Molecular characterization of poliovirus isolates from children who contracted vaccine-associated paralytic poliomyelitis (VAPP) following administration of monovalent type 3 oral poliovirus vaccine in the 1960s in Hungary.
Hungarian children were immunized with monovalent oral poliovaccine (mOPV) delivered at 6-week intervals in the order Sabin 1, Sabin 3, Sabin 2, from 1959 until 1992. During that period, 90 cases of vaccine-associated paralytic poliomyelitis (VAPP) were reported, 52 of which were associated with Sabin 3-related virus (76% of VAPP cases with virologic data). Because of renewed interest in type 3 mOPV (mOPV3), molecular methods were used to reanalyze 18 of the Sabin 3-related isolates from 15 VAPP patients, confirming the original identification. All isolates had the U472C 5'-untranslated region (5'-UTR) substitution associated with reversion to neurovirulence, and from zero to seven nucleotide substitutions in the virus protein 1 (VP1) region. No evidence was found for prolonged mOPV3 replication in the VAPP patients or for spread of Sabin 3-related viruses beyond close vaccinee contacts. The VAPP diseases were prevented by a single dose of inactivated poliovirus vaccine from 1992 to 2006 in Hungary, as proved by continuous surveillance of acute flaccid paralysis.
Department of Viral Diagnostics, National Center for Epidemiology, Budapest, Hungary. kapusinszky.beatrix@oek.antsz.hu
Beatrix
B
Kapusinszky
Zsuzsanna
Z
Molnár
Katalin N
KN
Szomor
György
G
Berencsi
D020121:5' Untranslated Regions; D036022:Capsid Proteins / Q000235:genetics; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006814:Hungary; D007223:Infant; D008297:Male; D008969:Molecular Sequence Data; D017354:Point Mutation; D011051:Poliomyelitis / Q000821:virology*; D017955:Poliovirus / Q000235:genetics* / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000009:adverse effects*; D012367:RNA, Viral / Q000235:genetics*; D017422:Sequence Analysis, DNA; D014774:Virulence
D020121:5' Untranslated Regions; D036022:Capsid Proteins; D011055:Poliovirus Vaccine, Oral; D012367:RNA, Viral; C442540:VP1 protein, Poliovirus