 [[1948-49 Akureyri outbreak|Akureyri outbreak]] in Iceland, children in areas that had been affected responded to poliomyelitis vaccination with higher antibody titres, as if these children had already been exposed to an agent immunologically similar to poliomyelitis virus.<ref name=":02" /><ref>{{Cite journal|url=https://www.ncbi.nlm.nih.gov/pubmed/13515219| title = Response to poliomyelitis vaccination | last = Sigurdsson | first = B | author-link = Björn Sigurdsson | date = February 15, 1958|journal=The Lancet|volume=1|pages=370-1|via=}}</ref> During the 1949-1953 [[1949-53 Adelaide outbreak|outbreak in Adelaide]], cases of classic poliomyelitis dropped by 43%.<ref>[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2542300/ "Poliomyelitis in 1953"] ''Bulletin of the World Health Organization.'' 1955;12(4):595-649.</ref>
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