title: Evolution and circulation of type-2 vaccine-derived polioviruses in Nad Ali district of Southern Afghanistan during June 2009-February 2011.
abstract: Oral polio vaccine has been used successfully as a powerful tool to control the spread of wild polioviruses throughout the world; however, during replication in under immunized children, some vaccine viruses revert and acquire the neurovirulent phenotypic properties. In this study, we describe the evolution and circulation of Vaccine-Derived Polioviruses (VDPVs) in Helmand province of Afghanistan. We investigated 2646 AFP cases of Afghan children from June 2009-February 2011 and isolated 103 (04%) vaccine viruses, 45(1.7%) wild type polioviruses and six (0.22%) type 2 circulating vaccine-derived polioviruses (cVDPVs). These cVDPVs showed 97.7%-98.2% nucleotide and 98%-98.7% amino acid homology in VP1 region on comparison with Sabin type 2 reference strain. All these cVDPVs had two signature mutations of neurovirulent phenotypes and 12 additional mutations in P1 capsid region that might also have contributed to increase neurovirulence and replication. Phylogenetic analysis revealed that all these viruses were closely related and originated from previously reported Sabin like 2 virus from Pakistan which did not conform to the standard definition of VDPVs at that time. It was also observed that initial OPV dose was administered approximately 9 months prior to the collection of first stool specimen of index case. Our findings support that suboptimal surveillance and low routine immunization coverage have contributed to the emergence and spread of these viruses in Afghanistan. We therefore recommend high quality immunization campaigns not only in affected district Nad Ali but also in the bordering areas between Pakistan and Afghanistan to prevent the spread of cVDPVs.
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan ; Department of Biotechnology, Quaid-e-Azam University, Islamabad, Pakistan.
authors.forename: Salmaan
authors.initials: S
authors.lastname: Sharif
authors.affiliation: Department of Biotechnology, Quaid-e-Azam University, Islamabad, Pakistan.
authors.forename: Bilal Haider
authors.initials: BH
authors.lastname: Abbasi
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Adnan
authors.initials: A
authors.lastname: Khurshid
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Muhammad Masroor
authors.initials: MM
authors.lastname: Alam
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Shahzad
authors.initials: S
authors.lastname: Shaukat
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Mehar
authors.initials: M
authors.lastname: Angez
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Muhammad Suleman
authors.initials: MS
authors.lastname: Rana
authors.affiliation: Department of Virology, National Institute of Health, Islamabad, Pakistan.
authors.forename: Syed Sohail Zahoor
authors.initials: SS
authors.lastname: Zaidi
mesh_terms: D020121:5' Untranslated Regions; D000346:Afghanistan; D002675:Child, Preschool; D017931:DNA Primers / Q000235:genetics; D004279:DNA, Viral; D005243:Feces; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009154:Mutation; D010154:Pakistan; D010641:Phenotype; D010802:Phylogeny; D011051:Poliomyelitis / Q000517:prevention & control* / Q000821:virology; D017955:Poliovirus / Q000145:classification* / Q000472:pathogenicity; D011055:Poliovirus Vaccine, Oral / Q000627:therapeutic use*; D017422:Sequence Analysis, DNA; D013045:Species Specificity; D014774:Virulence; D014944:World Health Organization
chemical_list: D020121:5' Untranslated Regions; D017931:DNA Primers; D004279:DNA, Viral; D011055:Poliovirus Vaccine, Oral