Evolution of the Sabin Vaccine into Pathogenic Derivatives without Appreciable Changes in Antigenic Properties: Need for Improvement of Current Poliovirus Surveillance

Public health response to vaccine-derived poliovirus (VDPV) that is transmitted from person to person (circulating VDPV [cVDPV]) differs significantly from response to virus that replicates in individuals with primary immunodeficiency (immunodeficiency-associated VDPV [iVDPV]). cVDPV outbreaks require a community immunization response, whereas iVDPV chronic infections require careful patient monitoring and appropriate individual treatment. To support poliovirus outbreak response, particularly for type 2 VDPV, we investigated the genetic distinctions between cVDPV2 and iVDPV2 sequences. We observed that simple genetic measurements of nucleotide and amino acid substitutions are sufficient for distinguishing highly divergent iVDPV2 from cVDPV2 sequences, but are insufficient to make a clear distinction between the two categories among less divergent sequences. We presented quantitative approaches using genetic information as a surveillance tool for early detection of VDPV outbreaks. This work suggests that genetic variations between cVDPV2 and iVDPV2 may reflect differences in viral micro-environments, host-virus interactions, and selective pressures during person-to-person transmission compared with chronic infections in immunodeficient patients.

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“… United Kingdom 12 Dunn et al, 2015 [21] . Belarus 1 Yakovenko et al, 2009 [12] . Italy 1 Buttinelli et al, 2003 [31] .…”

Section: Resultsmentioning

confidence: 99%

“…Partial VP1 sequences, reference sequences [9] , [10] , duplicated sequences and Sabin-like sequences (< 6 NT differences) were removed. Four additional sequences that were not identified in the initial GenBank search were added after detailed literature reviews [11] , [12] , [13] .…”

Section: Methodsmentioning

confidence: 99%

Are Circulating Type 2 Vaccine-derived Polioviruses (VDPVs) Genetically Distinguishable from Immunodeficiency-associated VDPVs?

Zhao

Jorba

Shaw

et al. 2017

Computational and Structural Biotechnology Journal

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“…VAPP cases are known to be sporadic, each one considered to be an independent event (1, 2, 6), whereas VDPVs may cause not only sporadic illnesses in immunocompetent (7,8) or immunocompromised (2, 9) persons but also outbreaks, sometimes quite large (2,10). Because of the latter propensity, VDPVs are attracting special attention of public health authorities, requiring urgent large-scale responses to curb their transmission.…”

mentioning

confidence: 99%

A Cluster of Paralytic Poliomyelitis Cases Due to Transmission of Slightly Diverged Sabin 2 Vaccine Poliovirus

Короткова

Gmyl

Yakovenko

et al. 2016

J Virol

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IMPORTANCEThe oral poliovirus vaccine largely contributed to the nearly complete disappearance of poliovirus-caused poliomyelitis. Being generally safe, it can, in some cases, result in a paralytic disease. Two types of such outcomes are distinguished: those caused by slightly diverged (Sabin-like) viruses on the one hand and those caused by significantly diverged VDPVs on the other. This classification is based on the number of mutations in the viral genome region encoding a viral structural protein. Until now, only sporadic poliomyelitis cases due to Sabin-like polioviruses had been described, and in distinction from the VDPV-triggered outbreaks, they did not require broad-scale epidemiological responses. Here, an unusual outbreak of poliomyelitis caused by a Sabin-like virus is reported, which had an exceptionally high disease/infection ratio. This outbreak blurred the borderline between Sabin-like polioviruses and VDPVs both in pathogenicity and in the kind of responses required, as well as underscoring important gaps in understanding the pathogenicity, epidemiology, and evolution of vaccine-derived polioviruses.A s a result of the implementation of the Global Polio Eradication Initiative launched by the World Health Organization (WHO) in 1988, the worldwide incidence of paralytic poliomyelitis decreased by approximately 2 orders of magnitude. The success has been due largely to the use of two outstanding vaccines: the Salk inactivated polio vaccine (IPV) and Sabin live oral polio vaccine (OPV). Notwithstanding their obvious merits, these vaccines have drawbacks: the former fails to trigger a robust intestinal immunity and is unable therefore to prevent transmission of wild polioviruses, whereas the latter can be associated, although quite rarely, with cases of paralytic poliomyelitis, a circumstance especially important now that the incidence of the disease caused by wild polioviruses has substantially decreased.Two situations linked to the OPV-associated polio cases are usually distinguished. The disease may be triggered in vaccine recipients or their contacts by the original or slightly evolved (Sabinlike) vaccine viruses soon after the vaccination (1). Such cases are referred to as vaccine-associated paralytic poliomyelitis (VAPP).Other cases might be caused by markedly diverged vaccine viruses after their cryptic circulation or hidden evolution in a single organism before showing up. Such viruses are dubbed vaccine-derived polioviruses (VDPVs) (2). The current official criterion to classify an OPV-originated virus as a VDPV are the presence of 10 or more mutations in the region encoding the viral capsid protein

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“…The degree of divergence from the Sabin strains in the genome region encoding the VP1 protein did not exceed 0.5% nucleotide substitutions, except for vaccine-derived polioviruses (VDPV) (WHO, 2016) isolated from three cases of cVAPP. Poliovirus type 1 had 2.65% nucleotide substitutions (Cherkasova et al, 2002), type 2 had 1.44% substitutions (Yakovenko et al, 2009), and type 3 had 1.3% substitutions. Polioviruses types 1 and 2 were multiple recombinants: type 1/type 2/type 1 and type 2/type 3/type 2/type 1, respectively.…”

Section: Resultsmentioning

confidence: 99%

Vaccine-associated paralytic poliomyelitis in the Russian Federation in 1998–2014

Ivanova

Morozova

Shakaryan

et al. 2018

International Journal of Infectious Diseases

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Evolution of the Sabin Vaccine into Pathogenic Derivatives without Appreciable Changes in Antigenic Properties: Need for Improvement of Current Poliovirus Surveillance

Cited by 23 publications

References 26 publications

Are Circulating Type 2 Vaccine-derived Polioviruses (VDPVs) Genetically Distinguishable from Immunodeficiency-associated VDPVs?

Are Circulating Type 2 Vaccine-derived Polioviruses (VDPVs) Genetically Distinguishable from Immunodeficiency-associated VDPVs?

A Cluster of Paralytic Poliomyelitis Cases Due to Transmission of Slightly Diverged Sabin 2 Vaccine Poliovirus

Vaccine-associated paralytic poliomyelitis in the Russian Federation in 1998–2014

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