Type 2 Vaccine‐Derived Poliovirus from Patients with Acute Flaccid Paralysis in China: Current Immunization Strategy Effectively Prevented Its Sustained Transmission

Zhang, Yong; Yan, Dongmei; Zhu, Shuangli; Ning, Wen; Li, Li; Wang, Haiyan; Liu, Jianfeng; Ye, Xufang; Ding, Zhuang; Wang, Dongyan; Zhu, Hui; Chen, Li; Hou, Xuexin; An, Hailong; Liang, Xiaofeng; Luo, Hai‐Bin; Kew, Olen M.

doi:10.1086/657410

Cited by 32 publications

(35 citation statements)

References 35 publications

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“…In this study, none of the viruses of genomic patterns A and B (which have an unmodified Sabin 2 5′UTR sequence) was neurovirulent, whereas almost all the viruses of genomic patterns C and D caused disease in mice, confirming the crucial importance of the 5′UTR in the loss of attenuation of Sabin 2-derived recombinants. These results are consistent with observations that the 5′UTR of pathogenic type 2 cVDPVs is modified by mutations affecting the adenine nucleotide in position 481, which is known to be a major determinant of attenuation of Sabin 2, or by recombination with other EV-Cs15171819213747484950. The key role of the 5′UTR in the pathogenicity of PVs has also been demonstrated for serotypes 1 and 338515253.…”

Section: Discussionsupporting

confidence: 91%

“…Such mutations are probably necessary for the increase in fitness required for field cVDPVs to emerge as pathogenic strains. In particular, residue 143 of VP1, which is known to be a determinant of attenuation37, is generally found to be mutated in cVDPVs isolated from patients15171819214950. This result is consistent with the finding that most pathogenic cVDPVs circulate for months before causing poliomyelitis cases810.…”

Section: Discussionsupporting

confidence: 82%

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Exchanges of genomic domains between poliovirus and other cocirculating species C enteroviruses reveal a high degree of plasticity

Bessaud

Joffret

Blondel

et al. 2016

Sci Rep

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The attenuated Sabin strains contained in the oral poliomyelitis vaccine are genetically unstable, and their circulation in poorly immunized populations can lead to the emergence of pathogenic circulating vaccine-derived polioviruses (cVDPVs). The recombinant nature of most cVDPV genomes and the preferential presence of genomic sequences from certain cocirculating non-polio enteroviruses of species C (EV-Cs) raise questions about the permissiveness of genetic exchanges between EV-Cs and the phenotypic impact of such exchanges. We investigated whether functional constraints limited genetic exchanges between Sabin strains and other EV-Cs. We bypassed the natural recombination events by constructing 29 genomes containing a Sabin 2 capsid-encoding sequence and other sequences from Sabin 2 or from non-polio EV-Cs. Most genomes were functional. All recombinant viruses replicated similarly in vitro, but recombination modulated plaque size and temperature sensitivity. All viruses with a 5′UTR from Sabin 2 were attenuated in mice, whereas almost all viruses with a non-polio 5′UTR caused disease. These data highlight the striking conservation of functional compatibility between different genetic domains of cocirculating EV-Cs. This aspect is only one of the requirements for the generation of recombinant cVDPVs in natural conditions, but it may facilitate the generation of viable intertypic recombinants with diverse phenotypic features, including pathogenicity.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 82%

Exchanges of genomic domains between poliovirus and other cocirculating species C enteroviruses reveal a high degree of plasticity

Bessaud

Joffret

Blondel

et al. 2016

Sci Rep

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“…In order to elucidate the divergence and evolution of the Sichuan type 2 cVDPVs, the VP1 sequences of the following viruses were analyzed: 5 Sichuan type 2 cVDPV strains in this study, sporadic type 2 VDPV identified in China earlier (GenBank accession numbers AY948201 and HM107832-HM107835) (7,22), Egypt type 2 cVDPVs (GenBank accession numbers AF448782 and AF448783) (23), Madagascar type 2 cVDPVs (GenBank accession numbers AM084223 and AM084225) (24), and Nigeria type 2 cVDPVs (GenBank accession numbers JX274980, JX274985, JX275162, and JX275380) (9).…”

Section: Epidemiologic and Clinical Background Circulation Of Indigementioning

confidence: 99%

Limited and Localized Outbreak of Newly Emergent Type 2 Vaccine-Derived Poliovirus in Sichuan, China

Yan¹,

Zhang²,

Zhu³

et al. 2014

Clin. Vaccine Immunol.

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an outbreak caused by type 2 circulating vaccine-derived poliovirus (cVDPV) occurred in Aba County, Sichuan, China. During the outbreak, four type 2 VDPVs (>0.6% nucleotide divergence in the VP1 region relative to the Sabin 2 strain) were isolated from 3 patients with acute flaccid paralysis (AFP) and one close contact. In addition, a type 2 pre-VDPV (0.3% to 0.5% divergence from Sabin 2) that was genetically related to these type 2 VDPVs was isolated from another AFP patient. These 4 patients were all unimmunized children 0.7 to 1.1 years old. Nucleotide sequencing revealed that the 4 VDPV isolates differed from Sabin 2 by 0.7% to 1.2% in nucleotides in the VP1 region and shared 5 nucleotide substitutions with the pre-VDPV. All 5 isolates were closely related, and all were S2/S3/S2/S3 recombinants sharing common recombination crossover sites. Although the two major determinants of attenuation and temperature sensitivity phenotype of Sabin 2 (A 481 in the 5= untranslated region and Ile 143 in the VP1 protein) had reverted in all 5 isolates, one VDPV (strain CHN16017) still retained the temperature sensitivity phenotype. Phylogenetic analysis of the third coding position of the complete P1 coding region suggested that the cVDPVs circulated locally for about 7 months following the initiating oral poliovirus vaccine (OPV) dose. Our findings reinforce the point that cVDPVs can emerge and spread in isolated communities with immunity gaps and highlight the emergence risks of type 2 cVDPVs accompanying the trivalent OPV used. To solve this issue, it is recommended that type 2 OPV be removed from the trivalent OPV or that inactivated polio vaccine (IPV) be used instead.

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“…The Chinese immunization program is widely regarded to be one of the country's most successful public health endeavors under challenging conditions: (i) a very large population (estimated population, 1.336 billion in 2009; proportion of population aged Ͻ15 years, 18.5%; birth rate, 12.09‰; birth cohort, estimated at 16.46 million); (ii) high population density with an unbalanced distribution, average of 134 persons per square kilometer; eastern coastal area, Ͼ400 persons per square kilometer; central area, about 200 persons per square kilometer; western plateau area, Ͻ10 persons per square kilometer; and (iii) hard-to-reach populations in the mountainous area (32). Despite the challenging conditions, all Chinese children have the opportunity to receive vac-cination against these infectious diseases free of charge, and vaccine-preventable diseases targeted by the expanded program on immunization are at low levels of incidence overall.…”

mentioning

confidence: 99%

Emergence and Continuous Evolution of Genotype 1E Rubella Viruses in China

et al. 2012

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In China, rubella vaccination was introduced into the national immunization program in 2008, and a rubella epidemic occurred in the same year. In order to know whether changes in the genotypic distribution of rubella viruses have occurred in the postvaccination era, we investigate in detail the epidemiological profile of rubella in China and estimate the evolutionary rate, molecular clock phylogeny, and demographic history of the predominant rubella virus genotypes circulating in China using Bayesian Markov chain Monte Carlo phylodynamic analyses. 1E was found to be the predominant rubella virus genotype since its initial isolation in China in 2001, and no genotypic shift has occurred since then. The results suggest that the global 1E genotype may have diverged in 1995 and that it has evolved at a mutation rate of 1.65 ؋ 10 ؊3 per site per year. The Chinese 1E rubella virus isolates were grouped into either cluster 1 or cluster 2, which likely originated in 1997 and 2006, respectively. Cluster 1 viruses were found in all provinces examined in this study and had a mutation rate of 1.90 ؋ 10 ؊3 per site per year. The effective number of infections remained constant until 2007, and along with the introduction of rubella vaccine into the national immunization program, although the circulation of cluster 1 viruses has not been interrupted, some viral lineages have disappeared, and the epidemic started a decline that led to a decrease in the effective population size. Cluster 2 viruses were found only in Hainan Province, likely because of importation.

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Type 2 Vaccine‐Derived Poliovirus from Patients with Acute Flaccid Paralysis in China: Current Immunization Strategy Effectively Prevented Its Sustained Transmission

Cited by 32 publications

References 35 publications

Exchanges of genomic domains between poliovirus and other cocirculating species C enteroviruses reveal a high degree of plasticity

Exchanges of genomic domains between poliovirus and other cocirculating species C enteroviruses reveal a high degree of plasticity

Limited and Localized Outbreak of Newly Emergent Type 2 Vaccine-Derived Poliovirus in Sichuan, China

Emergence and Continuous Evolution of Genotype 1E Rubella Viruses in China

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