Dataset Information

Circulation of Type 2 Vaccine-Derived Poliovirus in China in 2018-2019.

ABSTRACT:

Background

China implemented the globally synchronized switch from trivalent oral poliovirus vaccine (tOPV) to bivalent OPV (bOPV) on May 1, 2016. During April 2018 to May 2019, the first outbreak caused by type 2 circulating vaccine-derived poliovirus (cVDPV2) after the switch occurred in Xinjiang and Sichuan, China. Methods. We performed sequence analysis of VP1 and the whole genome to determine the genomic characteristics of type 2 cVDPVs, and carried out coverage surveys to assess the risk of viral propagation. Surveillance for environment and acute flaccid paralysis was intensified to enhance case ascertainment. Results. Comparison of the complete genomes between early (Xinjiang strain) and late strains (Sichuan strains) revealed that recombination pattern and reverse mutation of attenuation sites had been fixed early, but the mutations of the neutralizing antigenic sites were introduced over the circulation. The Markov Chain Monte Carlo tree showed that the cVDPV2 initial infection was April 2016, earlier than the switch. So, we speculated that the cVDPV2 was originated from tOPV recipients and spread among children with a low level of immunity against the type 2.

Conclusions

The detection of this outbreak combined acute flaccid paralysis (AFP) surveillance with environmental surveillance (ES) indicates that ES should be expanded geographically to further complement AFP surveillance.

SUBMITTER: Zhao H

PROVIDER: S-EPMC8677525 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Publications

Circulation of Type 2 Vaccine-Derived Poliovirus in China in 2018-2019.

Zhao Hehe H Ma Xiaozhen X Tang Haishu H Zhang Yong Y Chen Na N Kaisaier Wusiman W Wang Qi Q Wang Cheng C Zhu Shuangli S Qi Qi Q Liu Yu Y Ma Qianli Q Yang Qing Q Li Junhan J Wang Dongyan D Li Xiaolei X Xiao Jinbo J Zhu Hui H Xu Wenbo W Tong Wenbin W Yan Dongmei D

Open forum infectious diseases 20211017 12

<h4>Background</h4>China implemented the globally synchronized switch from trivalent oral poliovirus vaccine (tOPV) to bivalent OPV (bOPV) on May 1, 2016. During April 2018 to May 2019, the first outbreak caused by type 2 circulating vaccine-derived poliovirus (cVDPV2) after the switch occurred in Xinjiang and Sichuan, China. <b><i>Methods.</i></b> We performed sequence analysis of VP1 and the whole genome to determine the genomic characteristics of type 2 cVDPVs, and carried out coverage survey ...[more]

PMID: 34926714

Similar Datasets

Project description:ImportanceThe Sabin-strain inactivated poliovirus vaccine (IPV) may be a tool for polio outbreak response in certain situations.ObjectiveTo investigate the response to a type 2 vaccine-derived poliovirus (VDPV2) outbreak.Design, setting, and participantsThis case series was conducted in China after a VDPV2 was detected in stool specimens from a child with acute flaccid paralysis (AFP) in Sichuan Province in 2019, 3 years after the global withdrawal of live, attenuated type 2 oral poliovirus vaccine (OPV). Investigation followed National Health Commission and World Health Organization guidance and included searching hospitals for unreported AFP cases; testing stool specimens from the child, his contacts, and local children; enhanced environmental surveillance for VDPV2s in wastewater; and measuring vaccination coverage. Sabin-strain IPV campaigns were conducted in a wide geographic area.Main outcomes and measuresAny VDPV2 detection after completion of the supplementary immunization activities.ResultsA 28-nucleotide-change VDPV2 was isolated from a young boy. Three VDPV2s were detected in healthy children; 2 were contacts of the original child, and none had paralysis. A search of 31 million hospital records found 10 unreported AFP cases; none were polio. No type 2 polioviruses were found in wastewater. Prior to the event, polio vaccine coverage was 65% among children younger than 5 years. Sabin-strain IPV campaigns reached more than 97% of targeted children, administering 1.4 million doses. No transmission source was identified. More than 1 year of enhanced poliovirus environmental and AFP surveillance detected no additional VDPVs.Conclusions and relevanceThese findings suggest that the circulating VPDV2 outbreak in 2019 was associated with low vaccine coverage. An investigation discovered 3 infected but otherwise healthy children and no evidence of the virus in wastewater. Following Sabin-strain IPV-only campaigns expanding from county to prefecture, the poliovirus was not detected, and the outbreak response was considered by an expert panel and the World Health Organization to have been successful. This success suggests that the Sabin-strain IPV may be a useful tool for responding to circulating VDPV2 outbreaks when high-quality supplementary immunization activities can be conducted and carefully monitored in settings with good sanitation.

Dataset Information

Circulation of Type 2 Vaccine-Derived Poliovirus in China in 2018-2019.

Background

Conclusions

Publications

Circulation of Type 2 Vaccine-Derived Poliovirus in China in 2018-2019.

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