title: Characterization of mutations in the VP(1) region of Sabin strain type 1 polioviruses isolated from vaccine-associated paralytic poliomyelitis cases in Iran.
abstract: BACKGROUND
  The live-attenuated oral polio vaccine used to interrupt poliovirus transmission is genetically unstable. Reversion of some attenuating mutations, which normally occurs during vaccine strain replication in some recipients, and can rarely cause vaccine-associated paralytic poliomyelitis (VAPP). The poliovirus eradication program designed by the World Health Organization (WHO) includes immunization with OPV in addition to careful surveillance of all acute-flaccid paralysis (AFP) cases.
  
  
  OBJECTIVE
  In Iran we last isolated imported wild poliovirus in 2000 and the immunization coverage was 100% in 2002. During 2001, there were three AFP cases with residual paralysis from which Sabin-like type 1 polioviruses were isolated in our national polio laboratory.
  
  
  METHODS
  The complete VP(1) region of the three isolates was sequenced and amino acid substitutions associated with these neurovirulent isolates were recorded.
  
  
  RESULTS
  These isolates had either 4, 2 or 1 nucleotide substitution(s) in the VP(1) region, corresponding to amino acid change in the VP(1) of isolate 1 of either (H-[149]->Y), (T-[106]->A) or (I-[90]->L), respectively.
  
  
  CONCLUSIONS
  Surveillance of the VAPP cases in countries where endemic transmission has recently ceased increases our understanding of the important neurovirulent mutations in vaccine-strain isolates and assists in planning the next step in the eradication program in these countries.
authors.affiliation: Polio National Laboratory, Division of Virology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Iran. prahimi@razi.tums.ac.ir
authors.forename: Pooneh
authors.initials: P
authors.lastname: Rahimi
authors.forename: H
authors.initials: H
authors.lastname: Tabatabaie
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Gouya
authors.forename: Mohsen
authors.initials: M
authors.lastname: Zahraie
authors.forename: M
authors.initials: M
authors.lastname: Mahmudi
authors.forename: A
authors.initials: A
authors.lastname: Ziaie
authors.forename: K Samimi
authors.initials: KS
authors.lastname: Rad
authors.forename: Sh
authors.initials: Sh
authors.lastname: Shahmahmudi
authors.forename: T
authors.initials: T
authors.lastname: Musavi
authors.forename: T Mokhtari
authors.initials: TM
authors.lastname: Azad
authors.forename: R
authors.initials: R
authors.lastname: Nategh
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution; D036022:Capsid Proteins / Q000235:genetics*; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009123:Muscle Hypotonia / Q000453:epidemiology / Q000821:virology; D009154:Mutation; D010243:Paralysis / Q000453:epidemiology / Q000821:virology*; D011051:Poliomyelitis / Q000453:epidemiology / Q000821:virology*; D017955:Poliovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000009:adverse effects*
chemical_list: D036022:Capsid Proteins; D011055:Poliovirus Vaccine, Oral; C442540:VP1 protein, Poliovirus