title: Isolation of a type 3 vaccine-derived poliovirus (VDPV) from an Iranian child with X-linked agammaglobulinemia.
abstract: Type 3 immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) were isolated from a 15-month-old Iranian boy with acute flaccid paralysis (AFP) who was subsequently diagnosed with X-linked agammaglobulinemia (XLA). VP1 nucleotide sequences of the two isolates differed from Sabin 3 by 2.0% and 2.1% and from each other by 0.6%. Although the key determinant of attenuation and temperature sensitivity in the 5'-untranslated region (U(472)-->C) had reverted, a second capsid-region determinant (VP3:Phe(091)) was unchanged, but a presumptive suppressor (VP1:Ala(054)-->Val) was found. The isolates were Sabin 3/Sabin 1 recombinants, sharing a single recombination breakpoint in the 2C region. Although the two isolates were antigenically distinct from Sabin 3, only one amino acid replacement was found in the neutralizing antigenic sites (VP3:Ser(059)-->Asn in site 3). The patient was placed on intravenous immunoglobulin (IVIG) therapy within 9 days of onset of AFP, and iVDPV excretion ceased thereafter, but the patient remained severely paralyzed until his death approximately 11 months after paralysis. No secondary AFP cases were found, and none of the seven tested contacts of the patient were found to be infected with poliovirus.
authors.affiliation: National Polio Laboratory, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shohreh
authors.initials: S
authors.lastname: Shahmahmoodi
authors.forename: Nima
authors.initials: N
authors.lastname: Parvaneh
authors.forename: Cara
authors.initials: C
authors.lastname: Burns
authors.forename: Humayun
authors.initials: H
authors.lastname: Asghar
authors.forename: Setareh
authors.initials: S
authors.lastname: Mamishi
authors.forename: Hamideh
authors.initials: H
authors.lastname: Tabatabaie
authors.forename: Qi
authors.initials: Q
authors.lastname: Chen
authors.forename: Shahram
authors.initials: S
authors.lastname: Teimourian
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Gooya
authors.forename: Abdol-Reza
authors.initials: AR
authors.lastname: Esteghamati
authors.forename: Taha
authors.initials: T
authors.lastname: Mousavi
authors.forename: Maryam
authors.initials: M
authors.lastname: Yousefi
authors.forename: Kobra
authors.initials: K
authors.lastname: Farrokhi
authors.forename: Maryam
authors.initials: M
authors.lastname: Mashlool
authors.forename: Olen
authors.initials: O
authors.lastname: Kew
authors.forename: Rakhshandeh
authors.initials: R
authors.lastname: Nategh
mesh_terms: D000361:Agammaglobulinemia / Q000150:complications*; D036022:Capsid Proteins / Q000235:genetics; D045744:Cell Line, Tumor; D040181:Genetic Diseases, X-Linked / Q000150:complications*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007223:Infant; D007492:Iran; D008297:Male; D008969:Molecular Sequence Data; D011051:Poliomyelitis / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control / Q000821:virology*; D017955:Poliovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000009:adverse effects*
chemical_list: D036022:Capsid Proteins; D007136:Immunoglobulins; D007155:Immunologic Factors; D011055:Poliovirus Vaccine, Oral