A nation-wide case surveillance was conducted in China since 1995 for the objective of identifying acute flaccid paralysis(AFP)in children so that potential wild polioviruses and vaccine-derived poliovirus(VDPV)could ...A nation-wide case surveillance was conducted in China since 1995 for the objective of identifying acute flaccid paralysis(AFP)in children so that potential wild polioviruses and vaccine-derived poliovirus(VDPV)could be identified on time.Two outbreaks associated with type I circulating VDPVs,eight native independent type I ambiguous VDPVs(aVDPV),and one imported aVDPV were identified during the AFP case surveillance in China from 1995 to 2019.The VP1 coding region of the Chinese type I VDPVs differed from the polio vaccine strain by 1.00%–3.75%(9–34 substitutions in 906 nucleotides).Most of the Chinese type I VDPV strains shared 4 amino acid substitutions in the neutralizing antigenic(NAg)sites:3 located at the BC loop,which formed the NAg site 1,and another at NAg site 3a.All of the Chinese type I VDPVs identified during the AFP case surveillance were young VDPVs,which indicated a limited viral replication resulted from the administration of the initiating oral polio vaccine(OPV)dose.VDPVs can emerge and spread in isolated communities with immunity gaps and the circulation ceases following a mass immunization with OPV.As such,high-quality surveillance permitted very early detection and response and it played a key role in stalling the widespread circulation of the emergent cVDPV strains in China.展开更多
Background:Vaccine-derived poliovirus(VDPV)is a potential threat to polio eradication because they can reintroduce into the general population and cause paralytic polio outbreaks,a phenomenon that has recently emerged...Background:Vaccine-derived poliovirus(VDPV)is a potential threat to polio eradication because they can reintroduce into the general population and cause paralytic polio outbreaks,a phenomenon that has recently emerged as a prominent public health concern at the end of global polio eradication.This study aimed to describe the epidemiology and genetic characteristics of the frst VDPV identifed from a patient with acute faccid paralysis(AFP),with four doses of inactivated polio vaccine immunization in Henan Province,China in 2017.Methods:The patient was diagnosed with type 3 VDPV.Subsequently,a series of epidemiological approaches was implemented,including a retrospective search of AFP cases,rate of vaccination assessment,study of contacts,and supplementary immunization activities.Fecal samples were collected,viral isolation was performed,and the viral isolates were characterized using full-length genomic sequencing and bioinformatic analysis.Results:Phylogenetic analysis showed that the viral isolates from the patient were diferent from other reported genetic clusters of type 3 VDPV worldwide.They were identifed as a Sabin 3/Sabin 1 recombinant VDPV with a crossover site in the P2 region.Nucleotide substitutions,including U→C(472)and C→U(2493),have been identifed,both of which are frequently observed as reversion mutations in neurovirulent type 3 poliovirus.A unique aspect of this case is that the patient had been vaccinated with four doses of inactive polio vaccine,and the serum neutralizing antibody for Sabin types 1 and 3 were 1∶16 and 1∶512,respectively.Thus,the patient was speculated to have been infected with type 3 VDPV,and the virus continued to replicate and be excreted for at least 41 d.Conclusions:The existence of this kind of virus in human population is a serious risk and poses a severe challenge in maintaining a polio-free status in China.To the best of our knowledge,this is the frst report of VDPV identifed in the Henan province of China.Our results highlight the importance of maintaining a high-level vaccination rate and highly sensitive AFP case surveillance system in intercepting VDPV transmission.展开更多
基金This study was supported by the National Science and Technology Major Project of China(Project Nos.2018ZX10711001,2017ZX10104001,and 2018ZX10713002).
文摘A nation-wide case surveillance was conducted in China since 1995 for the objective of identifying acute flaccid paralysis(AFP)in children so that potential wild polioviruses and vaccine-derived poliovirus(VDPV)could be identified on time.Two outbreaks associated with type I circulating VDPVs,eight native independent type I ambiguous VDPVs(aVDPV),and one imported aVDPV were identified during the AFP case surveillance in China from 1995 to 2019.The VP1 coding region of the Chinese type I VDPVs differed from the polio vaccine strain by 1.00%–3.75%(9–34 substitutions in 906 nucleotides).Most of the Chinese type I VDPV strains shared 4 amino acid substitutions in the neutralizing antigenic(NAg)sites:3 located at the BC loop,which formed the NAg site 1,and another at NAg site 3a.All of the Chinese type I VDPVs identified during the AFP case surveillance were young VDPVs,which indicated a limited viral replication resulted from the administration of the initiating oral polio vaccine(OPV)dose.VDPVs can emerge and spread in isolated communities with immunity gaps and the circulation ceases following a mass immunization with OPV.As such,high-quality surveillance permitted very early detection and response and it played a key role in stalling the widespread circulation of the emergent cVDPV strains in China.
文摘Background:Vaccine-derived poliovirus(VDPV)is a potential threat to polio eradication because they can reintroduce into the general population and cause paralytic polio outbreaks,a phenomenon that has recently emerged as a prominent public health concern at the end of global polio eradication.This study aimed to describe the epidemiology and genetic characteristics of the frst VDPV identifed from a patient with acute faccid paralysis(AFP),with four doses of inactivated polio vaccine immunization in Henan Province,China in 2017.Methods:The patient was diagnosed with type 3 VDPV.Subsequently,a series of epidemiological approaches was implemented,including a retrospective search of AFP cases,rate of vaccination assessment,study of contacts,and supplementary immunization activities.Fecal samples were collected,viral isolation was performed,and the viral isolates were characterized using full-length genomic sequencing and bioinformatic analysis.Results:Phylogenetic analysis showed that the viral isolates from the patient were diferent from other reported genetic clusters of type 3 VDPV worldwide.They were identifed as a Sabin 3/Sabin 1 recombinant VDPV with a crossover site in the P2 region.Nucleotide substitutions,including U→C(472)and C→U(2493),have been identifed,both of which are frequently observed as reversion mutations in neurovirulent type 3 poliovirus.A unique aspect of this case is that the patient had been vaccinated with four doses of inactive polio vaccine,and the serum neutralizing antibody for Sabin types 1 and 3 were 1∶16 and 1∶512,respectively.Thus,the patient was speculated to have been infected with type 3 VDPV,and the virus continued to replicate and be excreted for at least 41 d.Conclusions:The existence of this kind of virus in human population is a serious risk and poses a severe challenge in maintaining a polio-free status in China.To the best of our knowledge,this is the frst report of VDPV identifed in the Henan province of China.Our results highlight the importance of maintaining a high-level vaccination rate and highly sensitive AFP case surveillance system in intercepting VDPV transmission.
