[PubMed] [Google Scholar] 23. 1 in 3 individuals and serotype 3 in 1 patient). Sequencing exposed more than 99% homology with homotypic Sabin strains, suggesting LY2812223 recent illness. Duration of viral excretion ranged from 1 to 7 weeks. Nine out of eleven isolates from your three poliovirus serotype 1-infected individuals disclosed a non-Sabin-like phenotype by enzyme-linked immunosorbent assay and experienced recurrent mutations within or close to the neutralizing antigenic sites. In summary, the risk of secondary illness in immunodeficient individuals is within the range previously reported for the general population. Although none of the four infected individuals developed long term viral excretion, particular viral variants were selected and may become of epidemiological significance. In 1988, the World Health Assembly committed the World Health Corporation (WHO) to global eradication of poliomyelitis by the year 2000 (34). The global eradication system has emphasized the use of oral poliovirus vaccine (OPV), considering its several advantages, compared to the inactivated vaccine, i.e., its low cost, the logistic ease of its administration, and its ability to induce local gut immunity. During the last decade, the use of OPV was prolonged LY2812223 through mass campaigns which proved to be highly effective in interrupting crazy virus transmission. This strategy aims to displace circulating crazy polioviruses with vaccine-derived strains through considerable and synchronized national immunization days (NIDs). Once crazy polioviruses are eradicated, vaccine-derived strains may then rapidly disappear from the community after cessation of immunization with OPV. Studies carried out in Cuba, where OPV is definitely specifically delivered through mass campaigns, shown that OPV strains become undetectable, in young children and in the environment, 3 months after the last immunization round (24, 26). These features are certainly due to the limited survival of polioviruses in the environment and to the absence of long-term carrier state for polioviruses LY2812223 in immunocompetent individuals (1, 10). In contrast, individuals with immunodeficiencies may excrete polioviruses for a number of weeks and even years. In addition to the enhanced risk of emergence of a neurovirulent revertant causing paralytic disease in those individuals (16, 19), the long-term excretion of polioviruses may constitute a potentially protracted source of illness in the posteradication era (13, 19). Recent findings, in Egypt (36), the Dominican Republic, and Haiti (27) shown that OPV strains that reverted to neurovirulence Notch4 are capable of sustained blood circulation, a characteristic of wild-type viruses. Therefore, a better understanding of the mechanisms and epidemiological situations favoring the blood circulation and transmission of OPV strains may shed light on the most appropriate vaccination strategies in the posteradication era. Good WHO’s LY2812223 strategy for eradicating poliomyelitis, a two-round NID was carried out in October and November 1996 in Tunisia. All children under 5 years received two doses of OPV. The present study was carried out in 16 children with well-characterized main immunodeficiencies (4), therefore excluded from OPV vaccination during the NIDs, to assess the risk of community-acquired poliovirus illness in these individuals and to study the dynamics of enteric viral excretion and the genetic variance of excreted viruses. MATERIALS AND METHODS Patients. Sixteen individuals with various main immunodeficiencies were investigated (Table ?(Table1).1). The certain diagnosis was founded according to the International Union of Immunological Societies classification (17): X-linked agammaglobulinemia (X-LA) (= 4), common variable immunodeficiency (CVID) (= 2), X-linked hyper-immunoglobulin M syndrome (X-LHIGM) (= 5), T-cell activation deficiency (TCAD, = 1), idiopathic disseminated BCGitis (= 1), and chronic granulomatous disease (CGD) (= 3). Patient characteristics are outlined in Table ?Table1.1. The children lived in eight different districts of the country. None was given OPV during the two NID rounds (14 October and 16 November 1996). Thirteen experienced uneventfully received OPV during the 1st yr of age, before their immunodeficiency was diagnosed. Ten individuals were under substitutive intramuscular immunoglobulin therapy when the study was carried out. TABLE 1. Clinical features and polio vaccination status of immunodeficient individuals in this study= 11) and poliovirus type 3 (= 2) isolates: therefore, a positive signal was acquired with homotypic Sabin-specific probes (Fig. ?(Fig.2)2) and RFLP analysis of the VP1/2A region using em Hae /em III, em Hpa /em II, and em Dde /em I restriction enzymes, gave a pattern similar.
