Outbreak of Paralytic Poliomyelitis in Finland: Widespread Circulation of Antigenically Altered Poliovirus Type 3 in a Vaccinated Population

Hovi, Tapani; Huovilainen, Anita; Kuronen, Tapani; Pöyry, Tuija; Salama, Noha N.; Cantell, K; Kinnunen, Esko; Lapinleimu, K; Roivainen, Merja; Stenvik, Mirja; Silander, A.; Thodén, Carl‐Johan; Salminen, Seppo; Weckström, Pertti

doi:10.1016/s0140-6736(86)91566-7

Cited by 177 publications

(73 citation statements)

References 16 publications

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“…The poliovirus type 3 strains isolated during the epidemic differ from the vaccine strains (Magrath et al, 1986;Hovi et al, 1986;Hughes et al, 1986;Kinnunen & Hovi, 1989) and were recently shown to be genetically related to strains which circulated in the Mediterranean countries in the late 1970s (P6yry el al., 1990).…”

Section: Introductionmentioning

confidence: 99%

Generation of virus genetic lineages during an outbreak of poliomyelitis

Kinnunen

Pöyry

Hovi

1991

Journal of General Virology

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Wild poliovirus type 3 isolates collected during the Finnish outbreak (1984 to 1985) in different geographical locations were compared by partial RNA sequencing. The entire 5' non-coding end and a discontinuous part of the capsid coding region were sequenced from 15 isolates. Combining the present sequence data with previously published data and analysing these by the maximum parsimony method showed that the epidemic strains had diverged in cocirculating lineages. Genetic comparison of strains isolated from a single person often revealed a branched structure in the phylogenetic tree indicating high potential for diversification. The extent of variation generated under immunological pressure during an infection lasting for weeks in one person was high as compared with the observed geographical variation.

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Section: Introductionmentioning

confidence: 99%

Generation of virus genetic lineages during an outbreak of poliomyelitis

Kinnunen

Pöyry

Hovi

1991

Journal of General Virology

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“…A limited outbreak of poliomyelitis occurred in Finland in 1984 to 1985 after 20 years without a single case and without documented poliovirus circulation in the population (Hovi et al, 1986). Before this outbreak only IPV and not live attenuated oral poliovaccine had been used in Finland for general immunization.…”

Section: Introductionmentioning

confidence: 99%

Antigenic Variation among 173 Strains of Type 3 Poliovirus Isolated in Finland during the 1984 to 1985 Outbreak

Huovilainen

Kinnunen

Ferguson

et al. 1988

Journal of General Virology

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SUMMARY Antigenic properties of 128 clinical type 3 poliovirus isolates of the 1984 to 1985Finland outbreak from 95 persons and 45 strains from sewage water specimens were evaluated using five neutralizing monoclonal antibodies (MAbs) directed against an antigenic site (designated site 1) on VP1 at amino acids 89 to 100. All five MAbs neutralized the type 3 poliovirus strains used in the vaccines, P3/Saukett and P3/Sabin, but none of them neutralized the prototype strain of the outbreak (P3/Finland/ 23127/84). Forty-six percent of the clinical isolates resembled the prototype strain (class A) while the rest of the isolates were neutralized by one or more of the MAbs (classes B to D). Although an antigenic drift from A to one of the other classes was observed in sequential specimens from several individuals, no clear-cut overall change in the class distribution was found within the 3 months time span of the outbreak. Homogeneous virus populations were isolated from the sewage specimens using a microtitre endpoint dilution method. The last positive sewage specimens which were obtained in January to February 1985 still had a majority of the class A strain. Some of the clinical isolates were also tested using MAbs directed against distinct antigenic sites. These studies showed that strains that gave the same pattern of reactivity with site 1 MAbs could be differentiated using antibodies directed against other sites. Fifteen strains belonging to different antigenic subclasses were subjected to partial RNA sequencing of the genome region coding for antigenic site t. The antigenic variation was usually, but not always associated with corresponding amino acid substitutions in antigenic site 1. These results indicate that the antigenic sites of type 3 poliovirus vary extensively within a given outbreak and even during replication in a given host. This variation may have both pathogenetic and epidemiological significance. INTRODUCTIONThere are three distinct serotypes of poliovirus that can be distinguished from each other in neutralization tests using polyclonal antisera. Individual clinical poliovirus isolates can be easily classified into one of the three serotypes using unabsorbed antisera. The poliovirus strains used in vaccines were isolated several decades ago but still appear to induce antibodies that protect well against the poliovirus strains that are prevalent today. This would suggest that the antigenic structure of polioviruses is relatively stable. In contrast, it has been shown by oligonucleotide fingerprinting (Nottay et al., 1981 ;Minor et al., 1982) that the genome of polioviruses (like that of other RNA viruses) can vary remarkably during replication in vivo.At least three separate antigenic sites are known to be involved in neutralization of polioviruses. Regions of the three major structural proteins (VP1, 2 and 3) have been identified as antigenic sites and designated sites 1, 2 and 3 (Minor et al., 1985). These sites have also been

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“…Examples include a severe poliomyelitis outbreak among adult Canadian Eskimos in 1949 with an unusually high CFR following (re)introduction of a WPV (34). Similarly, a WPV3 with deviations of its major AgS caused a poliomyelitis outbreak in Finland during 1984-1985 after its introduction to a population vaccinated with low potency IPV since almost 30 y (35). Another example includes the reemergence of type 2 VDPVs as a cause of AFP in countries with suboptimal vaccination coverage such as in Nigeria (26).…”

Section: Discussionmentioning

confidence: 99%

Robustness against serum neutralization of a poliovirus type 1 from a lethal epidemic of poliomyelitis in the Republic of Congo in 2010

Drexler

Grard

Lukashev

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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Significance In 2010, a large outbreak of poliomyelitis involving 445 laboratory-confirmed cases occurred in the Republic of Congo. The 47% case-fatality rate was unusually high. Outbreak severity was attributed to low immunization coverage but vaccine-mediated immunity against the outbreak virus was never investigated. We isolated the poliovirus type 1 responsible for the outbreak and located its evolutionary origins to Southeast Asia. Fatal cases showed evidence for previous vaccination against polioviruses and the outbreak virus was refractive against neutralization by monoclonal and vaccine-derived antibodies. This pointed to immune escape contributing to the severity of the outbreak. Sustained vaccination regimens in polio-free regions, together with clinical and environmental poliovirus surveillance will be necessary to combat antigenetically variant polioviruses in the poliomyelitis eradication endgame.

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Outbreak of Paralytic Poliomyelitis in Finland: Widespread Circulation of Antigenically Altered Poliovirus Type 3 in a Vaccinated Population

Cited by 177 publications

References 16 publications

Generation of virus genetic lineages during an outbreak of poliomyelitis

Generation of virus genetic lineages during an outbreak of poliomyelitis

Antigenic Variation among 173 Strains of Type 3 Poliovirus Isolated in Finland during the 1984 to 1985 Outbreak

Robustness against serum neutralization of a poliovirus type 1 from a lethal epidemic of poliomyelitis in the Republic of Congo in 2010

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