Multiplex PCR Method for Identifying Recombinant Vaccine-Related Polioviruses

Kilpatrick, David R.; Ching, Karen; Iber, Jane; Campagnoli, Raymond P.; Freeman, Christopher; Mishrik, Nada; Li, Hongmei; Pallansch, Mark A.; Kew, Olen M.

doi:10.1128/jcm.42.9.4313-4315.2004

Cited by 33 publications

(17 citation statements)

References 20 publications

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“…For example, intertypic recombination among the three Sabin strains is well documented (12,23,48) and frequently occurs in immunocompetent individuals fed trivalent OPV (17,38), but natural intratypic recombination among OPV variants has been more difficult to demonstrate. Recently, Cherkasova et al presented evidence consistent with intratypic recombination between coevolving lineages of virus derived from Sabin 2 (14).…”

Section: Discussionmentioning

confidence: 99%

Intratypic Recombination among Lineages of Type 1 Vaccine-Derived Poliovirus Emerging during Chronic Infection of an Immunodeficient Patient

Yang

Chen

Jorba

et al. 2005

J Virol

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We determined the complete genomic sequences of nine type 1 immunodeficient vaccine-derived poliovirus (iVDPV) isolates obtained over a 337-day period from a poliomyelitis patient from Taiwan with common variable immunodeficiency. The iVDPV isolates differed from the Sabin type 1 oral poliovirus vaccine (OPV) strain at 1.84% to 3.15% of total open reading frame positions and had diverged into at least five distinct lineages. Phylogenetic analysis suggested that the chronic infection was initiated by the fifth and last OPV dose, given 567 days before onset of paralysis, and that divergence of major lineages began very early in the chronic infection. Key determinants of attenuation in Sabin 1 had reverted in the iVDPV isolates, and representative isolates of each lineage showed increased neurovirulence for PVR-Tg21 transgenic mice. None of the isolates had retained the temperature-sensitive phenotype of Sabin 1. All isolates were antigenic variants of Sabin 1, having multiple amino acid substitutions within or near neutralizing antigenic sites 1, 2, and 3a. Antigenic divergence of the iVDPV variants from Sabin 1 followed two major independent evolutionary pathways. The emergence of distinct coreplicating lineages suggests that iVDPVs can replicate for many months at separate sites in the gastrointestinal tract. Some isolates had mosaic genome structures indicative of recombination across and within lineages. iVDPV excretion apparently ceased after 30 to 35 months of chronic infection. The appearance of a chronic VDPV excretor in a tropical, developing country has important implications for the strategy to stop OPV immunization after eradication of wild polioviruses.The central strategy of the World Health Organization Global Polio Eradication Initiative is widespread use of oral poliovirus vaccine (OPV) at high rates of coverage. This strategy has reduced the global incidence of polio by over 99% since the start of the Initiative in 1988 and restricted wild poliovirus circulation to countries in western and central Africa and southern Asia (87). However, use of OPV is associated with some rare adverse events, including the appearance of cases of vaccine-associated paralytic poliomyelitis among OPV recipients and contacts (76), and the occurrence of polio outbreaks associated with circulating vaccine-derived poliovirus (cVDPV) (36). While cVDPV outbreaks can be prevented by maintenance of high rates of OPV coverage, the occurrence of vaccine-associated paralytic poliomyelitis is associated with the inherent genetic instability of the live, attenuated OPV strains (56).In immunocompetent individuals, the risk of vaccine-associated paralytic poliomyelitis is very low, estimated in the United States at 1 case per 2.4 million OPV doses distributed (75,76).

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Section: Discussionmentioning

confidence: 99%

Intratypic Recombination among Lineages of Type 1 Vaccine-Derived Poliovirus Emerging during Chronic Infection of an Immunodeficient Patient

Yang

Chen

Jorba

et al. 2005

J Virol

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“…Although vaccine/vaccine recombinants of Sabin 1 are relatively infrequent (16,20), it is likely that the recombination occurred in the original tOPV recipient. Spread of the vaccine progeny was sufficiently limited that no subsequent recombination with various species C human enteroviruses (HEVs-C) was observed.…”

Section: Fig 2 Bayesian Markov Chain Montementioning

confidence: 99%

Emergence and Localized Circulation of a Vaccine-Derived Poliovirus in an Isolated Mountain Community in Guangxi, China

Yan¹,

Li²,

Zhu³

et al. 2010

J Clin Microbiol

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, type 1 circulating vaccine-derived poliovirus (cVDPV) was isolated from one case patient with acute flaccid paralysis (AFP) and six unimmunized healthy contacts in isolated mountain villages in Guangxi, China. We conducted epidemiological investigations in the affected communities and nucleotide sequence analyses of the cVDPV isolates. The results of the investigations showed that the AFP patient, an unimmunized 10-year-old boy, and five laboratory-confirmed contacts lived in the same village; one contact lived in a neighboring village. Only ϳ27% of children 5 to 10 years of age in the affected villages had received three or more doses of the trivalent oral poliovirus vaccine (OPV). Nucleotide sequence analyses revealed that the cVDPV isolates differed from the Sabin 1 (S1) isolate at 1.4 to 2.2% of VP1 nucleotide positions and shared 12 nucleotide substitutions within VP1. All isolates were S1/S2/S1/S3 recombinants sharing common recombination junctions. Key determinants of attenuation were replaced. Phylogenetic analysis suggested that the cVDPV circulated locally for ϳ12 months following the initiating OPV dose. No VDPVs were found after mass OPV immunizations, conducted from May to June 2006, that targeted all children <12 years of age. Our findings reinforce the point that VDPVs can emerge and spread in isolated communities with immunity gaps. Maintenance of sensitive AFP and poliovirus surveillance is essential to permit early detection and a rapid response to VDPV circulation. China in 1994 (23, 38, 44). High levels of population immunity have been maintained throughout most of the country, and vigorous immunization responses to the detection of poliovirus circulation have subsequently protected against widespread poliovirus transmission. The WPVs (WPV type 1 [WPV1] and WPV3), introduced into communities bordering Myanmar in 1995 and 1996, were associated with only four paralytic poliomyelitis (polio) cases (44), and WPV1 imported into Qinghai, China, from northern India was associated with only one case in 1999 (45) Keys to the success in China are (i) a strong routine immunization program with trivalent oral poliovirus vaccine (tOPV) supplemented by synchronized mass campaigns in the form of national immunization days (NIDs) and subnational immunization days (SNIDs) (38), (ii) sensitive surveillance for cases of acute flaccid paralysis (AFP) (47), and (iii) rapid, detailed characterization of poliovirus isolates (23,47). The eradication of polio in China (40), whose population constitutes 23% of the world population, provided strong impetus to the World Health Organization's (WHO's) Global Polio Eradication Initiative, whose efforts have reduced the polio incidence by Ͼ99% since 1988, such that only four countries have never stopped WPV circulation (43). Circulation of indigenous wild poliovirus (WPV) ceased inSuccessful eradication of WPV, however, does not entirely eliminate risks of paralytic poliomyelitis. The primary weapon in polio eradication, OPV, is genetically unstable and can revert to incr...

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“…The serotype distribution of VAPP cases among immunologically healthy individuals is uneven: Sabin 1 is rarely implicated, Sabin 2 is most frequently associated with VAPP in unimmunized contacts of OPV recipients, and Sabin 3 is most frequently associated with VAPP in OPV recipients (25)(26)(27). Vaccine-related isolates from immunologically healthy VAPP patients typically show limited genetic divergence (Ͻ1% of nucleotide positions) from the parental OPV strains (apart from mosaic genomes arising from vaccine/vaccine recombination) (28,29), consistent with durations of infections of only 1 to 2 months (30). Individuals with primary immunodeficiencies have an ϳ3,000-fold-higher risk of VAPP (31) and, in rare instances, the further risk of prolonged infection (some lasting Ͼ10 years) with excretion of highly divergent immunodeficiency-associated VDPVs (iVDPVs) (3,19,21,22,(32)(33)(34)(35)(36).…”

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confidence: 99%

Multiple Independent Emergences of Type 2 Vaccine-Derived Polioviruses during a Large Outbreak in Northern Nigeria

Burns

Shaw

Jorba

et al. 2013

J Virol

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Multiplex PCR Method for Identifying Recombinant Vaccine-Related Polioviruses

Cited by 33 publications

References 20 publications

Intratypic Recombination among Lineages of Type 1 Vaccine-Derived Poliovirus Emerging during Chronic Infection of an Immunodeficient Patient

Intratypic Recombination among Lineages of Type 1 Vaccine-Derived Poliovirus Emerging during Chronic Infection of an Immunodeficient Patient

Emergence and Localized Circulation of a Vaccine-Derived Poliovirus in an Isolated Mountain Community in Guangxi, China

Multiple Independent Emergences of Type 2 Vaccine-Derived Polioviruses during a Large Outbreak in Northern Nigeria

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