Neurovirulent Vaccine-Derived Polioviruses in Sewage from Highly Immune Populations
Open Access
- 20 December 2006
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 1 (1) , e69
- https://doi.org/10.1371/journal.pone.0000069
Abstract
Vaccine-derived polioviruses (VDPVs) have caused poliomyelitis outbreaks in communities with sub-optimal vaccination. Israeli environmental surveillance of sewage from populations with high (>95%) documented vaccine coverage of confirmed efficacy identified two separate evolutionary clusters of VDPVs: Group 1 (1998–2005, one system, population 1.6×106) and Group 2 (2006, 2 systems, populations 0.7×106 and 5×104). Molecular analyses support evolution of nine Group 1 VDPVs along five different lineages, starting from a common ancestral type 2 vaccine-derived Sabin-2/Sabin-1 recombinant strain, and independent evolution of three Group 2 VDPVs along one lineage starting from a different recombinant strain. The primary evidence for two independent origins was based on comparison of unique recombination fingerprints, the number and distribution of identical substitutions, and evolutionary rates. Geometric mean titers of neutralizing antibodies against Group 1 VDPVs were significantly lower than against vaccine strains in all age-group cohorts tested. All individuals had neutralizing titers >1∶8 against these VDPVs except 7% of the 20–50 year cohort. Group 1 VDPVs were highly neurovirulent in a transgenic mouse model. Intermediate levels of protective immunity against Group 2 VDPVs correlated with fewer (5.0+1.0) amino acid substitutions in neutralizing antigenic sites than in Group 1 VDPV's (12.1±1.5). VDPVs that revert from live oral attenuated vaccines and reacquire characteristics of wild-type polioviruses not only threaten populations with poor immune coverage, but are also a potential source for re-introduction of poliomyelitis into highly immune populations through older individuals with waning immunity. The presence of two independently evolved groups of VDPVs in Israel and the growing number of reports of environmental VDPV elsewhere make it imperative to determine the global frequency of environmental VDPV. Our study underscores the importance of the environmental surveillance and the need to reconsider the global strategies for polio eradication and the proposed cessation of vaccination.Keywords
This publication has 53 references indexed in Scilit:
- Antigenic Evolution of Vaccine-Derived Polioviruses: Changes in Individual Epitopes and Relative Stability of the Overall Immunological PropertiesJournal of Virology, 2006
- Intratypic Recombination among Lineages of Type 1 Vaccine-Derived Poliovirus Emerging during Chronic Infection of an Immunodeficient PatientJournal of Virology, 2005
- Immune status to poliovirus among immigrant workers in IsraelPreventive Medicine, 2005
- Nucleotide variation in Sabin type 2 poliovirus from an immunodeficient patient with poliomyelitisJournal of General Virology, 2003
- Genomic Features of Intertypic Recombinant Sabin Poliovirus Strains Excreted by Primary VaccineesJournal of Virology, 2001
- Fifteen years of experience with Vero-produced enhanced potency inactivated poliovirus vaccineThe Pediatric Infectious Disease Journal, 1997
- GENETICS OF POLIOVIRUSAnnual Review of Genetics, 1993
- Poliomyelitis outbreak in Israel in 1988: a report with two commentariesThe Lancet, 1990
- Rapid molecular evolution of wild type 3 poliovirus during infection in individual hostsJournal of General Virology, 1990
- Complete nucleotide sequences of all three poliovirus serotype genomesJournal of Molecular Biology, 1984