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Vaccine-associated paralytic poliomyelitis in a patient with MHC class II deficiency

Nima Parvaneh1, Shohreh Shahmahmoudi, Hamideh Tabatabai

  • 1Department of Pediatrics, Infectious Disease Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology
|May 19, 2007
PubMed

Insights

Vaccine-associated paralytic poliomyelitis (VAPP) is a rare oral polio vaccine complication. A fatal VAPP case in an infant with immune deficiency involved a rare poliovirus recombinant.

Area of Science:

  • Immunology
  • Virology
  • Pediatrics

Background:

  • Vaccine-associated paralytic poliomyelitis (VAPP) is a rare but serious complication associated with the oral polio vaccine (OPV).
  • Major Histocompatibility Complex (MHC) Class II deficiency is a primary immunodeficiency disorder affecting cellular immunity.

Observation:

  • This report details a fatal case of VAPP in an 8-month-old boy diagnosed with MHC Class II deficiency.
  • The patient developed paralytic poliomyelitis following OPV administration.

Findings:

  • The poliovirus isolated from the patient was a Sabin type 2-type 1 recombinant.
  • Genetic analysis revealed a 1.4% divergence in the VP1 gene compared to the Sabin type 2 strain, suggesting potential alterations in viral properties.

Implications:

  • This case highlights the risks of OPV in immunocompromised individuals, particularly those with primary immunodeficiencies.
  • Understanding the characteristics of poliovirus recombinants is crucial for assessing VAPP risk and informing vaccination strategies.

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