Search for poliovirus carriers among people with primary immune deficiency diseases in the United States, Mexico, Brazil, and the United Kingdom.
OBJECTIVE
To estimate the rate of long-term poliovirus excretors in people known to have B-cell immune deficiency disorders.


METHODS
An active search for chronic excretors was conducted among 306 persons known to have immunoglobulin G (IgG) deficiency in the United States, Mexico, Brazil, and the United Kingdom, and 40 people with IgA deficiency in the United States. Written informed consent or assent was obtained from the participants or their legal guardians, and the studies were formally approved. Stool samples were collected from participants and cultured for polioviruses. Calculation of the confidence interval for the proportion of participants with persistent poliovirus excretion was based on the binomial distribution.


RESULTS
No individuals with long-term excretion of polioviruses were identified. Most participants had received oral poliovirus vaccine (OPV) and almost all had been exposed to household contacts who had received OPV. Polioviruses of recent vaccine origin were transiently found in four individuals in Mexico and Brazil, where OPV is recommended for all children.


CONCLUSIONS
Although chronic poliovirus excretion can occur in immunodeficient persons, it appears to be rare.
Halsey
Neal A
NA
Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
Pinto
Jorge
J
Espinosa-Rosales
Francisco
F
Faure-Fontenla
María A
MA
da Silva
Edson
E
Khan
Aamir J
AJ
Webster
A D
AD
Minor
Philip
P
Dunn
Glynis
G
Asturias
Edwin
E
Hussain
Hamidah
H
Pallansch
Mark A
MA
Kew
Olen M
OM
Winkelstein
Jerry
J
Sutter
Roland
R
D000293:Adolescent; D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications; D000368:Aged; D001938:Brazil; D002353:Carrier State / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D017074:Common Variable Immunodeficiency / Q000150:complications; D016001:Confidence Intervals; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D017098:IgA Deficiency / Q000150:complications; D017099:IgG Deficiency / Q000150:complications; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D007223:Infant; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011051:Poliomyelitis / Q000175:diagnosis* / Q000635:transmission; D017955:Poliovirus / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000009:adverse effects; D006113:United Kingdom; D014481:United States; D017201:Virus Shedding
D011055:Poliovirus Vaccine, Oral