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Response to Vaccine-Derived Polioviruses Detected through Environmental Surveillance, Guatemala, 2019.

ABSTRACT: Guatemala implemented wastewater-based poliovirus surveillance in 2018, and three genetically unrelated vaccine-derived polioviruses (VDPVs) were detected in 2019. The Ministry of Health (MoH) response included event investigation through institutional and community retrospective case searches for acute flaccid paralysis (AFP) during 2018-2020 and a bivalent oral polio/measles, mumps, and rubella vaccination campaign in September 2019. This response was reviewed by an international expert team in July 2021. During the campaign, 93% of children 6 months <7 years of age received a polio-containing vaccine dose. No AFP cases were detected in the community search; institutional retrospective searches found 37% of unreported AFP cases in 2018‒2020. No additional VDPV was isolated from wastewater. No evidence of circulating VDPV was found; the 3 isolated VDPVs were classified as ambiguous VDPVs by the international team of experts. These detections highlight risk for poliomyelitis reemergence in countries with low polio vaccine coverage.

SUBMITTER: Rodriguez R

PROVIDER: S-EPMC10370855 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Response to Vaccine-Derived Polioviruses Detected through Environmental Surveillance, Guatemala, 2019.

Rodríguez Rodrigo R Juárez Elisa E Estívariz Concepción F CF Cajas Coralia C Rey-Benito Gloria G Amézquita María Olga Bautista MOB Miles Stacey Jeffries SJ Orantes Oscar O Freire María Cecilia MC Chévez Ana-Elena AE Signor Leticia Castillo LC Sayyad Leanna L Jarquin Claudia C Cain Emilia E Villalobos Rodríguez Andrea Patricia AP Mendoza Linda L Ovando Carlos A CA Mayorga Haroldo de Jesús Barillas HJB Gaitán Ericka E Paredes Antonio A Belgasmi-Allen Hanen H Gobern Lorena L Rondy Marc M

Emerging infectious diseases 20230801 8

Guatemala implemented wastewater-based poliovirus surveillance in 2018, and three genetically unrelated vaccine-derived polioviruses (VDPVs) were detected in 2019. The Ministry of Health (MoH) response included event investigation through institutional and community retrospective case searches for acute flaccid paralysis (AFP) during 2018-2020 and a bivalent oral polio/measles, mumps, and rubella vaccination campaign in September 2019. This response was reviewed by an international expert team i ...[more]

PMID: 37486156

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Project description:BACKGROUND: Vaccine-derived polioviruses (VDPVs) have caused poliomyelitis outbreaks in communities with sub-optimal vaccination. Israeli environmental surveillance of sewage from populations with high (>95%) documented vaccine coverage of confirmed efficacy identified two separate evolutionary clusters of VDPVs: Group 1 (1998-2005, one system, population 1.6x10(6)) and Group 2 (2006, 2 systems, populations 0.7x10(6) and 5x10(4)). PRINCIPAL FINDINGS: Molecular analyses support evolution of nine Group 1 VDPVs along five different lineages, starting from a common ancestral type 2 vaccine-derived Sabin-2/Sabin-1 recombinant strain, and independent evolution of three Group 2 VDPVs along one lineage starting from a different recombinant strain. The primary evidence for two independent origins was based on comparison of unique recombination fingerprints, the number and distribution of identical substitutions, and evolutionary rates. Geometric mean titers of neutralizing antibodies against Group 1 VDPVs were significantly lower than against vaccine strains in all age-group cohorts tested. All individuals had neutralizing titers >1:8 against these VDPVs except 7% of the 20-50 year cohort. Group 1 VDPVs were highly neurovirulent in a transgenic mouse model. Intermediate levels of protective immunity against Group 2 VDPVs correlated with fewer (5.0+1.0) amino acid substitutions in neutralizing antigenic sites than in Group 1 VDPV's (12.1+/-1.5). SIGNIFICANCE: VDPVs that revert from live oral attenuated vaccines and reacquire characteristics of wild-type polioviruses not only threaten populations with poor immune coverage, but are also a potential source for re-introduction of poliomyelitis into highly immune populations through older individuals with waning immunity. The presence of two independently evolved groups of VDPVs in Israel and the growing number of reports of environmental VDPV elsewhere make it imperative to determine the global frequency of environmental VDPV. Our study underscores the importance of the environmental surveillance and the need to reconsider the global strategies for polio eradication and the proposed cessation of vaccination.

Dataset Information

Response to Vaccine-Derived Polioviruses Detected through Environmental Surveillance, Guatemala, 2019.

Publications

Response to Vaccine-Derived Polioviruses Detected through Environmental Surveillance, Guatemala, 2019.

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