title: Oral polio vaccine response in breast fed infants with malnutrition and diarrhea.
abstract: Oral vaccines for polio (OPV) and rotavirus are less effective in children in the developing world. The reasons for this are not well understood. We tested for risk factors for poor response to OPV in infants from an urban slum of Dhaka, Bangladesh. Diminished serum neutralizing response to OPV, but not failure of intramuscularly administered vaccines, was associated with malnutrition, diarrhea, and shorter breastfeeding duration. Children with malnutrition (WAZ <-2) had significantly lower OPV 3 titers (p=0.029). Children who had 2 or more diarrhea episodes during the 1st months of life were more than twice as likely to experience OPV failure as those who had 1 diarrhea episode or no diarrhea (p=0.0245). In contrast, each additional month in exclusive breastfeeding was associated with an increase in OPV 3 titer by 0.41 (p=0.0072) and 0.16 (p=0.0065) at the 25th and 50th percentiles of OPV 3 titers respectively. These data are consistent with a defect in induction of immunity in the gut for OPV but not parenteral vaccines, a defect that may be amenable to intervention in part via promotion of exclusive breastfeeding.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Snider
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Yue
authors.initials: Y
authors.lastname: Liu
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Jennie Z
authors.initials: JZ
authors.lastname: Ma
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Uma
authors.initials: U
authors.lastname: Nayak
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Josyf C
authors.initials: JC
authors.lastname: Mychaleckyj
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Poonum
authors.initials: P
authors.lastname: Korpe
authors.affiliation: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Mondal
authors.affiliation: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Mamun
authors.initials: M
authors.lastname: Kabir
authors.affiliation: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Masud
authors.initials: M
authors.lastname: Alam
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Pallansch
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: M Steven
authors.initials: MS
authors.lastname: Oberste
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: William
authors.initials: W
authors.lastname: Weldon
authors.affiliation: University of Vermont College of Medicine, Burlington, Vermont, USA.
authors.forename: Beth D
authors.initials: BD
authors.lastname: Kirkpatrick
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA. Electronic address: wap3g@virginia.edu.
authors.forename: William A
authors.initials: WA
authors.lastname: Petri
mesh_terms: D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D001459:Bangladesh / Q000453:epidemiology; D001942:Breast Feeding; D003967:Diarrhea / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D044342:Malnutrition / Q000453:epidemiology*; D011051:Poliomyelitis / Q000517:prevention & control*; D011055:Poliovirus Vaccine, Oral / Q000627:therapeutic use*
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D011055:Poliovirus Vaccine, Oral