Genetic Evolution of Vaccine-Derived Poliovirus (VDPV) in an Immunodeficient Patient
2004 Vol.20 NO.11
In April 2001, the Center for Disease Control received a report of a patient diagnosed with acute flaccid paralysis at the Chang Gung Linkou Hospital. This patient was immunodeficient. In an 11 month period, one throat swab and eight fecal specimens were collected: on days 5, 17, 18, 52, 54, 179, 224, 261, and 337 after onset of the disease. The difference between this viral genomic sequence and that of the Sabin type 1 vaccine strains was between 1.80 and 2.96%.
The entire genomic sequence did not show genetic recombination. Some neucleotide and amino acids of the Sabin type 1 vaccine strains had mutated to the original strains of Mahoney.
This was the first immunodeficient patient with vaccine-derived poliovirus (iVDPD) recorded in Taiwan. The patient continued to shed the virus. If Polio immunization is discontinued after global eradication of polio is declared, the iVDPD could cause circulating Vaccine Derived Polio Virus (cVDPV) infection. Findings of the present study could serve as a scientific reference for the formulation of immunization strategies after the global eradication of polio.