Poliovirus Excretion in Children with Primary Immunodeficiency Disorders, India

Emerg Infect Dis. 2017 Oct;23(10):1664-1670. doi: 10.3201/eid2310.170724.

Abstract

Prolonged excretion of poliovirus can occur in immunodeficient patients who receive oral polio vaccine, which may lead to propagation of highly divergent vaccine-derived polioviruses (VDPVs), posing a concern for global polio eradication. This study aimed to estimate the proportion of primary immunodeficient children with enterovirus infection and to identify the long-term polio/nonpolio enterovirus excreters in a tertiary care unit in Mumbai, India. During September 2014-April 2017, 151 patients received diagnoses of primary immunodeficiency (PID). We isolated 8 enteroviruses (3 polioviruses and 5 nonpolio enteroviruses) in cell culture of 105 fecal samples collected from 42 patients. Only 1 patient with severe combined immunodeficiency was identified as a long-term VDPV3 excreter (for 2 years after identification of infection). Our results show that the risk of enterovirus excretion among children in India with PID is low; however, systematic screening is necessary to identify long-term poliovirus excreters until the use of oral polio vaccine is stopped.

Keywords: India; Mumbai; OPV; VDPV; children; enterovirus; oral polio vaccine; poliovirus; primary immunodeficiency disorder; vaccine-derived polioviruses; viruses.

MeSH terms

  • Child
  • Child, Preschool
  • Enterovirus C, Human / immunology
  • Enterovirus C, Human / pathogenicity
  • Enterovirus Infections / immunology
  • Enterovirus Infections / transmission
  • Enterovirus Infections / virology
  • Feces / virology
  • Female
  • Humans
  • Immunologic Deficiency Syndromes / immunology
  • Immunologic Deficiency Syndromes / pathology
  • Immunologic Deficiency Syndromes / virology*
  • India
  • Infant
  • Male
  • Poliomyelitis / immunology
  • Poliomyelitis / prevention & control*
  • Poliomyelitis / transmission
  • Poliomyelitis / virology
  • Poliovirus / immunology*
  • Poliovirus / pathogenicity
  • Poliovirus Vaccine, Oral / administration & dosage*
  • Risk
  • Virus Shedding / immunology*

Substances

  • Poliovirus Vaccine, Oral