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  • Title: Nucleotide variation in Sabin type 2 poliovirus from an immunodeficient patient with poliomyelitis.
    Author: Buttinelli G, Donati V, Fiore S, Marturano J, Plebani A, Balestri P, Soresina AR, Vivarelli R, Delpeyroux F, Martin J, Fiore L.
    Journal: J Gen Virol; 2003 May; 84(Pt 5):1215-1221. PubMed ID: 12692287.
    Abstract:
    The molecular and antigenic properties of a Sabin-like type 2 poliovirus, isolated from the stool samples of a 2-year-old agammaglobulinaemic child who developed paralysis 1 year after receiving the third dose of oral poliovirus vaccine, were analysed. The virus revealed 0.88 % genome variation in the VP1 region compared with the standard reference strain, compatible with replication of the virus in the intestine over approximately 1 year. The typical mutations in the 5'NCR and VP1 associated with reversion to neurovirulence for Sabin type 2 poliovirus were found. Despite this, the virus was characterized by both PCR and ELISA tests as Sabin-like and showed temperature sensitivity and neurovirulence in transgenic mice typical of the Sabin type 2 vaccine strain. Gammaglobulin replacement therapy led rapidly to virus clearance, which, when combined with treatment with the antiviral drug pleconaril, stopped virus excretion; no further virus shedding occurred. This is the first case of poliomyelitis and long-term excretion from an immunodeficient patient to be reported in Italy through the active 'Acute Flaccid Paralysis' surveillance system.
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