Circulating vaccine-derived poliovirus: a menace to the end game of polio eradication

Ming, Long Chiau; Hussain, Zahid; Yeoh, Siang Fei; Koh, David; Lee, Kah Seng

doi:10.1186/s12992-020-00594-z

Cited by 28 publications

(22 citation statements)

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“…Although the incidence of polio globally has decreased and wild poliovirus transmission has been interrupted in many countries, polio epidemics have been and are still being reported in Pakistan and Afghanistan [ 2 ]. In 2019, polio re-emerged after almost 20 years in the Philippines and Malaysia after both countries were declared polio-free in 2000 [ 9 , 10 ]. Since the risk of polio importation and re-emergence persists, it is important to maintain a high population level of immunity and surveillance quality to mitigate the risks of polio outbreaks.…”

Section: Discussionmentioning

confidence: 99%

Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012–2019

Yoon

Lee

et al. 2021

Viruses

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The risk of polio importation and re-emergence persists since epidemic polio still occurs in some countries, and the resurgence of polio occurring almost 20 years after polio eradication was declared in Asia has been reported. We analyzed the results of acute flaccid paralysis (AFP) surveillance in Korea to assess the quality of AFP surveillance and understand the etiology of non-polio enterovirus (NPEV)-associated central nervous system diseases in a polio-free area. We investigated 637 AFP patients under 15 years of age whose cases were confirmed during 2012–2019 by virus isolation, real-time reverse transcription polymerase chain reaction, and VP1 gene sequencing. Among the 637 AFP cases, NPEV was detected in 213 (33.4%) patients, with the majority observed in EV-A71, with 54.9% of NPEV positives. EV-A71 has been shown to play a role as a major causative agent in most neurological diseases except for Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), and meningitis. This study provides information on the AFP surveillance situation in Korea and highlights the polio eradication stage in the monitoring and characterization of NPEV against the outbreak of neurological infectious diseases such as polio.

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Section: Discussionmentioning

confidence: 99%

Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012–2019

Yoon

Lee

et al. 2021

Viruses

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“…In such circumstances, monovalent type 2 OPV (mOPV2) was the best available vaccine to induce immunity for interrupting ongoing cVDPV2 transmissions. However, most of the current cVDPV2 outbreaks after the Switch in 2016 are derived from the supplemental mOPV2 immunization in high-risk areas with suboptimal intestinal immunity against type 2 poliovirus (11, [22][23][24][25][26][27]. To overcome this dilemmas, novel type 2 OPV (nOPV2), a genetically (36,37).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Outbreaks of Circulating Vaccine-Derived Poliovirus in the World Health Organization Western Pacific Region, 2000–2021

Kïtamura

Shimizu

2022

Jpn J Infect Dis

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The World Health Organization Western Pacific Region (WPR) has maintained the polio-free status for more than two decades. At the global level, there were only 6 confirmed polio cases due to wild type 1 poliovirus in Pakistan, Afghanistan, and Malawi in 2021, therefore, the risk of the importation of wild poliovirus from the endemic countries to the WPR is considerably lower than ever before. On the other hand, the risk of polio outbreaks associated with circulating vaccine-derived polioviruses (cVDPVs) still cannot be ignored even in the WPR.Since late 2010s, cVDPV outbreaks in the WPR have appeared to be more extensive in frequency and magnitude. Moreover, the emergence of concomitant polio outbreaks of type 1 and type 2 cVDPVs in the Philippines and Malaysia during 2019-2020 has highlighted the remaining risk of cVDPV outbreaks in highrisk areas and/or communities in the WPR. The previous cVDPV outbreaks in the WPR have been rapidly and effectively controlled, however, the future risk of polio outbreaks associated with cVDPVs needs to be reconsidered and polio immunization and surveillance strategies should be updated accordingly.

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“…Limitations of the OPV, on the other hand, are related to the generation of vaccine-associated paralytic polio. Due to genetic instability, the live-attenuated virus can regain virulence leading to the production of new pathogenic strains called circulating vaccine-derived poliovirus (cVDPV) and increased outbreaks in recent years ( Ming et al., 2020 ; Alleman et al., 2021 ). As a response, in 2020 the World Health Organization (WHO) approved the use of the novel OPV monovalent type 2 (nOPV2) vaccine, a genetically more stable vaccine produced form the Sabin type 2 strain.…”

Section: Host Immune Response and Current Vaccines To Prevent Poliomy...mentioning

confidence: 99%

Plant-made poliovirus vaccines – Safe alternatives for global vaccination

Bolaños-Martínez¹,

Strasser²

2022

Front. Plant Sci.

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Human polioviruses are highly infectious viruses that are spread mainly through the fecal-oral route. Infection of the central nervous system frequently results in irreversible paralysis, a disease called poliomyelitis. Children under five years are mainly affected if they have not acquired immunity through natural infection or via vaccination. Current polio vaccines comprise the injectable inactivated polio vaccine (IPV, also called the Salk vaccine) and the live-attenuated oral polio vaccine (OPV, also called the Sabin vaccine). The main limitations of the IPV are the reduced protection at the intestinal mucosa, the site of virus replication, and the high costs for manufacturing due to use of live viruses. While the OPV is more effective and stimulates mucosal immunity, it is manufactured using live-attenuated strains that can revert into pathogenic viruses resulting in major safety concerns and vaccine-derived outbreaks. During the last fifteen years, plant-based poliovirus vaccines have been explored by several groups as a safe and low-cost alternative, and promising results in protection against challenges with viruses and induction of neutralizing antibodies have been obtained. However, low yields and a high frequency in dose administration highlight the need for improvements in polioviral antigen production. In this review, we provide insights into recent efforts to develop plant-made poliovirus candidates, with an emphasis on strategies to optimize the production of viral antigens.

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Circulating vaccine-derived poliovirus: a menace to the end game of polio eradication

Cited by 28 publications

References 0 publications

Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012–2019

Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012–2019

Outbreaks of Circulating Vaccine-Derived Poliovirus in the World Health Organization Western Pacific Region, 2000–2021

Plant-made poliovirus vaccines – Safe alternatives for global vaccination

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