NEWS | I N D E P T H
The two trials were conducted in India,
where the battle against polio has been per-
haps the most intensethe Science study in
Moradabad in the northern state of Uttar
Pradesh in 2011, and the Lancet in Vellore in
the southern state of Tamil Nadu in 2013.
India reported its last case of polio in
January 2011, but when the Moradabad
study began, that victory was by no means
secure. Indeed, Moradabad was the polio
heartland at the time, says Hamid Jafari,
who directs polio research and operations at
WHO in Geneva, Switzerland, and who led
the Science study. The virus thrived in the
heat and the open sewers, and the huge bur-
den of diarrhea interfered with the vaccine.
In this holdout, where kids were bombarded
with OPV from birth and still poliovirus
circulated, OPV clearly needed some help.
Jafari and his colleagues wondered if IPV
might provide it.
To find out, the collaborators recruited
almost 1000 kids in three age groups
6- to 11-month-olds, 5-year-olds, and
10-year-oldswho had all received mul-
tiple doses of OPV. At the start of the study,
children were given either a dose of IPV
or OPV, or, for controls, no vaccine. Four
weeks later, each child was given a chal-
Polio strongholds
Where the virus persists and
confict limits access, the injected
vaccine may help.
Source: World Health Organization
lenge dose of OPV, as a proxy for infection
with the wild type virus.
To gauge how well the two vaccines
blocked transmission, the researchers
looked at viral shedding in the childrens
stool, a measure of so-called gut immunity,
several days after the challenge. The team
found the greatest reduction in viral shed-
ding in the children who had received IPV
up to 75% in the oldest age group. In other
words, IPV did a better job at boosting gut
immunity than another dose of OPV did.
The Moradabad study showed very ele-
gantly and persuasively that giving a dose of
IPV to a child receiving the full dose of OPV
does an excellent job at boosting intestinal
immunity, says Stephen Cochi of the U.S.
Centers for Disease Control and Prevention
(CDC) in Atlanta. The Lancet study, led by
862 22 AUGUST 2014 VOL 345 ISSUE 6199
Jacob John of Christian Medical College in
Vellore and his colleagues, showed strikingly
similar results in 500 kids there in 2013.
When news of the encouraging findings
began circulating through the polio com-
munity last year, health officials were grap-
pling with a polio outbreak in the Horn of
Africa. It had erupted in May 2013 near
Mogadishu, Somalias capital, and Kenyas
Dadaab refugee camp, and spread fast
across the war-torn region.
Over the next few months, GPEI tried ev-
ery new tactic that seemed to have helped
in other outbreaks: vaccinating older kids
and sometimes adults, instead of just chil-
dren under age 5; setting up vaccination
posts along major transit routes; and, where
access was compromised, sending in vol-
unteers to deliver vaccine in short, quick
bursts. Then in December GPEI and the Ke-
nyan Ministry of Health decided to try the
combination strategy, despite the challenges
of administering shots and the fear that
people would not accept them. Vaccinators
in Dadaab targeted 126,000 kids with a one-
two punch of IPV and OPV drops, as CDC
epidemiologist Concepcion Estivariz and
colleagues described in the 21 March issue of
the Morbidity and Mortality Weekly Report.
Wild poliovirus type 1, 2014
Endemic countries
Importation countries
No one is asserting that one campaign
turned the tide in Dadaab, and immuno-
logical data are lacking. Whats remarkable,
experts say, is that, a few glitches aside, the
program was able to pull it off, and coverage
reached about 95%. Nigeria isnt waiting for
more data. The country just wrapped up its
first IPV-OPV campaign in the northern
states of Borno and Yobe. Plans are afoot to
try it in Pakistan in the Federally Adminis-
tered Tribal Areas.
But as the December Dadaab pilot showed,
the cost and logistics of IPV are still daunt-
ing, so these campaigns should be saved for
the toughest spotssmall geographic areas
where transmission is occurring and access
to kids is tough, Modlin says. As Estivariz
puts it, thats when you go in and give them
everything youve got.
Published by AAAS
MATHEMATICS
Wheels when
you need them
Can special algorithms help
keep shared bicycles rolling?
By Chelsea Wald, in Vienna
G
rigorij Kuklin pulls his van over as
far as he can while cars stream past.
Its nearly rush hour in Vienna, and
intermittent July rainstorms are
Downloaded from http://science.sciencemag.org/ on November 9, 2016
worsening the traffic. A driver for
Citybike Wien, Viennas bike-sharing
system, Kuklin is helping test a new algo-
rithm to route vans like his, which pick up
bikes from stations that are full and take
them to ones that are empty.
Kuklin is keen to see whether mathemat-
ics can really make his job more efficient.
But the instructions that appear on his
smart phone are telling him to stop and
pick up bikes where its not safe. Im not
going to do that, he says as he jumps back
into the van and pulls into traffic.
Perhaps it was the right call. But com-
puter scientist Gnther Raidl of the Vienna
University of Technology, who is developing
the algorithm, is hopeful that his work will
ultimately help drivers like Kuklin better
address what bike-sharing operators call
the rebalancing problem. Raidl is one of
many scientists drawn to a challenge that
is both mathematically complex and prac-
tically important. There may be 20 to
30 researchers that are devoting significant
parts of their research agendas to rebalanc-
ing, says computer scientist David Shmoys
of Cornell University.
For most, its still a theoretical exercise,
but a few have also seen their work applied.
Shmoys collaborates with NYC Bike Share,
the company that operates New York Citys
system; his algorithms now provide the
overarching vision for how we like our sys-
tem to look, says Michael Pellegrino, direc-
tor of operations for NYC Bike Share. Cornell
is also running tests in Chicago, Illinois.
Some 600 cities in 52 countries have intro-
duced bike-sharing systems, according to the
Earth Policy Institute in Washington, D.C.;
Vienna, which was among the early adopt-
ers in 2003, now has 1500 bikes. (The larg-
est system, in Wuhan, China, has 90,000.)
Nearly all of them share the same problem:
Riders tend to take some routesdownhill,
for exampleand not others. As a result, the
bikes tend to collect in a few places.
sciencemag.org SCIENCE
 A bicycle station in
New York City has
almost filled up.
For users, an unbalanced system is a
drag: You either cant get a bike, or theres
no room to drop one off. For operators, its
a costly headache. Unbalanced systems can
cause riders to abandon their bikes, which
increases the risk of theft. In Vienna, two to
three vans haul 20 bikes at a time from full
stations to empty ones. In New York Citys
6000-bicycle system, introduced last year,
managing rebalancing is a good part of my
day-to-day, Pellegrino says.
Oliver OBrien of University College Lon-
don, who runs the online Bike Share Map,
says that in most systems, drivers or dis-
patchers squint at a map of the system to
rebalance it. Theyll say OK, these ones are
full, these ones are empty, and then route
a truck between them, he says. That often
doesnt work well enough; unbalanced sta-
tions are among the top user complaints in
many cities. Mathematicians believe there
has to be a more efficient way.
Raidls approach, which he developed
with colleagues at the Austrian Institute of
Technology, resembles the pickup and deliv-
ery vehicle routing algorithms that package
delivery services use to route their trucks
most efficiently. His algorithmwhich gives
PHOTO: TIM CLAYTON/CORBIS
updated suggestions throughout the day
also takes into account a forecast of demand
based mainly on season, day of the week,
and weather. The problem is too complex to
allow an exact solution; instead, Raidl came
up with ways to approximate one.
SCIENCE sciencemag.org
The algorithm works well on paper, but
this summers trials showed that its sugges-
tions dont always suit drivers in the thick of
things. It can also irk drivers by suggesting
they pick up fewer than the 20 bikes the van
can carry, which seems inefficient, even
though it may not be, Kuklin says.
New York also has a fleet of trucks to do
the rebalancing. The system that Cornell
developed works differently than Raidls:
It doesnt give drivers specific instruc-
tions, but produces an online map showing
the stations that are farthest off from the
predicted need. Dispatchers use the map,
in combination with precomputed truck
routes, to guide the drivers, especially over-
night when theres time to prepare for the
next day. New York drivers, too, balk when
instructed not to fill their trucks to capac-
ity, says Ph.D. student Eoin OMahony, who
works with Shmoys; luckily, he adds, weve
seen from data that moving nothing but
truckloads of bikes gets you close to the
same solution anyway, so the map now pre-
scribes only full loads.
Because traffic seriously hinders the
trucks during rush hour, New York has also
introduced ricksha-like trailers, powered by
human pedaling, which carry up to three
bicycles at a time. (In rush hour, a single
trailer can move more bikes per hour than
a truck, OMahony says.) He and Shmoys
came up with an algorithm for routing the
trailers as well. The researchers first figured
Published by AAAS
Downloaded from http://science.sciencemag.org/ on November 9, 2016
out which stations normally ran empty
and which full; then they paired nearby
stationsone normally empty and one nor-
mally full. Bike trailers can now shuttle be-
tween those two stations.
A London-based company called Stage
Intelligence envisions an alternative to
such top-down planning. Computer scien-
tist Lin Li modeled autonomous rebalanc-
ing trucks, which self-organize like a bee
colony, he says. The trucks flit from station
to station like bees to flowers, attracted
by signals that the stations feed into the
model, announcing whether they are short
of bikes or have too many.
No operator is ready to give rebalanc-
ing over to an algorithm entirely, because
it can never know everything. A big sport-
ing event or a transit failure can drasti-
cally change demand or traffic conditions;
media attention or political pressure could
force an operator to give a certain station
priority. Thats why in New York, human
dispatchers are ultimately in charge, Pel-
legrino says.
And sometimes, the riders themselves do
part of the rebalancing. Some cities are giv-
ing users rewardssuch as a small refund
or extra riding timeif they ride against
the flow, Shmoys says. Thats another
means for letting rebalancing be done in
an automatic kind of way.
Chelsea Wald is a science writer in Vienna.
22 AUGUST 2014 VOL 345 ISSUE 6199 863
 Wheels when you need them
Chelsea Wald (August 21, 2014)
Science 345 (6199), 862-863. [doi: 10.1126/science.345.6199.862]

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