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Particle Agglutination Method for Poliovirus Identification
Published on: April 20, 2011
Transmission of imported vaccine-derived poliovirus in an undervaccinated community in Minnesota
James P Alexander1, Kristen Ehresmann, Jane Seward
1National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. axj1@cdc.gov
Background:
Oral poliovirus vaccine (OPV) has not been used in the United States since 2000. Type 1 vaccine-derived poliovirus (VDPV) was identified in September 2005, from an unvaccinated Amish infant hospitalized in Minnesota with severe combined immunodeficiency. An investigation was conducted to determine the source of the virus and its means of transmission.
Methods:
The infant was tested serially for poliovirus excretion. Investigations were conducted to detect poliovirus infections or paralytic poliomyelitis in Amish communities in Minnesota, neighboring states, and Ontario, Canada. Genomic sequences of poliovirus isolates were determined for phylogenetic analysis.
Results:
No source for the VDPV could be identified. In the index community, 8 (35%) of 23 children tested, including the infant, had evidence of type 1 poliovirus or VDPV infection. Phylogenetic analysis suggested that the VDPV circulated in the community for approximately 2 months before the infant's infection was detected and that the initiating OPV dose had been given before her birth. No paralytic disease was found in the community, and no poliovirus infections were found in other Amish communities investigated.
Conclusions:
This is the first demonstrated transmission of VDPV in an undervaccinated community in a developed country. Continued vigilance is needed in all countries to identify poliovirus infections in communities at high risk of poliovirus transmission.
Insights
Type 1 vaccine-derived poliovirus (VDPV) was detected in an unvaccinated Amish community in Minnesota. This marked the first documented VDPV transmission in a developed country, highlighting the need for ongoing surveillance.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Oral poliovirus vaccine (OPV) use ceased in the US in 2000.
- A type 1 vaccine-derived poliovirus (VDPV) case was identified in 2005 in an unvaccinated infant with immunodeficiency.
- An investigation was launched to trace the VDPV source and transmission routes.
Observation:
- The infant was monitored for poliovirus shedding.
- Amish communities in Minnesota, surrounding states, and Ontario were screened for poliovirus infections.
- Phylogenetic analysis of poliovirus isolates was performed.
Findings:
- No definitive source of the VDPV was identified.
- In the primary community, 35% of children, including the infant, showed evidence of type 1 poliovirus or VDPV infection.
- Phylogenetic analysis indicated VDPV circulation for two months prior to detection, with initial OPV exposure before the infant's birth. No paralytic polio or infections were found in other Amish communities.
Implications:
- This represents the first documented VDPV transmission within an under-vaccinated community in a developed nation.
- Sustained vigilance is crucial globally to detect poliovirus infections in high-risk populations.
- The findings underscore the importance of monitoring for VDPV in communities with suboptimal vaccination coverage.
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