Isolation of a type 3 vaccine-derived poliovirus (VDPV) from an Iranian child with X-linked agammaglobulinemia.
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.
Shahmahmoodi
Shohreh
S
National Polio Laboratory, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran.
Parvaneh
Nima
N
Burns
Cara
C
Asghar
Humayun
H
Mamishi
Setareh
S
Tabatabaie
Hamideh
H
Chen
Qi
Q
Teimourian
Shahram
S
Gooya
Mohammad Mehdi
MM
Esteghamati
Abdol-Reza
AR
Mousavi
Taha
T
Yousefi
Maryam
M
Farrokhi
Kobra
K
Mashlool
Maryam
M
Kew
Olen
O
Nategh
Rakhshandeh
R
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*
D036022:Capsid Proteins; D007136:Immunoglobulins; D007155:Immunologic Factors; D011055:Poliovirus Vaccine, Oral