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.
Kapusinszky
Beatrix
B
Department of Viral Diagnostics, National Center for Epidemiology, Budapest, Hungary. kapusinszky.beatrix@oek.antsz.hu
Molnár
Zsuzsanna
Z
Szomor
Katalin N
KN
Berencsi
György
G
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