Nucleotide variation in Sabin type 2 poliovirus from an immunodeficient patient with poliomyelitis.
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.
Buttinelli
Gabriele
G
Laboratory of Virology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
Donati
Valentina
V
Laboratory of Virology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
Fiore
Stefano
S
Laboratory of Virology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
Marturano
Jill
J
Laboratory of Virology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
Plebani
Alessandro
A
Department of Pediatrics, University of Brescia, Italy.
Balestri
Paolo
P
Pediatrics Unit, University of Siena, Italy.
Soresina
Anna Rosa
AR
Department of Pediatrics, University of Brescia, Italy.
Vivarelli
Rossella
R
Pediatrics Unit, University of Siena, Italy.
Delpeyroux
Francis
F
Epidemiologie Moleculaire des Enterovirus, Institut Pasteur, Paris, France.
Martin
Javier
J
NIBSC, Blanche Lane, South Mimms, Potters Bar, Hertfordshire EN6 3QG, UK.
Fiore
Lucia
L
Laboratory of Virology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
D020121:5' Untranslated Regions / Q000235:genetics; D000361:Agammaglobulinemia / Q000821:virology*; D019943:Amino Acid Substitution; D000818:Animals; D036022:Capsid Proteins / Q000235:genetics; D002675:Child, Preschool; D005243:Feces / Q000821:virology; D014644:Genetic Variation; D006801:Humans; D051379:Mice; D008969:Molecular Sequence Data; D011051:Poliomyelitis / Q000821:virology*; D017955:Poliovirus / Q000145:classification / Q000235:genetics / Q000472:pathogenicity*; D011055:Poliovirus Vaccine, Oral / Q000235:genetics*; D017422:Sequence Analysis, DNA; D014613:Vaccines, Attenuated / Q000235:genetics; D014774:Virulence
D020121:5' Untranslated Regions; D036022:Capsid Proteins; D011055:Poliovirus Vaccine, Oral; C442540:VP1 protein, Poliovirus; D014613:Vaccines, Attenuated