%0 Journal Article %A Buttinelli, Gabriele %A Donati, Valentina %A Fiore, Stefano %A Marturano, Jill %A Plebani, Alessandro %A Balestri, Paolo %A Soresina, Anna Rosa %A Vivarelli, Rossella %A Delpeyroux, Francis %A Martin, Javier %A Fiore, Lucia %T Nucleotide variation in Sabin type 2 poliovirus from an immunodeficient patient with poliomyelitis %D 2003 %J Journal of General Virology, %V 84 %N 5 %P 1215-1221 %@ 1465-2099 %R https://doi.org/10.1099/vir.0.18974-0 %I Microbiology Society, %X 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. %U https://www.microbiologyresearch.org/content/journal/jgv/10.1099/vir.0.18974-0