Update on Immunodeficiency-Associated Vaccine-Derived Polioviruses — Worldwide, July 2018–December 2019

Macklin, Grace; Diop, Ousmane M.; Asghar, Humayun; Shahmahmoodi, Shohreh; El-Sayed, Zeinab A.; Triki, Henda; Rey, Gloria; Avagyan, Tigran; Grabovac, Varja; Jorba, Jaume; Farag, Noha H.; Mach, Ondrej

doi:10.15585/mmwr.mm6928a4

Cited by 30 publications

(48 citation statements)

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“…In 2017, there were even fewer cases: only 22 by the end of October (the year before, 27 cases were reported in the same period). However, in the following years, in 2018 (33 cases WPV1, 104 cases cVDPV) and 2019 (176 cases WPV1, 368 cases cVDPV) there was a renewed increase in the number of polio infected cases with a further increase in 2020 (81 cases WPV1, 194 cases cVDPV on July 2020 (6). The risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and its spread is at the highest point since 2014.…”

Section: Resultsmentioning

confidence: 99%

Is polio eradication possible?

Ruszel

Nieradko-Iwanicka

2020

J Educ Health Sport

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Poliomyelitis is called childhood paralysis, anterior horn inflammation of the spinal cord and Heine-Medin disease. Poliomyelitis is caused by poliovirus. Infection spreads through ingestion of objects and foodstuffs contaminated with pharyngeal secretions or faeces. The virus multiplies in the intestine, from where it can attack the nervous system and can cause paralysis that is often permanent. The initial symptoms of polio include fever, headache, vomiting, stiff neck, and pain in the extremities. Majority of cases is either completely asymptomatic or result in a mild disease typical of a generalized viral infection; Poliomyelitis paralysis occurs in 0.1-1% of infections. There is no cure for polio, it can only be prevented by immunization. In 1988, the World Health Assembly adopted a resolution that committed all countries to polio eradication by the year 2000. The aim of the review is to summarize data on the incidence of polio virus infection in recent years in the world. PubMed databases and statistics from the Centers for Disease Control and Prevention (CDC), Polio Global Eradication Initiative and world data from WHO websites were searched in July and August 2020. In PubMed we used any text and medical terms 'polio', 'poliomyelitis', 'polio vaccine'. Twenty two publications were cited. In conclusion: Majority of the wold is free from polio. Polio still spreads in several countries. In a country which is not free of polio all residents and long-term visitors (> four weeks) of all ages, should receive a dose of bivalent oral poliovirus vaccine (bOPV) or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel. It can helps with restrict of transmission of polio outside the border.

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Section: Resultsmentioning

confidence: 99%

Is polio eradication possible?

Ruszel

Nieradko-Iwanicka

2020

J Educ Health Sport

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“…Among the patients with predominantly antibody deficiencies, CVID patients are more associated with asymptomatic and prolonged iVDPV infection than those with agammaglobulinemia and hypogammaglobulinemia [32]. 2 of Reference [12]. CVID: common variable immunodeficiency.…”

Section: Prevalence Of Ivdpv2-positive Casesmentioning

confidence: 99%

“…VDPVs are diverse OPV-derived variants with more than 1% nucleotide divergence in the capsid VP1 region from the corresponding type 1 and type 3 Sabin strains and more than 0.6% nucleotide divergence from the Sabin 2 strain [ 12 ]. VDPVs are categorized by the source of samples and epidemiological information, including cVDPVs identified in person-to-person transmission in the community, iVDPVs isolated from persons with primary immunodeficiency (PID), and ambiguous VDPVs (aVDPVs) indicating neither cVDPV nor iVDPV [ 12 , 18 , 19 , 20 ]. Some of the PID individuals may excrete iVDPV for a prolonged period.…”

Section: Definition and Classification Of Vaccine-derived Poliovirusesmentioning

confidence: 99%

“…Some of the PID individuals may excrete iVDPV for a prolonged period. In this study, we classified iVDPV excretors as long-term (6 months to 5 years) or chronic (more than 5 years) [ 12 ].…”

Section: Definition and Classification Of Vaccine-derived Poliovirusesmentioning

confidence: 99%

“…Even after cVDPV2 outbreaks were controlled, VDPV infections in immunocompromised individuals, known as immunodeficiency-associated VDPV (iVDPV), remain a potential risk factor for VDPV outbreaks [ 9 , 12 , 13 ]. The molecular evolution of RNA viruses in chronic infections can lead to the emergence of unique genetic variants with distinct phenotypes from the parental viruses, even for those that are commonly associated with acute viral infections [ 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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The Molecular Evolution of Type 2 Vaccine-Derived Polioviruses in Individuals with Primary Immunodeficiency Diseases

Kitamura

Shimizu

2021

Viruses

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The oral poliovirus vaccine (OPV), which prevents person-to-person transmission of poliovirus by inducing robust intestinal immunity, has been a crucial tool for global polio eradication. However, polio outbreaks, mainly caused by type 2 circulating vaccine-derived poliovirus (cVDPV2), are increasing worldwide. Meanwhile, immunodeficiency-associated vaccine-derived poliovirus (iVDPV) is considered another risk factor during the final stage of global polio eradication. Patients with primary immunodeficiency diseases are associated with higher risks for long-term iVDPV infections. Although a limited number of chronic iVDPV excretors were reported, the recent identification of a chronic type 2 iVDPV (iVDPV2) excretor in the Philippines highlights the potential risk of inapparent iVDPV infection for expanding cVDPV outbreaks. Further research on the genetic characterizations and molecular evolution of iVDPV2, based on comprehensive iVDPV surveillance, will be critical for elucidating the remaining risk of iVDPV2 during the post-OPV era.

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Molecular evolution and antigenic drift of type 3 iVDPVs excreted from a patient with immunodeficiency in Ningxia, China

Fan

et al. 2022

Journal of Medical Virology

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A 2.5‐year‐old pediatric patient with acute flaccid paralysis was diagnosed with primary immunodeficiency (PID) in Ningxia Province, China, in 2011. Twelve consecutive stool specimens were collected from the patient over a period of 10 months (18 February 2011 to 20 November 2011), and 12 immunodeficiency vaccine‐derived poliovirus (iVDPV) strains (CHN15017‐1 to CHN15017‐12) were subsequently isolated. Nucleotide sequencing analysis of the plaque‐purified iVDPVs revealed 2%–3.5% VP1‐region differences from their parental Sabin 3 strain. Full‐length genome sequencing showed they were all Sabin 3/Sabin 1 recombinants, sharing a common 2C‐region crossover site, and the two key determinants of attenuation (U472C in the 5′ untranslated region and T2493C in the VP1 region) had reverted. Temperature‐sensitive experiments demonstrated that the first two iVDPV strains partially retained the temperature‐sensitive phenotype's nature, while the subsequent ten iVDPV strains distinctly lost it, possibly associated with increased neurovirulence. Nineteen amino‐acid substitutions were detected between 12 iVDPVs and the parental Sabin strain, of which only one (K1419R) was found on the subsequent 10 iVDPV isolates, suggesting this site's potential as a temperature‐sensitive determination site. A Bayesian Monte Carlo Markov Chain phylogenetic analysis based on the P1 coding region yielded a mean iVDPV evolutionary rate of 1.02 × 10−2 total substitutions/site/year, and the initial oral‐polio‐vaccine dose was presumably administered around June 2009. Our findings provide valuable information regarding the genetic structure, high‐temperature growth sensitivity, and antigenic properties of iVDPVs following long‐term evolution in a single PID patient, thus augmenting the currently limited knowledge regarding the dynamic changes and evolutionary pathway of iVDPV populations with PID during long‐term global replication.

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Update on Immunodeficiency-Associated Vaccine-Derived Polioviruses — Worldwide, July 2018–December 2019

Cited by 30 publications

References 9 publications

Is polio eradication possible?

Is polio eradication possible?

The Molecular Evolution of Type 2 Vaccine-Derived Polioviruses in Individuals with Primary Immunodeficiency Diseases

Molecular evolution and antigenic drift of type 3 iVDPVs excreted from a patient with immunodeficiency in Ningxia, China

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