1887

Abstract

The molecular and antigenic properties of a Sabin-like type 2 poliovirus, isolated from the stool samples of a 2-year-old agammaglobulinaemic child who developed paralysis 1 year after receiving the third dose of oral poliovirus vaccine, were analysed. The virus revealed 0·88 % genome variation in the VP1 region compared with the standard reference strain, compatible with replication of the virus in the intestine over approximately 1 year. The typical mutations in the 5′NCR and VP1 associated with reversion to neurovirulence for Sabin type 2 poliovirus were found. Despite this, the virus was characterized by both PCR and ELISA tests as Sabin-like and showed temperature sensitivity and neurovirulence in transgenic mice typical of the Sabin type 2 vaccine strain. Gammaglobulin replacement therapy led rapidly to virus clearance, which, when combined with treatment with the antiviral drug pleconaril, stopped virus excretion; no further virus shedding occurred. This is the first case of poliomyelitis and long-term excretion from an immunodeficient patient to be reported in Italy through the active ‘Acute Flaccid Paralysis' surveillance system.

Loading

Article metrics loading...

/content/journal/jgv/10.1099/vir.0.18974-0
2003-05-01
2020-10-20
Loading full text...

Full text loading...

/deliver/fulltext/jgv/84/5/vir841215.html?itemId=/content/journal/jgv/10.1099/vir.0.18974-0&mimeType=html&fmt=ahah

References

  1. Bellmunt A., May G., Zell R., Pring-Akerblom P., Verhagen W., Heim A.. 1999; Evolution of poliovirus type I during 5·5 years of prolonged enteral replication in an immunodeficient patient. Virology265:178–184
    [Google Scholar]
  2. Bouchard M. J., Lam D. H., Racaniello V. R.. 1995; Determinants of attenuation and temperature sensitivity in the type 1 poliovirus Sabin vaccine. J Virol69:4972–4978
    [Google Scholar]
  3. Buttinelli G., Ruggeri F. M., Marturano J., Novello F., Donati V., Fiore L.. 2001; Antigenic sites of poliovirus type 3 eliciting IgA monoclonal antibodies in orally immunized mice. Virology281:265–271
    [Google Scholar]
  4. CDC 2002a; Acute flaccid paralysis associated with circulating vaccine-derived poliovirus: Philippines 2001. JAMA287:311
    [Google Scholar]
  5. CDC 2002b; Public health dispatch: poliomyelitis, Madagascar, 2002. MMWR Morb Mortal Wkly Rep51:622
    [Google Scholar]
  6. Christodoulou C., Colbère-Garapin F., Macadam A., Taffs L. F., Marsden P., Minor P., Horaud F.. 1990; Mapping of mutations associated with neurovirulence in monkeys infected with Sabin poliovirus revertants selected at high temperature. J Virol64:4922–4929
    [Google Scholar]
  7. Crainic R., Blondel B., Horaud F.. 1984; Antigenic variation of poliovirus studied by means of monoclonal antibodies. Rev Infect Dis6 (Suppl. 2):S535–S539
    [Google Scholar]
  8. Di Lonardo A., Buttinelli G., Amato C., Novello F., Ridolfi B., Fiore L.. 2002; Rapid methods for identification of poliovirus isolates and determination of polio neutralizing antibody titers in human sera. J Virol Methods101:189–196
    [Google Scholar]
  9. Domingo E., Holland J. J.. 1997; RNA virus mutations and fitness for survival. Annu Rev Microbiol51:151–178
    [Google Scholar]
  10. Ehrenfeld E., Semler B. L.. 1995; Anatomy of the poliovirus 5′ NCR. Curr Top Microbiol Immunol203:165–179
    [Google Scholar]
  11. Equestre M., Genovese D., Cavalieri F., Fiore L., Santoro R., Perez Bercoff R.. 1991; Identification of a consistent pattern of mutations in neurovirulent variants derived from the Sabin vaccine strain of poliovirus type 2. J Virol65:2707–2710
    [Google Scholar]
  12. Finney D. J.. 1971; Statistical aspects of monitoring for dangers in drug therapy. Methods Inf Med10:1–8
    [Google Scholar]
  13. Fiore L., Novello F., Simeoni P., Amato C., Vellucci L., De Stefano D., Grandolfo M. E., Luzzi I.. and the AFP Study Group 1999; Surveillance of acute flaccid paralysis in Italy: 1996–97. Eur J Epidemiol15:757–763
    [Google Scholar]
  14. Fiore L., Novello F., Simeoni P.. & 7 other authors and the Group for the Study of AFP. 2000; Epidemiology of acute flaccid paralysis in Italy: 1996–98. Ann Ig12:99–110 (in Italian
    [Google Scholar]
  15. Georgescu M. M., Balanant J., Macadam A., Otelea D., Combiescu M., Combiescu A. A., Crainic R., Delpeyroux F.. 1997; Evolution of the Sabin type 1 poliovirus in humans: characterization of strains isolated from patients with vaccine-associated paralytic poliomyelitis. J Virol71:7758–7768
    [Google Scholar]
  16. Hull H. F., Birmingham M. E., Melgaard B., Lee J. W.. 1997; Progress towards global polio eradication. J Infect Dis175 (Suppl. 1):S4–S9
    [Google Scholar]
  17. Kew O. M., Mulders M. N., Lipskaya G., da Silva E. E., Pallansch M. A.. 1995; Molecular epidemiology of polioviruses. Semin Virol6:401–414
    [Google Scholar]
  18. Kew O. M., Sutter R. W., Nottay B. K., McDonough M. J., Prevots D. R., Quick L., Pallansch M. A.. 1998; Prolonged replication of a type 1 vaccine-derived poliovirus in an immunodeficient patient. J Clin Microbiol36:2893–2899
    [Google Scholar]
  19. Kew O. M., Morris-Glasgow V., Landaverde M.. 21 other authors 2002; Outbreak of poliomyelitis in Hispaniola associated with circulating type 1 vaccine-derived poliovirus. Science296:356–359
    [Google Scholar]
  20. Kilpatrick D. R., Nottay B., Yang C. F., Yang S. J., Da Silva E., Penaranda S., Pallansch M. A., Kew O. M.. 1998; Serotype-specific identification of polioviruses by PCR using primers containing mixed-base or deoxyinosine residues at positions of codon degeneracy. J Clin Microbiol36:352–357
    [Google Scholar]
  21. Koike S., Taya C., Kurata T., Abe S., Ise I., Yonekawa H., Nomoto A.. 1991; Transgenic mice susceptible to poliovirus. Proc Natl Acad Sci U S A88:951–955
    [Google Scholar]
  22. Lentz K. N., Smith A. D., Geisler S. C.. 9 other authors 1997; Structure of poliovirus type 2 Lansing complexed with antiviral agent SCH48973: comparison of the structural and biological properties of three poliovirus serotypes. Structure5:961–978
    [Google Scholar]
  23. Martin J., Dunn G., Hull R., Patel V., Minor P. D.. 2000; Evolution of the Sabin strain of type 3 poliovirus in an immunodeficient patient during the entire 637-day period of virus excretion. J Virol74:3001–3010
    [Google Scholar]
  24. Martin J., Samoilovich E., Dunn G.. 7 other authors 2002; Isolation of an intertypic poliovirus capsid recombinant from a child with vaccine-associated paralytic poliomyelitis. J Virol76:10921–10928
    [Google Scholar]
  25. McKinney R. E. Jr, Katz S. L., Wilfert C. M.. 1987; Chronic enteroviral meningoencephalitis in agammaglobulinemic patients. Rev Infect Dis9:334–356
    [Google Scholar]
  26. Minor P. D.. 1980; Comparative biochemical studies of type 3 poliovirus. J Virol34:73–84
    [Google Scholar]
  27. Minor P. D.. 2001; Biosafety consequences of eradication of wild-type polioviruses. Lancet358:166–168
    [Google Scholar]
  28. Minor P. D., Dunn G.. 1988; The effect of sequences in the 5′ non-coding region on the replication of polioviruses in the human gut. J Gen Virol69:1091–1096
    [Google Scholar]
  29. Novello F., Lombardi F., Amato C., Santoro R., Fiore L., Grandolfo M. E., Pasquini P.. 1987; Paralytic poliomyelitis in Italy (1981–85). Eur J Epidemiol3:54–60
    [Google Scholar]
  30. Pevear D. C., Tull T. M., Seipel M. E., Groarke J. M.. 1999; Activity of pleconaril against enteroviruses. Antimicrob Agents Chemother43:2109–2115
    [Google Scholar]
  31. Pollard S. R., Dunn G., Cammack N., Minor P. D., Almond J. W.. 1989; Nucleotide sequence of a neurovirulent variant of the type 2 oral poliovirus vaccine. J Virol63:4949–4951
    [Google Scholar]
  32. Rezapkin G. V., Fan L., Asher D. M., Fibi M. R., Dragunsky E. M., Chumakov K. M.. 1999; Mutations in Sabin 2 strain of poliovirus and stability of attenuation phenotype. Virology258:152–160
    [Google Scholar]
  33. Rotbart H. A.. 1999; Antiviral therapy for enteroviral infections. Ped Infect Dis J18:632–633
    [Google Scholar]
  34. Rotbart H. A., Webster A. D.. 2001; Treatment of potentially life-threatening enterovirus infections with pleconaril. Clin Infect Dis32:228–235
    [Google Scholar]
  35. Sabin A. B., Boulger L. R.. 1973; History of Sabin attenuated poliovirus oral live vaccine strains. J Biol Stand1:115–118
    [Google Scholar]
  36. Shulman L. M., Manor Y., Handsher R.. 11 other authors 2000; Molecular and antigenic characterization of a highly evolved derivative of the type 2 oral poliovaccine strain isolated from sewage in Israel. J Clin Microbiol38:3729–3734
    [Google Scholar]
  37. van der Avoort H. G., Hull B. P., Hovi T., Pallansch M. A., Kew O. M., Crainic R., Wood D. J., Mulders M. N., van Loon A. M.. 1995; Comparative study of five methods for intratypic differentiation of polioviruses. J Clin Microbiol33:2562–2566
    [Google Scholar]
  38. WHO 1997; Manual for the Virologic Investigation of Poliomyelitis . WHO/EPI/GEN/97 I. World Health Organization; Geneva, Switzerland:
    [Google Scholar]
  39. WHO 2001; Polio Laboratory Manual World Health Organization; Geneva, Switzerland:
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jgv/10.1099/vir.0.18974-0
Loading
/content/journal/jgv/10.1099/vir.0.18974-0
Loading

Data & Media loading...

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error