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Dolgova AS, Kanaeva OI, Antonov SA, Shabalina AV, Klyuchnikova EO, Sbarzaglia VA, Gladkikh AS, Ivanova OE, Kozlovskaya LI, Dedkov VG. Qualitative real-time RT-PCR assay for nOPV2 poliovirus detection. J Virol Methods 2024; 329:114984. [PMID: 38885908 DOI: 10.1016/j.jviromet.2024.114984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
Based on the success of the Sabin2-based vaccine, a next-generation nOPV2 poliovirus vaccine has been developed. For epidemic monitoring and conducting epidemiological investigations, it is necessary to have a diagnostic assay with the ability to differentiate this variant from others. Here we describe such a real-time RT-PCR assay. The region with the cre insertion in the 5'-UTR was chosen as the target, and the limit of detection was 103 copies/mL (2.5×103 copies/mL using Probit analysis) determined using armored RNA particles. Sensitivity and specificity were 86.28 - 100 % and 76.84 - 100 %, respectively (with 95 % CI). Thus, this method can be effectively used when it is necessary to make a differential diagnosis of poliovirus strains.
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Affiliation(s)
- A S Dolgova
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia.
| | - O I Kanaeva
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia
| | - S A Antonov
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia
| | - A V Shabalina
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia
| | - E O Klyuchnikova
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia
| | - V A Sbarzaglia
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia
| | - A S Gladkikh
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia
| | - O E Ivanova
- Federal State Autonomous Scientific Institution "Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences" (Institute of Poliomyelitis), Moscow, Russia; Department of Organization and Technology of Production of Immunobiological Preparations, Institute for Translational Medicine and Biotechnology, First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - L I Kozlovskaya
- Federal State Autonomous Scientific Institution "Chumakov Federal Center for Research and Development of Immune-and-Biological Products of the Russian Academy of Sciences" (Institute of Poliomyelitis), Moscow, Russia; Department of Organization and Technology of Production of Immunobiological Preparations, Institute for Translational Medicine and Biotechnology, First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V G Dedkov
- Saint Petersburg Pasteur Institute, Federal Service on Consumer Rights Protection and Human Well-Being Surveillance, Saint Petersburg, Russia; Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
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Mejía LR, Mendez LP, Rüttimann RW, Gast C, Bandyopadhyay AS. Safety and Immunogenicity of Trivalent Oral Polio Vaccine in Vaccinated Children and Vaccine-Naïve Infants: A Phase 4 Study. Vaccines (Basel) 2024; 12:953. [PMID: 39339985 PMCID: PMC11436059 DOI: 10.3390/vaccines12090953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/14/2024] [Accepted: 08/15/2024] [Indexed: 09/30/2024] Open
Abstract
In the context of polio eradication, novel oral polio vaccines for type 2 (nOPV2) were developed, and types 1 and 3 polioviruses are being developed. We aimed to generate trivalent oral poliovirus vaccine (tOPV) safety and immunogenicity data as a reference for comparing with novel OPV formulations. This was a single-center, open-label, phase 4 study in March 2016 in the Dominican Republic with healthy children previously vaccinated with ≥3 doses of tOPV receiving one dose of tOPV and vaccine-naïve infants receiving 3 doses of tOPV. Safety and immunogenicity were assessed. No serious adverse reactions or important medical reactions were reported. Seroconversion (SC) rates at Day 28 in children were 32.7%, 36.7%, and 46.9% for types 1, 2, and 3, respectively, and seroprotection (SP) rates 28 days after one dose increased from 89.8% at baseline to 93.9%, 98.0% to 100%, and 83.7% to 98.0% for types 1, 2, and 3, respectively. In infants, SC rates were 88.5%, 98.1%, and 96.2% for types 1, 2, and 3, respectively. SP rates at Day 84 were 93.3%, 100%, and 96.2% for types 1, 2, and 3, respectively. This information can be used as a reference to compare with novel monovalent or trivalent OPVs under development.
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Affiliation(s)
- Luis Rivera Mejía
- Hospital Universitario Maternidad Nuestra Señora de la Altagracia, Fundación Dominicana de Perinatología PROBEBE, Calle Pedro Henríquez Ureña #49, Santo Domingo 10205, Dominican Republic
| | - Lourdes Peña Mendez
- Clínica Cruz Jiminian, Av Ortega y Gasset 90, Santo Domingo 10501, Dominican Republic
| | - Ricardo W Rüttimann
- Fighting Infectious Diseases in Emerging Countries (FIDEC), 2050 Coral Way, Suite 407, Miami, FL 33145, USA
| | - Chris Gast
- Independent Biostatistician Consultant, Seattle, WA 98029, USA
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Sun Y, Keskinocak P, Steimle LN, Kovacs SD, Wassilak SG. Modeling the spread of circulating vaccine-derived poliovirus type 2 outbreaks and interventions: A case study of Nigeria. Vaccine X 2024; 18:100476. [PMID: 38617838 PMCID: PMC11011220 DOI: 10.1016/j.jvacx.2024.100476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
Background Despite the successes of the Global Polio Eradication Initiative, substantial challenges remain in eradicating the poliovirus. The Sabin-strain (live-attenuated) virus in oral poliovirus vaccine (OPV) can revert to circulating vaccine-derived poliovirus (cVDPV) in under-vaccinated communities, regain neurovirulence and transmissibility, and cause paralysis outbreaks. Since the cessation of type 2-containing OPV (OPV2) in 2016, there have been cVDPV type 2 (cVDPV2) outbreaks in four out of six geographical World Health Organization regions, making these outbreaks a significant public health threat. Preparing for and responding to cVDPV2 outbreaks requires an updated understanding of how different factors, such as outbreak responses with the novel type of OPV2 (nOPV2) and the existence of under-vaccinated areas, affect the disease spread. Methods We built a differential-equation-based model to simulate the transmission of cVDPV2 following reversion of the Sabin-strain virus in prolonged circulation. The model incorporates vaccinations by essential (routine) immunization and supplementary immunization activities (SIAs), the immunity induced by different poliovirus vaccines, and the reversion process from Sabin-strain virus to cVDPV. The model's outcomes include weekly cVDPV2 paralytic case counts and the die-out date when cVDPV2 transmission stops. In a case study of Northwest and Northeast Nigeria, we fit the model to data on the weekly cVDPV2 case counts with onset in 2018-2021. We then used the model to test the impact of different outbreak response scenarios during a prediction period of 2022-2023. The response scenarios included no response, the planned response (based on Nigeria's SIA calendar), and a set of hypothetical responses that vary in the dates at which SIAs started. The planned response scenario included two rounds of SIAs that covered almost all areas of Northwest and Northeast Nigeria except some under-vaccinated areas (e.g., Sokoto). The hypothetical response scenarios involved two, three, and four rounds of SIAs that covered the whole Northwest and Northeast Nigeria. All SIAs in tested outbreak response scenarios used nOPV2. We compared the outcomes of tested outbreak response scenarios in the prediction period. Results Modeled cVDPV2 weekly case counts aligned spatiotemporally with the data. The prediction results indicated that implementing the planned response reduced total case counts by 79% compared to no response, but did not stop the transmission, especially in under-vaccinated areas. Implementing the hypothetical response scenarios involving two rounds of nOPV2 SIAs that covered all areas further reduced cVDPV2 case counts in under-vaccinated areas by 91-95% compared to the planned response, with greater impact from completing the two rounds at an earlier time, but it did not stop the transmission. When the first two rounds were completed in early April 2022, implementing two additional rounds stopped the transmission in late January 2023. When the first two rounds were completed six weeks earlier (i.e., in late February 2022), implementing one (two) additional round stopped the transmission in early February 2023 (late November 2022). The die out was always achieved last in the under-vaccinated areas of Northwest and Northeast Nigeria. Conclusions A differential-equation-based model of poliovirus transmission was developed and validated in a case study of Northwest and Northeast Nigeria. The results highlighted (i) the effectiveness of nOPV2 in reducing outbreak case counts; (ii) the need for more rounds of outbreak response SIAs that covered all of Northwest and Northeast Nigeria in 2022 to stop the cVDPV2 outbreaks; (iii) that persistent transmission in under-vaccinated areas delayed the progress towards stopping outbreaks; and (iv) that a quicker outbreak response would avert more paralytic cases and require fewer SIA rounds to stop the outbreaks.
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Affiliation(s)
- Yuming Sun
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Pinar Keskinocak
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Lauren N. Steimle
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA
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Xu J, Liu Y, Qiu W, Li W, Hu X, Li X, Fan Q, Tang W, Wang Y, Wang Q, Yao N. Immunogenicity evaluation of primary polio vaccination schedule with inactivated poliovirus vaccines and bivalent oral poliovirus vaccine. BMC Infect Dis 2024; 24:535. [PMID: 38807038 PMCID: PMC11131326 DOI: 10.1186/s12879-024-09389-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 05/08/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND To assess the immunogenicity of the current primary polio vaccination schedule in China and compare it with alternative schedules using Sabin or Salk-strain IPV (sIPV, wIPV). METHODS A cross-sectional investigation was conducted at four sites in Chongqing, China, healthy infants aged 60-89 days were conveniently recruited and divided into four groups according to their received primary polio vaccination schedules (2sIPV + bOPV, 2wIPV + bOPV, 3sIPV, and 3wIPV). The sero-protection and neutralizing antibody titers against poliovirus serotypes (type 1, 2, and 3) were compared after the last dose. RESULTS There were 408 infants completed the protocol. The observed seropositivity was more than 96% against poliovirus types 1, 2, and 3 in all groups. IPV-only groups induced higher antibody titers(GMT) against poliovirus type 2 (Median:192, QR: 96-384, P<0.05) than the "2IPV + bOPV" group. While the "2IPV + bOPV" group induced significantly higher antibody titers against poliovirus type 1 (Median:2048, QR: 768-2048, P<0.05)and type 3 (Median:2048, QR: 512-2048, P<0.05) than the IPV-only group. CONCLUSIONS Our findings have proved that the two doses of IPV with one dose of bOPV is currently the best polio routine immunization schedule in China.
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Affiliation(s)
- Jiawei Xu
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, No.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Yang Liu
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, No.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Wei Qiu
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, No.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Wenwen Li
- EPI Department, Hechuan District Center Disease Control and Prevention, Chongqing, China
| | - Xiaoxiao Hu
- EPI Department, Liangping District Center Disease Control and Prevention, Chongqing, China
| | - Xia Li
- EPI Department, Rongchang District Center Disease Control and Prevention, Chongqing, China
| | - Qiang Fan
- EPI Department, Zhongxian County Center Disease Control and Prevention, Chongqing, China
| | - Wenge Tang
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, No.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Yujie Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qing Wang
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, No.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China.
| | - Ning Yao
- EPI Department, Chongqing Municipal Center for Disease Control and Prevention, No.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China.
- Department of Health Statistics, College of Preventive Medicine, Army Medical University, Chongqing, 400038, China.
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Devaux CA, Pontarotti P, Levasseur A, Colson P, Raoult D. Is it time to switch to a formulation other than the live attenuated poliovirus vaccine to prevent poliomyelitis? Front Public Health 2024; 11:1284337. [PMID: 38259741 PMCID: PMC10801389 DOI: 10.3389/fpubh.2023.1284337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
The polioviruses (PVs) are mainly transmitted by direct contact with an infected person through the fecal-oral route and respiratory secretions (or more rarely via contaminated water or food) and have a primary tropism for the gut. After their replication in the gut, in rare cases (far less than 1% of the infected individuals), PVs can spread to the central nervous system leading to flaccid paralysis, which can result in respiratory paralysis and death. By the middle of the 20th century, every year the wild polioviruses (WPVs) are supposed to have killed or paralyzed over half a million people. The introduction of the oral poliovirus vaccines (OPVs) through mass vaccination campaigns (combined with better application of hygiene measures), was a success story which enabled the World Health Organization (WHO) to set the global eradication of poliomyelitis as an objective. However this strategy of viral eradication has its limits as the majority of poliomyelitis cases today arise in individuals infected with circulating vaccine-derived polioviruses (cVDPVs) which regain pathogenicity following reversion or recombination. In recent years (between January 2018 and May 2023), the WHO recorded 8.8 times more cases of polio which were linked to the attenuated OPV vaccines (3,442 polio cases after reversion or recombination events) than cases linked to a WPV (390 cases). Recent knowledge of the evolution of RNA viruses and the exchange of genetic material among biological entities of the intestinal microbiota, call for a reassessment of the polio eradication vaccine strategies.
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Affiliation(s)
- Christian Albert Devaux
- Laboratory Microbes Evolution Phylogeny and Infection (MEPHI), Aix-Marseille Université, IRD, APHM, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
- Centre National de la Recherche Scientifique (CNRS-SNC5039), Marseille, France
| | - Pierre Pontarotti
- Laboratory Microbes Evolution Phylogeny and Infection (MEPHI), Aix-Marseille Université, IRD, APHM, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
- Centre National de la Recherche Scientifique (CNRS-SNC5039), Marseille, France
| | - Anthony Levasseur
- Laboratory Microbes Evolution Phylogeny and Infection (MEPHI), Aix-Marseille Université, IRD, APHM, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Philippe Colson
- Laboratory Microbes Evolution Phylogeny and Infection (MEPHI), Aix-Marseille Université, IRD, APHM, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Laboratory Microbes Evolution Phylogeny and Infection (MEPHI), Aix-Marseille Université, IRD, APHM, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
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Manukyan H, Tritama E, Wahid R, Anstadt J, Konz J, Chumakov K, Laassri M. Improvement of the qmosRT-PCR Assay and Its Application for the Detection and Quantitation of the Three Serotypes of the Novel Oral Polio Vaccine in Stool Samples. Vaccines (Basel) 2023; 11:1729. [PMID: 38006061 PMCID: PMC10675353 DOI: 10.3390/vaccines11111729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Recently, genetically stable novel OPVs (nOPV) were developed by modifying the genomes of Sabin viruses of conventional OPVs to reduce the risk of reversion to neurovirulence and therefore the risk of generating circulating vaccine-derived polioviruses. There is a need for specific and sensitive methods for the identification and quantification of nOPV viruses individually and in mixtures for clinical trials and potentially for manufacturing quality control and environmental surveillance. In this communication, we evaluated and improved the quantitative multiplex one-step reverse transcriptase polymerase chain reaction (qmosRT-PCR) assay for the identification and quantification of nOPV viruses in samples with different formulations and virus concentrations and in virus-spiked stool samples. The assay was able to specifically identify at least 1 log10 CCID50/mL of each serotype in the presence of the two other serotypes at high concentrations (6-7 log10 CCID50/mL) in the same sample. In addition, the lowest viral concentration that the assay was able to detect in stool samples was 17 CCID50/mL for nOPV1 and nOPV2 viruses and 6 CCID50/mL for nOPV3. We also found high correlation between the expected and observed (by qmosRT-PCR) concentrations of spiked viruses in stool samples for all three nOPV viruses, with R-squared values above 0.95. The analysis of samples collected from an nOPV2 clinical trial showed that 100% of poliovirus type 2 was detected and few samples showed the presence of type 1 and 3 residuals from previous vaccinations with bOPV (at least 4 weeks prior vaccination with nOPV2), confirming the high sensitivity of the method. The qmosRT-PCR was specific and sensitive for the simultaneous identification and quantification of all three nOPV viruses. It can be used as an identity test during the nOPV manufacturing process and in evaluation of virus excretion in nOPV clinical trials.
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Affiliation(s)
- Hasmik Manukyan
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Erman Tritama
- Research and Development Division, PT. BioFarma, Bandung 40161, Indonesia
| | - Rahnuma Wahid
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA (J.A.)
| | - Jennifer Anstadt
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA (J.A.)
| | - John Konz
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA (J.A.)
| | - Konstantin Chumakov
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Majid Laassri
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
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Surekha S, Kumar A, Kasana H, Meena J, Sayal A. Comparative Evaluation of HEP-2(Cincinnati) and Vero cell lines sensitivity to Bivalent Oral Polio Virus Vaccine (Type 1 and Type 3) by using In-vitro Microtitration Potency Assay. RESEARCH JOURNAL OF PHARMACY AND TECHNOLOGY 2023:4719-4722. [DOI: 10.52711/0974-360x.2023.00766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Background: Poliomyelitis is a severe viral infectious disease caused by poliovirus and usually, children under the age of 5 years are affected mostly who are not immunized or fully vaccinated. For precise evaluation of quality control testing of the vaccine is based on three parameters i.e. Identity, efficacy and safety. One of the most important test is potency to know about the efficacy and well-founded results in quality control of vaccines. Objectives: To evaluate the and compare sensitivity of HEP-2(Cincinnati) and Vero cell lines to Bivalent Oral Polio Virus Vaccine (Type 1 and Type 3) Methods: The sensitivity of Hep 2-c and Vero cell lines were compared by using a cell culture-based potency test based on CCID 50 /SHD. Results: Present study showed that the Hep 2-C is most sensitive for bOPV (Type1 and Type3) and the Vero cell line is less sensitive for Type 3 Virus. The Vero cell line is similarly sensitive as Hep 2-c for Type1 virus and TVC (Total Virus Count) of bOPV. Conclusions: The present study, suggest that the Vero cell line can also be used for the Potency assay of TVC (Total Virus Count) and Type1 in bivalent oral polio vaccine or monovalent (Type1) OPV along with Hep 2-c cell line.
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Affiliation(s)
- Surekha Surekha
- National Institute of Biologicals, Sector - 62, Noida, Uttar Pradesh – 201309
| | - Anoop Kumar
- National Institute of Biologicals, Sector - 62, Noida, Uttar Pradesh – 201309
| | - Harit Kasana
- National Institute of Biologicals, Sector - 62, Noida, Uttar Pradesh – 201309
| | - Jaipal Meena
- National Institute of Biologicals, Sector - 62, Noida, Uttar Pradesh – 201309
| | - Archana Sayal
- National Institute of Biologicals, Sector - 62, Noida, Uttar Pradesh – 201309
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Liu S, Yu CY, Wei H. Spherical nucleic acids-based nanoplatforms for tumor precision medicine and immunotherapy. Mater Today Bio 2023; 22:100750. [PMID: 37545568 PMCID: PMC10400933 DOI: 10.1016/j.mtbio.2023.100750] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023] Open
Abstract
Precise diagnosis and treatment of tumors currently still face considerable challenges due to the development of highly degreed heterogeneity in the dynamic evolution of tumors. With the rapid development of genomics, personalized diagnosis and treatment using specific genes may be a robust strategy to break through the bottleneck of traditional tumor treatment. Nevertheless, efficient in vivo gene delivery has been frequently hampered by the inherent defects of vectors and various biological barriers. Encouragingly, spherical nucleic acids (SNAs) with good modularity and programmability are excellent candidates capable of addressing traditional gene transfer-associated issues, which enables SNAs a precision nanoplatform with great potential for diverse biomedical applications. In this regard, there have been detailed reviews of SNA in drug delivery, gene regulation, and dermatology treatment. Still, to the best of our knowledge, there is no published systematic review summarizing the use of SNAs in oncology precision medicine and immunotherapy, which are considered new guidelines for oncology treatment. To this end, we summarized the notable advances in SNAs-based precision therapy and immunotherapy for tumors following a classification standard of different types of precise spatiotemporal control on active species by SNAs. Specifically, we focus on the structural diversity and programmability of SNAs. Finally, the challenges and possible solutions were discussed in the concluding remarks. This review will promote the rational design and development of SNAs for tumor-precise medicine and immunotherapy.
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Affiliation(s)
- Songbin Liu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Cui-Yun Yu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Hua Wei
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, 421001, China
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9
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Wong W, Gauld J, Famulare M. From vaccine to pathogen: Modeling Sabin 2 vaccine virus reversion and evolutionary epidemiology in Matlab, Bangladesh. Virus Evol 2023; 9:vead044. [PMID: 37692896 PMCID: PMC10491863 DOI: 10.1093/ve/vead044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 06/26/2023] [Accepted: 07/07/2023] [Indexed: 09/12/2023] Open
Abstract
The oral poliovirus vaccines (OPVs) are one of the most effective disease eradication tools in public health. However, the OPV strains are genetically unstable and can cause outbreaks of circulating, vaccine-derived Type 2 poliovirus (cVDPV2) that are clinically indistinguishable from wild poliovirus (WPV) outbreaks. Here, we developed a Sabin 2 reversion model that simulates the reversion of Sabin 2 to reacquire a WPV-like phenotype based on the clinical differences in shedding duration and infectiousness between individuals vaccinated with Sabin 2 and those infected with WPV. Genetic reversion is informed by a canonical reversion pathway defined by three gatekeeper mutations (A481G, U2909C, and U398C) and the accumulation of deleterious nonsynonymous mutations. Our model captures essential aspects of both phenotypic and molecular evolution and simulates transmission using a multiscale transmission model that consolidates the relationships among immunity, susceptibility, and transmission risk. Despite rapid Sabin 2 attenuation reversal, we show that the emergence of a revertant virus does not guarantee a cVDPV2 outbreak. When simulating outbreaks in Matlab, Bangladesh, we found that cVDPV2 outbreaks are most likely in areas with low population-level immunity and poor sanitation. In Matlab, our model predicted that declining immunity against Type 2 poliovirus following the cessation of routine OPV vaccination was not enough to promote cVDPV2 emergence. However, cVDPV2 emergencedepended on the average viral exposure dose per contact, which was modeled as a combination of the viral concentration per fecal gram and the average fecal-oral dose per contact. These results suggest that cVDPV2 emergence risk can be mitigated by reducing the amount of infectious fecal material individuals are exposed to. Thus, a combined strategy of assessing and improving sanitation levels in conjunction with high-coverage vaccination campaigns could limit the future cVDPV2 emergence.
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Affiliation(s)
- Wesley Wong
- Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, SPH 1, Boston, MA 02115, USA
| | - Jillian Gauld
- Institute for Disease Modeling, Bill and Melinda Gates Foundation, 500 5th Ave N, Seattle, WA 98109, USA
| | - Michael Famulare
- Institute for Disease Modeling, Bill and Melinda Gates Foundation, 500 5th Ave N, Seattle, WA 98109, USA
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Gray EJ, Cooper LV, Bandyopadhyay AS, Blake IM, Grassly NC. The Origins and Risk Factors for Serotype-2 Vaccine-Derived Poliovirus Emergences in Africa During 2016-2019. J Infect Dis 2023; 228:80-88. [PMID: 36630295 PMCID: PMC10304761 DOI: 10.1093/infdis/jiad004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/23/2022] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
Serotype 2 oral poliovirus vaccine (OPV2) can revert to regain wild-type neurovirulence and spread to cause emergences of vaccine-derived poliovirus (VDPV2). After its global withdrawal from routine immunization in 2016, outbreak response use has created a cycle of VDPV2 emergences that threaten eradication. We implemented a hierarchical model based on VP1 region genetic divergence, time, and location to attribute emergences to campaigns and identify risk factors. We found that a 10 percentage point increase in population immunity in children younger than 5 years at the campaign time and location corresponds to a 18.0% decrease (95% credible interval [CrI], 6.3%-28%) in per-campaign relative risk, and that campaign size is associated with emergence risk (relative risk scaling with population size to a power of 0.80; 95% CrI, .50-1.10). Our results imply how Sabin OPV2 can be used alongside the genetically stable but supply-limited novel OPV2 (listed for emergency use in November 2020) to minimize emergence risk.
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Affiliation(s)
- Elizabeth J Gray
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Laura V Cooper
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | | | - Isobel M Blake
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Nicholas C Grassly
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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11
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Yu-Ping Z, Jing L, Teng H, Zhi-Fang Y, Ting Z, Yan-Chun C, Zhi-Mei Z, Yu-Ting F, Jun-Hui T, Qing-Hai Y, Ding-Kai W, Guo-Liang L, Xiao-Lei Y, Li Y, Hong-Bo C, Jian-Feng W, Rui-Ju J, Lei Y, Wei C, Wei Y, Ming-Xue X, Qiong-Zhou Y, Jing P, Li S, Chao H, Yan D, Lu-Kui C, Jian Z, Yu W, Hong-Sen L, Wei H, Zhao-Jun M, Chang-Gui L, Qi-Han L, Jing-Si Y. Evaluation of the immunization effectiveness of bOPV booster immunization and IPV revaccination. NPJ Vaccines 2023; 8:44. [PMID: 36934085 PMCID: PMC10024706 DOI: 10.1038/s41541-023-00642-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/07/2023] [Indexed: 03/20/2023] Open
Abstract
To provide a basis for further optimization of the polio sequential immunization schedule, this study evaluated the effectiveness of booster immunization with one dose of bivalent oral poliovirus vaccine (bOPV) at 48 months of age after different primary polio immunization schedules. At 48 months of age, one dose of bOPV was administered, and their poliovirus types 1-3 (PV1, PV2, and PV3, respectively)-specific neutralizing antibody levels were determined. Participants found to be negative for any type of PV-specific neutralizing antibody at 24, 36, or 48 months of age were re-vaccinated with inactivated polio vaccine (IPV). The 439 subjects who received a bOPV booster immunization at the age of 48 months had lower PV2-specific antibody levels compared with those who received IPV. One dose of IPV during basic polio immunization induced the lowest PV2-specific antibody levels. On the basis of our findings, to ensure that no less than 70% of the vaccinated have protection efficiency, we recommend the following: if basic immunization was conducted with 1IPV + 2bOPV (especially Sabin strain-based IPV), a booster immunization with IPV is recommended at 36 months of age, whereas if basic immunization was conducted with 2IPV + 1bOPV, a booster immunization with IPV is recommended at 48 months of age. A sequential immunization schedule of 2IPV + 1bOPV + 1IPV can not only maintain high levels of antibody against PV1 and PV3 but also increases immunity to PV2 and induces early intestinal mucosal immunity, with relatively good safety. Thus, this may be the best sequential immunization schedule for polio in countries or regions at high risk for polio.
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Affiliation(s)
- Zhao Yu-Ping
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Li Jing
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Huang Teng
- GuangXi Province Center for Disease Prevention and Control, Nanning, China
| | - Ying Zhi-Fang
- National Institutes for Food and Drug Control, Beijing, China
| | - Zhao Ting
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Che Yan-Chun
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Zhao Zhi-Mei
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Fu Yu-Ting
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Tao Jun-Hui
- Liujiang District Center for Disease Prevention and Control, Liuzhou, China
| | - Yang Qing-Hai
- Liucheng County Center for Disease Prevention and Control, Liuzhou, China
| | - Wei Ding-Kai
- Rong'an County Center for Disease Prevention and Control, Liuzhou, China
| | - Li Guo-Liang
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Yang Xiao-Lei
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Yi Li
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Chen Hong-Bo
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
| | - Wang Jian-Feng
- National Institutes for Food and Drug Control, Beijing, China
| | - Jiang Rui-Ju
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Yu Lei
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
| | - Cai Wei
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
| | - Yang Wei
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
| | - Xie Ming-Xue
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
| | - Yin Qiong-Zhou
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Pu Jing
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Shi Li
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Hong Chao
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Deng Yan
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
| | - Cai Lu-Kui
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Zhou Jian
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
| | - Wen Yu
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
| | - Li Hong-Sen
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Huang Wei
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China
| | - Mo Zhao-Jun
- GuangXi Province Center for Disease Prevention and Control, Nanning, China.
| | - Li Chang-Gui
- National Institutes for Food and Drug Control, Beijing, China.
| | - Li Qi-Han
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China.
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China.
| | - Yang Jing-Si
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China.
- National Local Joint Engineering Research Center for Biological Products of Viral Infectious Diseases, Kunming, China.
- Kunming Science and Technology Innovation Centre for Research, Development and Industrialization of New Outbreaks and Emerging Highly Pathogenic Pathogens Vaccines, Kunming, China.
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12
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Durrheim DN. Eliminating all circulating vaccine-derived poliovirus: a prerequisite to declaring global polio eradication. Int Health 2023; 15:109-110. [PMID: 36271900 PMCID: PMC9977216 DOI: 10.1093/inthealth/ihac068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
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13
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Wahid R, Mercer LD, De Leon T, DeAntonio R, Sáez-Llorens X, Macadam A, Chumakov K, Strating J, Koel B, Konopka-Anstadt JL, Oberste MS, Burns CC, Andino R, Tritama E, Bandyopadhyay AS, Aguirre G, Rüttimann R, Gast C, Konz JO. Genetic and phenotypic stability of poliovirus shed from infants who received novel type 2 or Sabin type 2 oral poliovirus vaccines in Panama: an analysis of two clinical trials. THE LANCET. MICROBE 2022; 3:e912-e921. [PMID: 36332645 PMCID: PMC9712124 DOI: 10.1016/s2666-5247(22)00254-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 07/29/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Sabin strains used in oral poliovirus vaccines (OPV) can revert to virulence and, in rare instances, cause disease or generate vaccine-derived strains leading to outbreaks in areas of low immunisation coverage. A novel OPV2 (nOPV2) was designed to stabilise the viral genome against reversion and reduce recombination events that might lead to virulent strains. In this study, we evaluated the genetic and phenotypic stability of shed poliovirus following administration of one dose of monovalent OPV2 (mOPV2) or nOPV2 to infants aged 18-22 weeks. METHODS In two similarly designed clinical trials (NCT02521974 and NCT03554798) conducted in Panama, infants aged 18-22-weeks, after immunisation with three doses of bivalent OPV (types 1 and 3) and one dose of inactivated poliovirus vaccine, were administered one or two doses of mOPV2 or nOPV2. In this analysis of two clinical trials, faecally shed polioviruses following one dose of mOPV2 or nOPV2 were isolated from stools meeting predetermined criteria related to sample timing and viral presence and quantity and assessed for nucleotide polymorphisms using next-generation sequencing. A transgenic mouse neurovirulence test was adapted to assess the effect of the possible phenotypic reversion of shed mOPV2 and nOPV2 with a logistic regression model. FINDINGS Of the 91 eligible samples, 86 were able to be sequenced, with 72 evaluated in the transgenic mouse assay. Sabin-2 poliovirus reverts rapidly at nucleotide 481, the primary attenuation site in domain V of the 5' untranslated region of the genome. There was no evidence of neurovirulence-increasing polymorphisms in domain V of shed nOPV2. Reversion of shed Sabin-2 virus corresponded with unadjusted paralysis rates of 47·6% at the 4 log10 50% cell culture infectious dose (CCID50) and 76·7% at the 5 log10 CCID50 inoculum levels, with rates of 2·8% for 4 log10 CCID50 and 11·8% for 5 log10 CCID50 observed for shed nOPV2 samples. The estimated adjusted odds ratio at 4·5 log10 of 0·007 (95% CI 0·002-0·023; p<0·0001) indicates significantly reduced odds of mouse paralysis from virus obtained from nOPV2 recipients compared with mOPV2 recipients. INTERPRETATION The data indicate increased genetic stability of domain V of nOPV2 relative to mOPV2, with significantly lower neurovirulence of shed nOPV2 virus compared with shed mOPV2. While this vaccine is currently being deployed under an emergency use listing, the data on the genetic stability of nOPV2 will support further regulatory and policy decision-making regarding use of nOPV2 in outbreak responses. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Rahnuma Wahid
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - Laina D Mercer
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - Tirza De Leon
- Hospital Materno Infantil José Domingo De Obaldía, David, Panama,CEVAXIN, Centro de Vacunación e Investigación, Panama City, Panama
| | | | - Xavier Sáez-Llorens
- CEVAXIN, Centro de Vacunación e Investigación, Panama City, Panama,Department of Infectious Diseases, Hospital del Niño Dr José Renán Esquivel and Sistema Nacional de Investigación at Secretaria Nacional de Ciencia y Tecnologia, Panama City, Panama
| | - Andrew Macadam
- Division of Virology, National Institute for Biological Standards and Control, South Mimms, UK
| | - Konstantin Chumakov
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA,Global Virus Network Center of Excellence, Baltimore, MD, USA
| | | | - Björn Koel
- Viroclinics Xplore, Viroclinics Biosciences, Rotterdam, Netherlands
| | | | - M Steven Oberste
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cara C Burns
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Raul Andino
- Department of Microbiology and Immunology, University of California, San Francisco, CA, USA
| | - Erman Tritama
- Research and Development Division, PT Bio Farma, Bandung, West Java, Indonesia
| | | | - Gabriela Aguirre
- Fighting Infectious Diseases in Emerging Countries, Miami, FL, USA
| | | | - Chris Gast
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - John O Konz
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA,Correspondence to: Dr John O Konz, Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
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14
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Razafindratsimandresy R, Joffret ML, Raharinantoanina J, Polston P, Andriamamonjy NS, Razanajatovo IM, Diop OM, Delpeyroux F, Héraud JM, Bessaud M. Strengthened surveillance revealed a rapid disappearance of the poliovirus serotype 2 vaccine strain in Madagascar after its removal from the oral polio vaccine. J Med Virol 2022; 94:5877-5884. [PMID: 35977919 DOI: 10.1002/jmv.28071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 01/06/2023]
Abstract
To assess circulation of the Sabin 2 poliovirus vaccine strain in Madagascar after its withdrawal from the oral polio vaccine in April 2016, a reinforced poliovirus surveillance was implemented in three regions of Madagascar from January 2016 to December 2017. Environmental samples and stool specimens from healthy children were screened using the Global Polio Laboratory Network algorithm to detect the presence of polioviruses. Detected polioviruses were molecularly typed and their genomes fully sequenced. Polioviruses were detected during all but 4 months of the study period. All isolates were related to the vaccine strains and no wild poliovirus was detected. The majority of isolates belong to the serotype 3. The last detection of Sabin 2 occurred in July 2016, 3 months after its withdrawal. No vaccine-derived poliovirus of any serotype was observed during the study. Only few poliovirus isolates contained sequences from non-polio origin. The genetic characterization of all the poliovirus isolates did not identify isolates that were highly divergent compared to the vaccine strains. This observation is in favor of a good vaccine coverage that efficiently prevented long-lasting transmission chains between unvaccinated persons. This study underlines that high commitment in the fight against polioviruses can succeed in stopping their circulation even in countries where poor sanitation remains a hurdle.
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Affiliation(s)
| | | | | | | | | | | | - Ousmane M Diop
- Polio Eradication, Director General's Office, World Health Organization, Geneva, Switzerland
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Quarleri J. Poliomyelitis is a current challenge: long-term sequelae and circulating vaccine-derived poliovirus. GeroScience 2022; 45:707-717. [PMID: 36260265 PMCID: PMC9886775 DOI: 10.1007/s11357-022-00672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/12/2022] [Indexed: 02/03/2023] Open
Abstract
For more than 20 years, the World Health Organization Western Pacific Region (WPR) has been polio-free. However, two current challenges are still polio-related. First, around half of poliomyelitis elderly survivors suffer late poliomyelitis sequelae with a substantial impact on daily activities and quality of life, experiencing varying degrees of residual weakness as they age. The post-polio syndrome as well as accelerated aging may be involved. Second, after the worldwide Sabin oral poliovirus (OPV) vaccination, the recent reappearance of strains of vaccine-derived poliovirus (VDPV) circulating in the environment is worrisome and able to persistent person-to-person transmission. Such VDPV strains exhibit atypical genetic characteristics and reversed neurovirulence that can cause paralysis similarly to wild poliovirus, posing a significant obstacle to the elimination of polio. Immunization is essential for preventing paralysis in those who are exposed to the poliovirus. Stress the necessity of maintaining high vaccination rates because declining immunity increases the likelihood of reemergence. If mankind wants to eradicate polio in the near future, measures to raise immunization rates and living conditions in poorer nations are needed, along with strict observation. New oral polio vaccine candidates offer a promissory tool for this goal.
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Affiliation(s)
- Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina. .,Consejo de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
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16
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Han Z, Xiao J, Song Y, Zhao X, Sun Q, Lu H, Zhang K, Li J, Li J, Si F, Zhang G, Zhao H, Jia S, Zhou J, Wang D, Zhu S, Yan D, Xu W, Fu X, Zhang Y. Highly diverse ribonucleic acid viruses in the viromes of eukaryotic host species in Yunnan province, China. Front Microbiol 2022; 13:1019444. [PMID: 36312977 PMCID: PMC9606678 DOI: 10.3389/fmicb.2022.1019444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background The diversity in currently documented viruses and their morphological characteristics indicates the need for understanding the evolutionary characteristics of viruses. Notably, further studies are needed to obtain a comprehensive landscape of virome, the virome of host species in Yunnan province, China. Materials and methods We implemented the metagenomic next-generation sequencing strategy to investigate the viral diversity, which involved in 465 specimens collected from bats, pangolins, monkeys, and other species. The diverse RNA viruses were analyzed, especially focusing on the genome organization, genetic divergence and phylogenetic relationships. Results In this study, we investigated the viral composition of eight libraries from bats, pangolins, monkeys, and other species, and found several diverse RNA viruses, including the Alphacoronavirus from bat specimens. By characterizing the genome organization, genetic divergence, and phylogenetic relationships, we identified five Alphacoronavirus strains, which shared phylogenetic association with Bat-CoV-HKU8-related strains. The pestivirus-like virus related to recently identified Dongyang pangolin virus (DYPV) strains from dead pangolin specimens, suggesting that these viruses are evolving. Some genomes showed higher divergence from known species (e.g., calicivirus CS9-Cali-YN-CHN-2020), and many showed evidence of recombination events with unknown or known strains (e.g., mamastroviruses BF2-astro-YN-CHN-2020 and EV-A122 AKM5-YN-CHN-2020). The newly identified viruses showed extensive changes and could be assigned as new species, or even genus (e.g., calicivirus CS9-Cali-YN-CHN-2020 and iflavirus Ifla-YN-CHN-2020). Moreover, we identified several highly divergent RNA viruses and estimated their evolutionary characteristics among different hosts, providing data for further examination of their evolutionary dynamics. Conclusion Overall, our study emphasizes the close association between emerging viruses and infectious diseases, and the need for more comprehensive surveys.
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Affiliation(s)
- Zhenzhi Han
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, China
| | - Jinbo Xiao
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Song
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaonan Zhao
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Qiang Sun
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huanhuan Lu
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Keyi Zhang
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jichen Li
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Junhan Li
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fenfen Si
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guoyan Zhang
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hehe Zhao
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Senquan Jia
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Jienan Zhou
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Dongyan Wang
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuangli Zhu
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongmei Yan
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenbo Xu
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Xiaoqing Fu
- Yunnan Center for Disease Control and Prevention, Kunming, China
- Xiaoqing Fu,
| | - Yong Zhang
- National Laboratory for Poliomyelitis, WHO Western Pacific Region Office (WPRO) Regional Polio Reference Laboratory, National Health Commission (NHC) Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
- *Correspondence: Yong Zhang,
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Hill M, Bandyopadhyay AS, Pollard AJ. Emergence of vaccine-derived poliovirus in high-income settings in the absence of oral polio vaccine use. Lancet 2022; 400:713-715. [PMID: 35988575 DOI: 10.1016/s0140-6736(22)01582-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Matilda Hill
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford OX3 7LE, UK.
| | | | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford OX3 7LE, UK
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18
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Manukyan H, Wahid R, Ansari A, Tritama E, Macadam A, Konz J, Chumakov K, Laassri M. Quantitative RT-PCR Assays for Quantification of Undesirable Mutants in the Novel Type 2 Oral Poliovirus Vaccine. Vaccines (Basel) 2022; 10:vaccines10091394. [PMID: 36146473 PMCID: PMC9502871 DOI: 10.3390/vaccines10091394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/09/2023] Open
Abstract
Emergence of mutations is an inherent property of RNA viruses with several implications for their replication, pathogenesis, and evolutionary adaptation. Oral poliovirus vaccine (OPV), developed by Albert Sabin, is composed of live attenuated polioviruses of three serotypes that can revert to neurovirulence during replication in cell culture and in vaccine recipients. Recently, a new modified variant of Sabin 2 virus was developed by introducing changes in its genome, making it more genetically stable to prevent the reversion. The new strain was used to manufacture novel OPV2 (nOPV2), which was approved by the World Health Organization for emergency use to stop outbreaks caused by circulating vaccine-derived poliovirus (cVDPV2). Manufacture of this improved vaccine requires close attention to the genetic heterogenicity to ensure that the levels of the undesirable mutations are limited. Preliminary studies using whole-genome Illumina sequencing (NGS) identified several genomic sites where mutations tend to occur with regularity. They include VP1-I143T amino acid change at the secondary attenuation site; VP1-N171D, a substitution that modestly increases neurovirulence in mice; and VP1-E295K, which may reduce the immunogenicity of the nOPV2. Therefore, to ensure the molecular consistency of vaccine batches, the content of these mutants must be quantified and kept within specifications. To do this, we have developed quantitative, multiplex, one-step reverse-transcriptase polymerase chain reactions (qmosRT-PCRs) as simple methods for quantification of these mutations. Each method uses specific short TaqMan probes with different dyes for the analysis of both mutants and non-mutants in the same sample. The quantification is done using calibration curves developed using validated reference materials. To evaluate the sensitivity and the linearity of the qmosRT-PCR method, the mutant viruses were spiked in non-mutant viruses, and nOPV2 batches were used to validate the method. The spiked samples and the nOPV2 batches were analyzed by qmosRT-PCR and NGS assays. The results showed that qmosRT-PCR is sensitive enough to detect around 1% of mutants. The percentages of mutants determined by qmosRT-PCR correlate well with the results of the NGS. Further, the analysis of the nOPV2 batches showed that the results of qmosRT-PCR correlated well with the results of NGS. In conclusion, the qmosRT-PCR is a specific, sensitive, and linear method. It could be used for quality control of the nOPV2 batches.
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Affiliation(s)
- Hasmik Manukyan
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Rahnuma Wahid
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
| | - Azeem Ansari
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
| | - Erman Tritama
- Research and Development Division, PT. Bio Farma, Bandung, West Java 40161, Indonesia
| | - Andrew Macadam
- National Institute for Biological Standards and Control (NIBSC), Hertfordshire EN6 3QG, UK
| | - John Konz
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
| | - Konstantin Chumakov
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Majid Laassri
- Division of Viral Products, Center for Biologics Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
- Correspondence: ; Tel.: +1-(240)-402-9656; Fax: +1-3015951440
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19
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Epidemiology of type 2 vaccine-derived poliovirus outbreaks between 2016 and 2020. Vaccine 2022; 41 Suppl 1:A19-A24. [PMID: 36008232 DOI: 10.1016/j.vaccine.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 03/31/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
The number and geographic breadth of circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks detected after the withdrawal of type 2 containing oral polio vaccine (April 2016) have exceeded forecasts.Using Acute Flaccid Paralysis (AFP) investigations and environmental surveillance (ES) data from the Global Polio Laboratory Network, we summarize the epidemiology of cVDPV2 outbreaks. Between 01 January 2016 to 31 December 2020, a total of 68 unique cVDPV2 genetic emergences were detected across 34 countries. The cVDPV2 outbreaks have been associated with 1596 acute flaccid paralysis cases across four World Health Organization regions: 962/1596 (60.3%) cases occurred in African Region; 619/1596 (38.8%) in the Eastern Mediterranean Region; 14/1596 (0.9%) in Western-Pacific Region; and 1/1596 (0.1%) in the European Region. As the majority of the cVDPV2 outbreaks have been seeded through monovalent type 2 oral poliovirus vaccine (mOPV2) use in outbreak responses, the introduction of the more stable novel oral poliovirus vaccine will be instrumental in stopping emergence of new cVDPV2 lineages.
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Belgasmi H, Miles SJ, Sayyad L, Wong K, Harrington C, Gerloff N, Coulliette-Salmond AD, Guntapong R, Tacharoenmuang R, Ayutthaya AIN, Apostol LNG, Valencia MLD, Burns CC, Benito GR, Vega E. CaFÉ: A Sensitive, Low-Cost Filtration Method for Detecting Polioviruses and Other Enteroviruses in Residual Waters. FRONTIERS IN ENVIRONMENTAL SCIENCE 2022; 10:10.3389/fenvs.2022.914387. [PMID: 35928599 PMCID: PMC9344547 DOI: 10.3389/fenvs.2022.914387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Acute flaccid paralysis (AFP) surveillance has been used to identify polio cases and target vaccination campaigns since the inception of the Global Poliovirus Eradication Initiative (GPEI) in 1988. To date, only Afghanistan and Pakistan have failed to interrupt wild poliovirus transmission. Circulation of vaccine-derived polioviruses (VDPV) continues to be a problem in high-risk areas of the Eastern Mediterranean, African, and Southeast Asian regions. Environmental surveillance (ES) is an important adjunct to AFP surveillance, helping to identify circulating polioviruses in problematic areas. Stools from AFP cases and contacts (>200,000 specimens/year) and ES samples (>642 sites) are referred to 146 laboratories in the Global Polio Laboratory Network (GPLN) for testing. Although most World Health Organization supported laboratories use the two-phase separation method due to its simplicity and effectiveness, alternative simple, widely available, and cost-effective methods are needed. The CAFÉ (Concentration and Filtration Elution) method was developed from existing filtration methods to handle any type of sewage or residual waters. At $10-20 US per sample for consumable materials, CAFÉ is cost effective, and all equipment and reagents are readily available from markets and suppliers globally. The report describes the results from a parallel study of CAFÉ method with the standard two-phase separation method. The study was performed with samples collected from five countries (Guatemala, Haïti, Thailand, Papua New Guinea, and the Philippines), run in three laboratories-(United States, Thailand and in the Philippines) to account for regional and sample-to-sample variability. Samples from each site were divided into two 500 ml aliquots and processed by both methods, with no other additional concentration or manipulation. The results of 338 parallel-tested samples show that the CAFÉ method is more sensitive than the two-phase separation method for detection of non-polio enteroviruses (p-value < 0.0001) and performed as well as the two-phase separation method for polioviruses detection with no significant difference (p-value > 0.05). The CAFÉ method is a robust, sensitive, and cost-effective method for isolating enteroviruses from residual waters.
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Affiliation(s)
- Hanen Belgasmi
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Stacey Jeffries Miles
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - Chelsea Harrington
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nancy Gerloff
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Angela D Coulliette-Salmond
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
- U.S Public Health Service, Rockville, MD, United States
| | - Ratigorn Guntapong
- Department of Medical Science, Enteric Viruses Section, National Institute of Health, Nonthaburi, Thailand
| | - Ratana Tacharoenmuang
- Department of Medical Science, Enteric Viruses Section, National Institute of Health, Nonthaburi, Thailand
| | | | | | | | - Cara C. Burns
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gloria-Rey Benito
- Pan American Health Organization, World Health Organization, Washington, DC, United States
| | - Everardo Vega
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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21
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Cooper LV, Bandyopadhyay AS, Gumede N, Mach O, Mkanda P, Ndoutabé M, Okiror SO, Ramirez-Gonzalez A, Touray K, Wanyoike S, Grassly NC, Blake IM. Risk factors for the spread of vaccine-derived type 2 polioviruses after global withdrawal of trivalent oral poliovirus vaccine and the effects of outbreak responses with monovalent vaccine: a retrospective analysis of surveillance data for 51 countries in Africa. THE LANCET. INFECTIOUS DISEASES 2022; 22:284-294. [PMID: 34648733 PMCID: PMC8799632 DOI: 10.1016/s1473-3099(21)00453-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Expanding outbreaks of circulating vaccine-derived type 2 poliovirus (cVDPV2) across Africa after the global withdrawal of trivalent oral poliovirus vaccine (OPV) in 2016 are delaying global polio eradication. We aimed to assess the effect of outbreak response campaigns with monovalent type 2 OPV (mOPV2) and the addition of inactivated poliovirus vaccine (IPV) to routine immunisation. METHODS We used vaccination history data from children under 5 years old with non-polio acute flaccid paralysis from a routine surveillance database (the Polio Information System) and setting-specific OPV immunogenicity data from the literature to estimate OPV-induced and IPV-induced population immunity against type 2 poliomyelitis between Jan 1, 2015, and June 30, 2020, for 51 countries in Africa. We investigated risk factors for reported cVDPV2 poliomyelitis including population immunity, outbreak response activities, and correlates of poliovirus transmission using logistic regression. We used the model to estimate cVDPV2 risk for each 6-month period between Jan 1, 2016, and June 30, 2020, with different numbers of mOPV2 campaigns and compared the timing and location of actual mOPV2 campaigns and the number of mOPV2 campaigns required to reduce cVDPV2 risk to low levels. FINDINGS Type 2 OPV immunity among children under 5 years declined from a median of 87% (IQR 81-93) in January-June, 2016 to 14% (9-37) in January-June, 2020. Type 2 immunity from IPV among children under 5 years increased from 3% (<1-6%) in January-June, 2016 to 35% (24-47) in January-June, 2020. The probability of cVDPV2 poliomyelitis among children under 5 years was negatively correlated with OPV-induced and IPV-induced immunity and mOPV2 campaigns (adjusted odds ratio: OPV 0·68 [95% CrI 0·60-0·76], IPV 0·82 [0·68-0·99] per 10% absolute increase in estimated population immunity, mOPV2 0·30 [0·20-0·44] per campaign). Vaccination campaigns in response to cVDPV2 outbreaks have been smaller and slower than our model shows would be necessary to reduce risk to low levels, covering only 11% of children under 5 years who are predicted to be at risk within 6 months and only 56% within 12 months. INTERPRETATION Our findings suggest that as mucosal immunity declines, larger or faster responses with vaccination campaigns using type 2-containing OPV will be required to stop cVDPV2 transmission. IPV-induced immunity also has an important role in reducing the burden of cVDPV2 poliomyelitis in Africa. FUNDING Bill & Melinda Gates Foundation, Medical Research Council Centre for Global Infectious Disease Analysis, and WHO. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Laura V Cooper
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK,Correspondence to: Dr Laura V Cooper, Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK
| | | | - Nicksy Gumede
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Ondrej Mach
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Pascal Mkanda
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Modjirom Ndoutabé
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Samuel O Okiror
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Alejandro Ramirez-Gonzalez
- Expanded Programme on Immunization, Vaccines, and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Kebba Touray
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Sarah Wanyoike
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Nicholas C Grassly
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Isobel M Blake
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
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22
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Famulare M, Wong W, Haque R, Platts-Mills JA, Saha P, Aziz AB, Ahmed T, Islam MO, Uddin MJ, Bandyopadhyay AS, Yunus M, Zaman K, Taniuchi M. Multiscale model for forecasting Sabin 2 vaccine virus household and community transmission. PLoS Comput Biol 2021; 17:e1009690. [PMID: 34932560 PMCID: PMC8726461 DOI: 10.1371/journal.pcbi.1009690] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/04/2022] [Accepted: 11/29/2021] [Indexed: 11/19/2022] Open
Abstract
Since the global withdrawal of Sabin 2 oral poliovirus vaccine (OPV) from routine immunization, the Global Polio Eradication Initiative (GPEI) has reported multiple circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. Here, we generated an agent-based, mechanistic model designed to assess OPV-related vaccine virus transmission risk in populations with heterogeneous immunity, demography, and social mixing patterns. To showcase the utility of our model, we present a simulation of mOPV2-related Sabin 2 transmission in rural Matlab, Bangladesh based on stool samples collected from infants and their household contacts during an mOPV2 clinical trial. Sabin 2 transmission following the mOPV2 clinical trial was replicated by specifying multiple, heterogeneous contact rates based on household and community membership. Once calibrated, the model generated Matlab-specific insights regarding poliovirus transmission following an accidental point importation or mass vaccination event. We also show that assuming homogeneous contact rates (mass action), as is common of poliovirus forecast models, does not accurately represent the clinical trial and risks overestimating forecasted poliovirus outbreak probability. Our study identifies household and community structure as an important source of transmission heterogeneity when assessing OPV-related transmission risk and provides a calibratable framework for expanding these analyses to other populations. Trial Registration: ClinicalTrials.gov This trial is registered with clinicaltrials.gov, NCT02477046.
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Affiliation(s)
- Michael Famulare
- Institute for Disease Modeling, Global Good, Intellectual Ventures, Bellevue, Washington, United States of America
| | - Wesley Wong
- Institute for Disease Modeling, Global Good, Intellectual Ventures, Bellevue, Washington, United States of America
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - James A. Platts-Mills
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | - Parimalendu Saha
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Asma B. Aziz
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tahmina Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ohedul Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Jashim Uddin
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | | | - Mohammed Yunus
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mami Taniuchi
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, Virginia, United States of America
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23
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Wahid R, Mercer L, Macadam A, Carlyle S, Stephens L, Martin J, Chumakov K, Laassri M, Petrovskaya S, Smits SL, Stittelaar KJ, Gast C, Weldon WC, Konopka-Anstadt JL, Steven Oberste M, Van Damme P, De Coster I, Rüttimann R, Bandyopadhyay A, Konz J. Assessment of genetic changes and neurovirulence of shed Sabin and novel type 2 oral polio vaccine viruses. NPJ Vaccines 2021; 6:94. [PMID: 34326330 PMCID: PMC8322168 DOI: 10.1038/s41541-021-00355-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 07/06/2021] [Indexed: 11/09/2022] Open
Abstract
Sabin-strain oral polio vaccines (OPV) can, in rare instances, cause disease in recipients and susceptible contacts or evolve to become circulating vaccine-derived strains with the potential to cause outbreaks. Two novel type 2 OPV (nOPV2) candidates were designed to stabilize the genome against the rapid reversion that is observed following vaccination with Sabin OPV type 2 (mOPV2). Next-generation sequencing and a modified transgenic mouse neurovirulence test were applied to shed nOPV2 viruses from phase 1 and 2 studies and shed mOPV2 from a phase 4 study. The shed mOPV2 rapidly reverted in the primary attenuation site (domain V) and increased in virulence. In contrast, the shed nOPV2 viruses showed no evidence of reversion in domain V and limited or no increase in neurovirulence in mice. Based on these results and prior published data on safety, immunogenicity, and shedding, the nOPV2 viruses are promising alternatives to mOPV2 for outbreak responses.
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Affiliation(s)
- Rahnuma Wahid
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA.
| | - Laina Mercer
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - Andrew Macadam
- National Institute for Biological Standards and Control (NIBSC), Hertfordshire, UK
| | - Sarah Carlyle
- National Institute for Biological Standards and Control (NIBSC), Hertfordshire, UK
| | - Laura Stephens
- National Institute for Biological Standards and Control (NIBSC), Hertfordshire, UK
| | - Javier Martin
- National Institute for Biological Standards and Control (NIBSC), Hertfordshire, UK
| | - Konstantin Chumakov
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
- Global Virus Network Center of Excellence, Baltimore, MD, USA
| | - Majid Laassri
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Svetlana Petrovskaya
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Saskia L Smits
- Viroclinics Biosciences B.V., Rotterdam, the Netherlands
| | - Koert J Stittelaar
- Viroclinics Xplore, Viroclinics Biosciences B.V., Rotterdam, the Netherlands
| | - Chris Gast
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - William C Weldon
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - M Steven Oberste
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Ilse De Coster
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Ricardo Rüttimann
- Fighting Infectious Diseases in Emerging Countries (FIDEC), Miami, FL, USA
| | | | - John Konz
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
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24
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Han Z, Song Y, Xiao J, Zhao X, Lu H, Zhang K, Jia S, Zhou J, Li J, Si F, Sun Q, Zhu S, Wang D, Yan D, Xu W, Fu X, Zhang Y. Monsavirus in monkey rectal swab and throat swab specimens in China: Proposal for Posaliviridae as a new family in Picornavirales. Virus Res 2021; 303:198501. [PMID: 34252491 DOI: 10.1016/j.virusres.2021.198501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/16/2022]
Abstract
Posa-like viruses have been detected in the fecal samples of several host species and are considered unclassified members of Picornavirales. Here, we identified genomic fragments of novel posa-like viruses (monsaviruses) in monkey specimens through next generation sequencing and obtained 11 full-length genomes. This monsavirus shared 88.5-89.2% nucleotide similarity with the Tottori-HG1 strain (GenBank accession LC123275). In total, 713 nucleotide polymorphism sites were identified, indicating their persistent evolution during circulation. The genomic organization and phylogenetic relationship of monsavirus were determined. Subsequent phylogenetic analysis of the conserved replication block of Hel-Pro-RdRp and core RNA-dependent RNA polymerase domain-based analysis of posa-like viruses showed significant separation compared with other known families. Further, posa-like virus genomes possessed the classical replication block of picornavirus in the 5' part of genome and picorna-like capsid domains at the structural coding region of 3' part of genome. Based on these results, we proposed the new family Posaliviridae, within Picornavirales. Four genera, which showed 68.6-75.5% amino acid distances but similar genomic organization including the conserved replication block of Hel-Pro-RdRp, the same order of the genomic coding region, and picorna-like capsid domains, were identified. The flexible genomic organization strategy and a large evolutionary scale of Posaliviridae was explicit. This study provides novel information on monsaviruses and important taxonomic data for the family Posaliviridae.
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Affiliation(s)
- Zhenzhi Han
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yang Song
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Jinbo Xiao
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Xiaonan Zhao
- Yunnan Center for Disease Control and Prevention, Kunming 650022, PR China
| | - Huanhuan Lu
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Keyi Zhang
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Senquan Jia
- Yunnan Center for Disease Control and Prevention, Kunming 650022, PR China
| | - Jienan Zhou
- Yunnan Center for Disease Control and Prevention, Kunming 650022, PR China
| | - Junhan Li
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Fenfen Si
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Qiang Sun
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Shuangli Zhu
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Dongyan Wang
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Dongmei Yan
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Wenbo Xu
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China; Center for Biosafety Mega-Science, Chinese Academy of Sciences. Wuhan 430071, PR China
| | - Xiaoqing Fu
- Yunnan Center for Disease Control and Prevention, Kunming 650022, PR China.
| | - Yong Zhang
- National Laboratory for poliomyelitis, WHO WPRO Regional Polio Reference Laboratory, NHC Key Laboratory for Medical Virology, NHC Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China; Center for Biosafety Mega-Science, Chinese Academy of Sciences. Wuhan 430071, PR China.
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25
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Tian X, Han Z, He Y, Sun Q, Wang W, Xu W, Li H, Zhang Y. Temporal phylogeny and molecular characterization of echovirus 30 associated with aseptic meningitis outbreaks in China. Virol J 2021; 18:118. [PMID: 34092258 PMCID: PMC8182919 DOI: 10.1186/s12985-021-01590-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An outbreak of aseptic meningitis occurred from June to August 2016, in Inner Mongolia Autonomous Region, China. METHODS To determine its epidemiological characteristics, etiologic agent, and possible origin, specimens were collected for virus isolation and identification, followed by molecular epidemiological analysis. RESULTS A total of 363 patients were clinically diagnosed from June 1st to August 31st 2016, and most cases (63.1%, n = 229) were identified between June 22nd and July 17th, with children aged 6 to 12 years constituting the highest percentage (68.9%, n = 250). All viral isolates from this study belonged to genotype C of echovirus 30 (E30), which dominated transmission in China. To date, two E30 transmission lineages have been identified in China, of which Lineage 2 was predominant. We observed fluctuant progress of E30 genetic diversity, with Lineage 2 contributing to increased genetic diversity after 2002, whereas Lineage 1 was significant for the genetic diversity of E30 before 2002. CONCLUSIONS We identified the epidemiological and etiological causes of an aseptic meningitis outbreak in Inner Mongolia in 2016, and found that Lineage 2 played an important role in recent outbreaks. Moreover, we found that Gansu province could play an important role in E30 spread and might be a possible origin site. Furthermore, Fujian, Shandong, Taiwan, and Zhejiang provinces also demonstrated significant involvement in E30 evolution and persistence over time in China.
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Affiliation(s)
- Xiaoling Tian
- Inner Mongolia Center for Disease Control and Prevention, Huhhot, 010031, People's Republic of China
| | - Zhenzhi Han
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Health Commission Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071, People's Republic of China
| | - Yulong He
- Tongliao City Center for Disease Control and Prevention, Tongliao, 028000, People's Republic of China
| | - Qiang Sun
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Health Commission Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071, People's Republic of China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Huhhot, 010031, People's Republic of China
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Health Commission Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071, People's Republic of China
| | - Hongying Li
- Tongliao City Hospital, Tongliao, 028000, People's Republic of China.
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory, National Health Commission Key Laboratory of biosafety, National Health Commission Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China. .,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071, People's Republic of China.
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26
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Chu K, Han W, Jiang D, Jiang Z, Zhu T, Xu W, Hu Y, Zeng G. Cross-neutralization Capacity of Immune Serum from Different Dosage of Sabin Inactivated Poliovirus Vaccine Immunization against Multiple Individual Polioviruses. Expert Rev Vaccines 2021; 20:761-767. [PMID: 33861679 DOI: 10.1080/14760584.2021.1919091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Sabin strain inactivated poliovirus vaccine (sIPV) developed by Sinovac Biotech Co., Ltd., has shown good safety and immunogenicity against parental strains among infants in several finished pre-licensure clinical trials.Areas covered: To further study the neutralizing capacity of investigational sIPV immune serum against Sabin, Salk and recently circulating poliovirus strains, neutralization assay against ten individual strains was performed on backup serum collected from 250 infant participants of the finished phase II clinical trial.Expert commentary:: The sIPV can generate good immunogenicity against Sabin, Salk and recently circulating poliovirus strains. Taking into account its lower containment requirements and financial costs compared with the conventional Salk strain inactivated poliovirus vaccine, sIPV is an affordable and practical option for polio eradication.
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Affiliation(s)
- Kai Chu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Weixiao Han
- Clinical Research Department, Sinovac Biotech Co., Ltd., Beijing, China
| | - Deyu Jiang
- Center for Research & Department, Sinovac Biotech Co., Ltd.,Beijing, China
| | - Zhiwei Jiang
- Statistics department, Beijing Key Tech Statistic Technology Co., Ltd, Beijing
| | - Taotao Zhu
- Clinical Research Department,Sinovac Biotech Co., Ltd., Beijing China
| | - Wenbo Xu
- WHO WPRO Regional Reference Measles/Rubella Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuemei Hu
- Department of Vaccine Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Gang Zeng
- Clinical Research Department, Sinovac Biotech Co., Ltd., Beijing, China
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27
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Tournier JN, Kononchik J. Virus Eradication and Synthetic Biology: Changes with SARS-CoV-2? Viruses 2021; 13:569. [PMID: 33800626 PMCID: PMC8066276 DOI: 10.3390/v13040569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/24/2022] Open
Abstract
The eradication of infectious diseases has been achieved only once in history, in 1980, with smallpox. Since 1988, significant effort has been made to eliminate poliomyelitis viruses, but eradication is still just out of reach. As the goal of viral disease eradication approaches, the ability to recreate historically eradicated viruses using synthetic biology has the potential to jeopardize the long-term sustainability of eradication. However, the emergence of the severe acute respiratory syndrome-coronavirus (SARS-CoV)-2 pandemic has highlighted our ability to swiftly and resolutely respond to a potential outbreak. This virus has been synthetized faster than any other in the past and is resulting in vaccines before most attenuated candidates reach clinical trials. Here, synthetic biology has the opportunity to demonstrate its truest potential to the public and solidify a footing in the world of vaccines.
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Affiliation(s)
- Jean-Nicolas Tournier
- Microbiology and Infectious Diseases Department, Institut de Recherche Biomédicale des Armées, 91220 Brétigny-sur-Orge, France;
- CNRS UMR-3569, Innovative Vaccine Laboratory, Virology Department, Institut Pasteur, 75015 Paris, France
- Ecole du Val-de-Grâce, 75005 Paris, France
| | - Joseph Kononchik
- Microbiology and Infectious Diseases Department, Institut de Recherche Biomédicale des Armées, 91220 Brétigny-sur-Orge, France;
- US Army Medical Research Institute of Chemical Defense (USAMRICD), 8350 Ricketts Point Rd., Aberdeen Proving Ground, MD 21010, USA
- Toxicology and Chemical Risk Department, Institut de Recherche Biomédicale des Armées, 91220 Brétigny-sur-Orge, France
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28
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Alleman MM, Coulliette-Salmond AD, Wilnique P, Belgasmi-Wright H, Sayyad L, Wong K, Gue E, Barrais R, Rey-Benito G, Burns CC, Vega E. Environmental Surveillance for Polioviruses in Haïti (2017-2019): The Dynamic Process for the Establishment and Monitoring of Sampling Sites. Viruses 2021; 13:v13030505. [PMID: 33803868 PMCID: PMC8003210 DOI: 10.3390/v13030505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 02/07/2023] Open
Abstract
Haïti is at risk for wild poliovirus (WPV) importation and circulation, as well as vaccine-derived poliovirus (VDPV) emergence. Environmental surveillance (ES) for polioviruses was established in Port au Prince and Gonaïves in 2016. During 2017–2019, initial ES sites were re-evaluated, and ES was expanded into Cap Haïtien and Saint Marc. Wastewater samples and data on weather, hour of collection, and sample temperature and pH were collected every 4 weeks during March 2017–December 2019 (272 sampling events) from 21 sites in Cap Haïtien, Gonaïves, Port au Prince, and Saint Marc. Samples were processed for the detection of polio and non-polio enteroviruses using the two-phase and “Concentration and Filter Elution” methodologies. Polioviruses were serotyped and underwent intra-typic characterization. No WPV or VDPVs were isolated. Sabin-like polioviruses (oral vaccine strain) of serotypes 1 and 3 were sporadically detected. Five of six (83%), one of six (17%), five of six (83%), and two of three (67%) sites evaluated in Cap Haïtien, Gonaïves, Port au Prince, and Saint Marc, respectively, had enterovirus isolation from >50% of sampling events; these results and considerations, such as watershed population size and overlap, influence of sea water, and excessive particulates in samples, were factors in site retention or termination. The evaluation of 21 ES sampling sites in four Haïtian cities led to the termination of 11 sites. Every-four-weekly sampling continues at the remaining 10 sites across the four cities as a core Global Polio Eradication Initiative activity.
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Affiliation(s)
- Mary M. Alleman
- Polio Eradication Branch, Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, GA 30329, USA
- Correspondence: ; Tel.: +1-404-639-8703
| | - Angela D. Coulliette-Salmond
- Polio and Picornavirus Laboratory Branch, Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA 30329, USA; (A.D.C.-S.); (C.C.B.); (E.V.)
- United States Public Health Service, Rockville, MD 20852, USA
| | - Pierre Wilnique
- Laboratory and Research, Division of Epidemiology, Ministère de la Santé Publique et de la Population (Ministry of Public Health and Population (MSPP)), Port au Prince HT6110, Haiti; (P.W.); (R.B.)
| | | | | | - Kimberly Wong
- IHRC, Inc., Atlanta, GA 30346, USA; (H.B.-W.); (K.W.)
- Cherokee Nation Assurance, Catoosa, OK 74015, USA;
| | - Edmund Gue
- Pan American Health Organization, World Health Organization, Region of the Americas, Port au Prince HT6110, Haiti;
| | - Robert Barrais
- Laboratory and Research, Division of Epidemiology, Ministère de la Santé Publique et de la Population (Ministry of Public Health and Population (MSPP)), Port au Prince HT6110, Haiti; (P.W.); (R.B.)
| | - Gloria Rey-Benito
- Pan American Health Organization, World Health Organization, Washington, DC 20037, USA;
| | - Cara C. Burns
- Polio and Picornavirus Laboratory Branch, Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA 30329, USA; (A.D.C.-S.); (C.C.B.); (E.V.)
| | - Everardo Vega
- Polio and Picornavirus Laboratory Branch, Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA 30329, USA; (A.D.C.-S.); (C.C.B.); (E.V.)
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29
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Li J, Zhang Z, Zhang H, Li M, Li X, Lu L, Huang F, Wu J. Seroprevalence of poliovirus antibodies before and after polio vaccine switch in 2012 and 2017 in Beijing. Hum Vaccin Immunother 2021; 17:389-396. [PMID: 32703060 PMCID: PMC7899662 DOI: 10.1080/21645515.2020.1778409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/28/2020] [Indexed: 10/23/2022] Open
Abstract
In 2000, China was declared polio-free. However, in 2018, wild poliovirus (WPV) was still endemic in two of its neighboring countries, making WPV importation and outbreak alarming possibilities. This study documents the seroprevalence of poliovirus antibodies before and after the polio vaccine switch in 2012 and 2017 in Beijing. Cross-sectional population-based serologic surveys were conducted in 2012 and 2017 in Beijing. The study subjects were selected from 10 different age groups (<1, 1-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, and ≥40 y) using a multi-stage-stratified sampling method. Neutralizing antibody titers against poliovirus serotypes 1 (P1), 2 (P2), and 3 (P3) were assayed by World Health Organization standards. The seropositive rates (SR) and geometric mean titer (GMT) of the neutralizing antibodies were 91.71% and 1:130.26, respectively, for P1, 94.09% and 1:113.39, respectively, for P2, and 88.78% and 1:79.65, respectively, for P3 before the switch in 2012, and 87.78% and 1:108.93, respectively, for P1, and 81.67% and 1:70.56, respectively, for P3 after the switch in 2017, with a statistically significant difference for P1 and P3 between 2012 and 2017. The neutralizing antibodies for all poliovirus serotypes differed among different age and vaccination groups in both 2012 and 2017. After switching polio vaccines twice in 2014 and 2016, the P1 and P3 polio antibody levels were lower in 2017 than in 2012. The P2 antibody levels were determined from the first dose of IPV. The seroprevalence of poliovirus antibodies after adjustment of the immunization schedule of the polio vaccine on January 1, 2020, must be further monitored.
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Affiliation(s)
- Juan Li
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
- Department of Immunization and Prevention, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Zhujiazi Zhang
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
| | - Herun Zhang
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
| | - Maozhong Li
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
| | - Xiaomei Li
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
| | - Li Lu
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
| | - Fang Huang
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
| | - Jiang Wu
- Department of Immunization and Prevention, Beijing Research Centre for Preventive Medicine, Beijing, PR China
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30
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Kalkowska DA, Pallansch MA, Wilkinson A, Bandyopadhyay AS, Konopka-Anstadt JL, Burns CC, Oberste MS, Wassilak SGF, Badizadegan K, Thompson KM. Updated Characterization of Outbreak Response Strategies for 2019-2029: Impacts of Using a Novel Type 2 Oral Poliovirus Vaccine Strain. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:329-348. [PMID: 33174263 PMCID: PMC7887065 DOI: 10.1111/risa.13622] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/08/2020] [Accepted: 10/16/2020] [Indexed: 05/06/2023]
Abstract
Delays in achieving the global eradication of wild poliovirus transmission continue to postpone subsequent cessation of all oral poliovirus vaccine (OPV) use. Countries must stop OPV use to end all cases of poliomyelitis, including vaccine-associated paralytic polio (VAPP) and cases caused by vaccine-derived polioviruses (VDPVs). The Global Polio Eradication Initiative (GPEI) coordinated global cessation of all type 2 OPV (OPV2) use in routine immunization in 2016 but did not successfully end the transmission of type 2 VDPVs (VDPV2s), and consequently continues to use type 2 OPV (OPV2) for outbreak response activities. Using an updated global poliovirus transmission and OPV evolution model, we characterize outbreak response options for 2019-2029 related to responding to VDPV2 outbreaks with a genetically stabilized novel OPV (nOPV2) strain or with the currently licensed monovalent OPV2 (mOPV2). Given uncertainties about the properties of nOPV2, we model different assumptions that appear consistent with the evidence on nOPV2 to date. Using nOPV2 to respond to detected cases may reduce the expected VDPV and VAPP cases and the risk of needing to restart OPV2 use in routine immunization compared to mOPV2 use for outbreak response. The actual properties, availability, and use of nOPV2 will determine its effects on type 2 poliovirus transmission in populations. Even with optimal nOPV2 performance, countries and the GPEI would still likely need to restart OPV2 use in routine immunization in OPV-using countries if operational improvements in outbreak response to stop the transmission of cVDPV2s are not implemented effectively.
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Affiliation(s)
| | - Mark A. Pallansch
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amanda Wilkinson
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jennifer L. Konopka-Anstadt
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cara C. Burns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M. Steven Oberste
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Steven G. F. Wassilak
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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31
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Kalkowska DA, Pallansch MA, Cochi SL, Kovacs SD, Wassilak SGF, Thompson KM. Updated Characterization of Post-OPV Cessation Risks: Lessons from 2019 Serotype 2 Outbreaks and Implications for the Probability of OPV Restart. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:320-328. [PMID: 32632925 PMCID: PMC7814395 DOI: 10.1111/risa.13555] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/15/2020] [Accepted: 06/22/2020] [Indexed: 05/06/2023]
Abstract
After the globally coordinated cessation of any serotype of oral poliovirus vaccine (OPV), some risks remain from undetected, existing homotypic OPV-related transmission and/or restarting transmission due to several possible reintroduction risks. The Global Polio Eradication Initiative (GPEI) coordinated global cessation of serotype 2-containing OPV (OPV2) in 2016. Following OPV2 cessation, the GPEI and countries implemented activities to withdraw all the remaining trivalent OPV, which contains all three poliovirus serotypes (i.e., 1, 2, and 3), from the supply chain and replace it with bivalent OPV (containing only serotypes 1 and 3). However, as of early 2020, monovalent OPV2 use for outbreak response continues in many countries. In addition, outbreaks observed in 2019 demonstrated evidence of different types of risks than previously modeled. We briefly review the 2019 epidemiological experience with serotype 2 live poliovirus outbreaks and propose a new risk for unexpected OPV introduction for inclusion in global modeling of OPV cessation. Using an updated model of global poliovirus transmission and OPV evolution with and without consideration of this new risk, we explore the implications of the current global situation with respect to the likely need to restart preventive use of OPV2 in OPV-using countries. Simulation results without this new risk suggest OPV2 restart will likely need to occur (81% of 100 iterations) to manage the polio endgame based on the GPEI performance to date with existing vaccine tools, and with the new risk of unexpected OPV introduction the expected OPV2 restart probability increases to 89%. Contingency planning requires new OPV2 bulk production, including genetically stabilized OPV2 strains.
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Affiliation(s)
| | - Mark A. Pallansch
- National Center for Immunization and Respiratory, Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephen L. Cochi
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephanie D. Kovacs
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Steven G. F. Wassilak
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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32
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Kalkowska DA, Franka R, Higgins J, Kovacs SD, Forbi JC, Wassilak SG, Pallansch MA, Thompson KM. Modeling Poliovirus Transmission in Borno and Yobe, Northeast Nigeria. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:289-302. [PMID: 32348621 PMCID: PMC7814397 DOI: 10.1111/risa.13485] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/18/2020] [Accepted: 03/27/2020] [Indexed: 05/05/2023]
Abstract
Beginning in 2013, multiple local government areas (LGAs) in Borno and Yobe in northeast Nigeria and other parts of the Lake Chad basin experienced a violent insurgency that resulted in substantial numbers of isolated and displaced people. Northeast Nigeria represents the last known reservoir country of wild poliovirus (WPV) transmission in Africa, with detection of paralytic cases caused by serotype 1 WPV in 2016 in Borno and serotype 3 WPV in late 2012. Parts of Borno and Yobe are also problematic areas for transmission of serotype 2 circulating vaccine-derived polioviruses, and they continue to face challenges associated with conflict and inadequate health services in security-compromised areas that limit both immunization and surveillance activities. We model poliovirus transmission of all three serotypes for Borno and Yobe using a deterministic differential equation-based model that includes four subpopulations to account for limitations in access to immunization services and dynamic restrictions in population mixing. We find that accessibility issues and insufficient immunization allow for prolonged poliovirus transmission and potential undetected paralytic cases, although as of the end of 2019, including responsive program activities in the modeling suggest die out of indigenous serotypes 1 and 3 WPVs prior to 2020. Specifically, recent and current efforts to access isolated populations and provide oral poliovirus vaccine continue to reduce the risks of sustained and undetected transmission, although some uncertainty remains. Continued improvement in immunization and surveillance in the isolated subpopulations should minimize these risks. Stochastic modeling can build on this analysis to characterize the implications for undetected transmission and confidence about no circulation.
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Affiliation(s)
| | - Richard Franka
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeff Higgins
- Geospatial Research, Analysis and Services Program, Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA
| | - Stephanie D. Kovacs
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joseph C. Forbi
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Steven G.F Wassilak
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark A. Pallansch
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kimberly M. Thompson
- Kid Risk, Inc., 7512 Dr. Phillips Blvd. #50-523 Orlando, FL 32819
- Corresponding author:
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33
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Hobday LK, Ibrahim A, Kaye ME, Bruggink L, Chanthalavanh P, Garcia-Clapes A, Roberts JA, Thorley BR. Australian National Enterovirus Reference Laboratory annual report, 2019. Commun Dis Intell (2018) 2020; 44. [PMID: 33349203 DOI: 10.33321/cdi.2020.44.94] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization. Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2019, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.34 non-polio AFP cases per 100,000 children, meeting the World Health Organization’s performance criterion for a sensitive surveillance system. The non-polio enteroviruses coxsackievirus A2, coxsackievirus A16, echovirus 9, and enterovirus A71 were identified from clinical specimens collected from AFP cases. Australia also performs enterovirus and environmental surveillance to complement the clinical system focussed on children. In 2019, 175 cases of wild polio were reported, with three countries remaining endemic: Afghanistan, Nigeria and Pakistan.
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Affiliation(s)
- Linda K Hobday
- National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
| | - Aishah Ibrahim
- National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
| | - Matthew E Kaye
- National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
| | - Leesa Bruggink
- National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
| | - Presa Chanthalavanh
- National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
| | - Arnau Garcia-Clapes
- National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
| | - Jason A Roberts
- Electron Microscopy Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
| | - Bruce R Thorley
- National Enterovirus Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, 792 Elizabeth St, Melbourne 3000, Victoria, Australia
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34
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The Early Evolution of Oral Poliovirus Vaccine Is Shaped by Strong Positive Selection and Tight Transmission Bottlenecks. Cell Host Microbe 2020; 29:32-43.e4. [PMID: 33212020 PMCID: PMC7815045 DOI: 10.1016/j.chom.2020.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/12/2020] [Accepted: 10/26/2020] [Indexed: 01/06/2023]
Abstract
The emergence of circulating vaccine-derived polioviruses through evolution of the oral polio vaccine (OPV) poses a significant obstacle to polio eradication. Understanding the early genetic changes that occur as OPV evolves and transmits is important for preventing future outbreaks. Here, we use deep sequencing to define the evolutionary trajectories of type 2 OPV in a vaccine trial. By sequencing 497 longitudinal stool samples from 271 OPV2 recipients and household contacts, we were able to examine the extent of convergent evolution in vaccinated individuals and the amount of viral diversity that is transmitted. In addition to rapid reversion of key attenuating mutations, we identify strong selection at 19 sites across the genome. We find that a tight transmission bottleneck limits the onward transmission of these early adaptive mutations. Our results highlight the distinct evolutionary dynamics of live attenuated virus vaccines and have important implications for the success of next-generation OPV.
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35
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Investigation Report of cVDPV2 Outbreak in Bokh Woreda of Dollo Zone, Somali Regional State, Ethiopia. Case Rep Infect Dis 2020; 2020:6917313. [PMID: 32908734 PMCID: PMC7471813 DOI: 10.1155/2020/6917313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 07/27/2020] [Accepted: 08/20/2020] [Indexed: 11/29/2022] Open
Abstract
Background Poliovirus isolates detected in persons or in the environment can fall into three major categories: wild, Sabin and Sabin-like, or vaccine-derived. Detection of wild or vaccine-derived poliovirus may constitute an emergency, which can be categorized as an event that can lead to an outbreak, depending on characteristics of the isolate and the context in which it appears. The aim of the study was investigation report of cVDPV2 outbreak in Bokh woreda of Dollo Zone, Somali regional state, Ethiopia. Methods A team of experts drawn from different organizations was deployed to Bokh woreda to make detailed field investigation from May 25 to June 17, 2019. By using standard World Health Organization polio outbreak investigation checklist, document review of surveillance, immunization, and clinical data related to the case was made. Key informant's interview was made to health professionals, managers, parents of case, woreda and kebele leaders, religious leaders, and HEWs related to acute flaccid paralysis outbreak. Result The notified AFP case was a 39-month-old female from Angalo kebele of Bokh woreda, Dollo Zone. On 19th May 2019, the patient developed high grade fever and was taken to Angalo Health Post on 20th May 2019. As per the examination by a health extension worker, the child had high grade fever and neck stiffness with preliminary diagnosis of meningitis for which ceftriaxone injection was prescribed. Contact sample was taken from three children on 28th May 2019 and 29th May 2019 and was sent to Addis Ababa National Polio Laboratory. All contact stool samples were found to be positive for poliovirus type 2 and referred for sequencing in National Institute of Communicable Diseases (NICD), South Africa, the Regional Polio Reference Laboratory. Conclusion and Recommendation. The clinical presentation of the cases is compatible with poliovirus infection, improving the quality and coverage of supplementary polio immunization activities through proper planning; strict supervision and follow-up can reduce the occurrence of acute flaccid paralysis.
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Han Z, Xiao J, Song Y, Hong M, Dai G, Lu H, Zhang M, Liang Y, Yan D, Zhu S, Xu W, Zhang Y. The Husavirus Posa-Like Viruses in China, and a New Group of Picornavirales. Viruses 2020; 12:v12090995. [PMID: 32906743 PMCID: PMC7551994 DOI: 10.3390/v12090995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/30/2020] [Accepted: 09/04/2020] [Indexed: 01/09/2023] Open
Abstract
Novel posa-like viral genomes were first identified in swine fecal samples using metagenomics and were designated as unclassified viruses in the order Picornavirales. In the present study, nine husavirus strains were identified in China. Their genomes share 94.1–99.9% similarity, and alignment of these nine husavirus strains identified 697 nucleotide polymorphism sites across their full-length genomes. These nine strains were directly clustered with the Husavirus 1 lineage, and their genomic arrangement showed similar characteristics. These posa-like viruses have undergone a complex evolutionary process, and have a wide geographic distribution, complex host spectrum, deep phylogenetic divergence, and diverse genomic organizations. The clade of posa-like viruses forms a single group, which is evolutionarily distinct from other known families and could represent a distinct family within the Picornavirales. The genomic arrangement of Picornavirales and the new posa-like viruses are different, whereas the posa-like viruses have genomic modules similar to the families Dicistroviridae and Marnaviridae. The present study provides valuable genetic evidence of husaviruses in China, and clarifies the phylogenetic dynamics and the evolutionary characteristics of Picornavirales.
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Affiliation(s)
- Zhenzhi Han
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Jinbo Xiao
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Yang Song
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Mei Hong
- Tibet Center for Disease Control and Prevention, Tibet Autonomous Region, Lhasa 850000, China; (M.H.); (G.D.)
| | - Guolong Dai
- Tibet Center for Disease Control and Prevention, Tibet Autonomous Region, Lhasa 850000, China; (M.H.); (G.D.)
| | - Huanhuan Lu
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Man Zhang
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Yueling Liang
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Dongmei Yan
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
- Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory and NHC Key Laboratory for Biosafety, NHC Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Z.H.); (J.X.); (Y.S.); (H.L.); (M.Z.); (Y.L.); (D.Y.); (S.Z.); (W.X.)
- Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China
- Correspondence: ; Tel.: +86-10-58900183; Fax: +86-10-58900184
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Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019-2023. Appl Environ Microbiol 2020; 86:AEM.00702-20. [PMID: 32444474 DOI: 10.1128/aem.00702-20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/14/2020] [Indexed: 11/20/2022] Open
Abstract
The Polio Endgame Strategy 2019-2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance.IMPORTANCE Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillance, provides continued high-quality surveillance performance in achieving the GPEI and detecting the circulation of enterovirus. Given the ongoing cVDPV outbreaks in the world, we present the surveillance capacity of environmental surveillance in capturing enterovirus circulation. The final poliovirus (especially VDPV) elimination has become increasingly complex, and the case-based AFP surveillance alone will lead to difficulties in early detecting dynamics of poliovirus transmission and monitoring the extent of environmental circulation. This study goes beyond previous work to provide a detailed comprehensive evaluation of the enterovirus surveillance and can be used to formulate a set of implementation plan and performance indicators for environmental surveillance.
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Thompson KM, Kalkowska DA. Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication. Expert Rev Vaccines 2020; 19:661-686. [PMID: 32741232 PMCID: PMC7497282 DOI: 10.1080/14760584.2020.1791093] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/22/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Over the last 20 years (2000-2019) the partners of the Global Polio Eradication Initiative (GPEI) invested in the development and application of mathematical models of poliovirus transmission as well as economics, policy, and risk analyses of polio endgame risk management options, including policies related to poliovirus vaccine use during the polio endgame. AREAS COVERED This review provides a historical record of the polio studies published by the three modeling groups that primarily performed the bulk of this work. This review also systematically evaluates the polio transmission and health economic modeling papers published in English in peer-reviewed journals from 2000 to 2019, highlights differences in approaches and methods, shows the geographic coverage of the transmission modeling performed, identified common themes, and discusses instances of similar or conflicting insights or recommendations. EXPERT OPINION Polio modeling performed during the last 20 years substantially impacted polio vaccine choices, immunization policies, and the polio eradication pathway. As the polio endgame continues, national preferences for polio vaccine formulations and immunization strategies will likely continue to change. Future modeling will likely provide important insights about their cost-effectiveness and their relative benefits with respect to controlling polio and potentially achieving and maintaining eradication.
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Jorgensen D, Pons-Salort M, Shaw AG, Grassly NC. The role of genetic sequencing and analysis in the polio eradication programme. Virus Evol 2020; 6:veaa040. [PMID: 32782825 PMCID: PMC7409915 DOI: 10.1093/ve/veaa040] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Genetic sequencing of polioviruses detected through clinical and environmental surveillance is used to confirm detection, identify their likely origin, track geographic patterns of spread, and determine the appropriate vaccination response. The critical importance of genetic sequencing and analysis to the Global Polio Eradication Initiative has grown with the increasing incidence of vaccine-derived poliovirus (VDPV) infections in Africa specifically (470 reported cases in 2019), and globally, alongside persistent transmission of serotype 1 wild-type poliovirus in Pakistan and Afghanistan (197 reported cases in 2019). Adapting what has been learned about the virus genetics and evolution to address these threats has been a major focus of recent work. Here, we review how phylogenetic and phylogeographic methods have been used to trace the spread of wild-type polioviruses and identify the likely origins of VDPVs. We highlight the analysis methods and sequencing technology currently used and the potential for new technologies to speed up poliovirus detection and the interpretation of genetic data. At a pivotal point in the eradication campaign with the threat of anti-vaccine sentiment and donor and public fatigue, innovation is critical to maintain drive and overcome the last remaining circulating virus.
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Affiliation(s)
- David Jorgensen
- Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Margarita Pons-Salort
- Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Alexander G Shaw
- Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Nicholas C Grassly
- Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
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Yeh MT, Bujaki E, Dolan PT, Smith M, Wahid R, Konz J, Weiner AJ, Bandyopadhyay AS, Van Damme P, De Coster I, Revets H, Macadam A, Andino R. Engineering the Live-Attenuated Polio Vaccine to Prevent Reversion to Virulence. Cell Host Microbe 2020; 27:736-751.e8. [PMID: 32330425 PMCID: PMC7566161 DOI: 10.1016/j.chom.2020.04.003] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 12/03/2019] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
Abstract
The live-attenuated oral poliovirus vaccine (OPV or Sabin vaccine) replicates in gut-associated tissues, eliciting mucosa and systemic immunity. OPV protects from disease and limits poliovirus spread. Accordingly, vaccination with OPV is the primary strategy used to end the circulation of all polioviruses. However, the ability of OPV to regain replication fitness and establish new epidemics represents a significant risk of polio re-emergence should immunization cease. Here, we report the development of a poliovirus type 2 vaccine strain (nOPV2) that is genetically more stable and less likely to regain virulence than the original Sabin2 strain. We introduced modifications within at the 5' untranslated region of the Sabin2 genome to stabilize attenuation determinants, 2C coding region to prevent recombination, and 3D polymerase to limit viral adaptability. Prior work established that nOPV2 is immunogenic in preclinical and clinical studies, and thus may enable complete poliovirus eradication.
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Affiliation(s)
- Ming Te Yeh
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Erika Bujaki
- National Institute for Biological Standards and Control (NIBSC), South Mimms, Herts EN6 3QG, UK
| | - Patrick T Dolan
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Matthew Smith
- National Institute for Biological Standards and Control (NIBSC), South Mimms, Herts EN6 3QG, UK
| | - Rahnuma Wahid
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
| | - John Konz
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA
| | - Amy J Weiner
- Bill and Melinda Gates Foundation, Seattle, WA 98109, USA
| | | | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp 2610, Belgium
| | - Ilse De Coster
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp 2610, Belgium
| | - Hilde Revets
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp 2610, Belgium
| | - Andrew Macadam
- National Institute for Biological Standards and Control (NIBSC), South Mimms, Herts EN6 3QG, UK.
| | - Raul Andino
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94158, USA.
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Macklin GR, O'Reilly KM, Grassly NC, Edmunds WJ, Mach O, Santhana Gopala Krishnan R, Voorman A, Vertefeuille JF, Abdelwahab J, Gumede N, Goel A, Sosler S, Sever J, Bandyopadhyay AS, Pallansch MA, Nandy R, Mkanda P, Diop OM, Sutter RW. Evolving epidemiology of poliovirus serotype 2 following withdrawal of the serotype 2 oral poliovirus vaccine. Science 2020; 368:401-405. [PMID: 32193361 PMCID: PMC10805349 DOI: 10.1126/science.aba1238] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/11/2020] [Indexed: 11/02/2022]
Abstract
Although there have been no cases of serotype 2 wild poliovirus for more than 20 years, transmission of serotype 2 vaccine-derived poliovirus (VDPV2) and associated paralytic cases in several continents represent a threat to eradication. The withdrawal of the serotype 2 component of oral poliovirus vaccine (OPV2) was implemented in April 2016 to stop VDPV2 emergence and secure eradication of all serotype 2 poliovirus. Globally, children born after this date have limited immunity to prevent transmission. Using a statistical model, we estimated the emergence date and source of VDPV2s detected between May 2016 and November 2019. Outbreak response campaigns with monovalent OPV2 are the only available method to induce immunity to prevent transmission. Yet our analysis shows that using monovalent OPV2 is generating more paralytic VDPV2 outbreaks with the potential for establishing endemic transmission. A novel OPV2, for which two candidates are currently in clinical trials, is urgently required, together with a contingency strategy if this vaccine does not materialize or perform as anticipated.
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Affiliation(s)
- G R Macklin
- Centre of Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | - K M O'Reilly
- Centre of Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - N C Grassly
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - W J Edmunds
- Centre of Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - O Mach
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | | | - A Voorman
- Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - J F Vertefeuille
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - J Abdelwahab
- United Nations Children's Fund (UNICEF), New York, NY, USA
| | - N Gumede
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - A Goel
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | - S Sosler
- Gavi (the Vaccine Alliance), Geneva, Switzerland
| | - J Sever
- Rotary International, Evanston, IL, USA
| | | | - M A Pallansch
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - R Nandy
- United Nations Children's Fund (UNICEF), New York, NY, USA
| | - P Mkanda
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - O M Diop
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | - R W Sutter
- Polio Eradication, World Health Organization, Geneva, Switzerland
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Development of a new oral poliovirus vaccine for the eradication end game using codon deoptimization. NPJ Vaccines 2020; 5:26. [PMID: 32218998 PMCID: PMC7083942 DOI: 10.1038/s41541-020-0176-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/14/2020] [Indexed: 11/30/2022] Open
Abstract
Enormous progress has been made in global efforts to eradicate poliovirus, using live-attenuated Sabin oral poliovirus vaccine (OPV). However, as the incidence of disease due to wild poliovirus has declined, vaccine-derived poliovirus (VDPV) has emerged in areas of low-vaccine coverage. Coordinated global cessation of routine, type 2 Sabin OPV (OPV2) use has not resulted in fewer VDPV outbreaks, and continued OPV use in outbreak-response campaigns has seeded new emergences in low-coverage areas. The limitations of existing vaccines and current eradication challenges warranted development of more genetically stable OPV strains, most urgently for OPV2. Here, we report using codon deoptimization to further attenuate Sabin OPV2 by changing preferred codons across the capsid to non-preferred, synonymous codons. Additional modifications to the 5′ untranslated region stabilized known virulence determinants. Testing of this codon-deoptimized new OPV2 candidate (nOPV2-CD) in cell and animal models demonstrated that nOPV2-CD is highly attenuated, grows sufficiently for vaccine manufacture, is antigenically indistinguishable from Sabin OPV2, induces neutralizing antibodies as effectively as Sabin OPV2, and unlike Sabin OPV2 is genetically stable and maintains an attenuation phenotype. In-human clinical trials of nOPV2-CD are ongoing, with potential for nOPV strains to serve as critical vaccine tools for achieving and maintaining polio eradication.
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Environmental Surveillance for Poliovirus and Other Enteroviruses: Long-Term Experience in Moscow, Russian Federation, 2004⁻2017. Viruses 2019; 11:v11050424. [PMID: 31072058 PMCID: PMC6563241 DOI: 10.3390/v11050424] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/24/2019] [Accepted: 05/07/2019] [Indexed: 11/17/2022] Open
Abstract
Polio and enterovirus surveillance may include a number of approaches, including incidence-based observation, a sentinel physician system, environmental monitoring and acute flaccid paralysis (AFP) surveillance. The relative value of these methods is widely debated. Here we summarized the results of 14 years of environmental surveillance at four sewage treatment plants of various capacities in Moscow, Russia. A total of 5450 samples were screened, yielding 1089 (20.0%) positive samples. There were 1168 viruses isolated including types 1–3 polioviruses (43%) and 29 different types of non-polio enteroviruses (51%). Despite using the same methodology, a significant variation in detection rates was observed between the treatment plants and within the same facility over time. The number of poliovirus isolates obtained from sewage was roughly 60 times higher than from AFP surveillance over the same time frame. All except one poliovirus isolate were Sabin-like polioviruses. The one isolate was vaccine-derived poliovirus type 2 with 17.6% difference from the corresponding Sabin strain, suggesting long-term circulation outside the scope of the surveillance. For some non-polio enterovirus types (e.g., Echovirus 6) there was a good correlation between detection in sewage and incidence of clinical cases in a given year, while other types (e.g., Echovirus 30) could cause large outbreaks and be almost absent in sewage samples. Therefore, sewage monitoring can be an important part of enterovirus surveillance, but cannot substitute other approaches.
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Tournier JN. [The eradication of infectious viral diseases endangered by advances in synthetic biology]. Med Sci (Paris) 2019; 35:181-186. [PMID: 30774089 DOI: 10.1051/medsci/2019005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The eradication of infectious diseases is one of the oldest dreams of mankind. It has been materialized only once in History with smallpox in 1980. Considerable efforts are being developed against poliomyelitis viruses since 1988, but the ultimate goal of eradication is not yet achieved. Paradoxically, while the objective of having eradicated these two viral diseases is approaching, synthetic biology multiplies the prowesses of virus "neosynthesis", imperiling at least virtually the durability of these advances. This article emphasizes the potential of a new biology on one side, and the difficult reality of the fight against infections on the other.
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Affiliation(s)
- Jean-Nicolas Tournier
- Institut de recherche biomédicale des armées, Unité Biothérapies anti-infectieuses et immunité, Département Microbiologie et maladies infectieuses, 1, place général Valérie André, 91220 Brétigny-sur-Orge, France - Institut Pasteur, unité génomique virale et vaccination, CNRS UMR-3569, 25, rue du Docteur Roux, 75015 Paris, France - École du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
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Kroiss SJ, Ahmadzai M, Ahmed J, Alam MM, Chabot-Couture G, Famulare M, Mahamud A, McCarthy KA, Mercer LD, Muhammad S, Safdar RM, Sharif S, Shaukat S, Shukla H, Lyons H. Assessing the sensitivity of the polio environmental surveillance system. PLoS One 2018; 13:e0208336. [PMID: 30592720 PMCID: PMC6310268 DOI: 10.1371/journal.pone.0208336] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The polio environmental surveillance (ES) system has been an incredible tool for advancing polio eradication efforts because of its ability to highlight the spatial and temporal extent of poliovirus circulation. While ES often outperforms, or is more sensitive than AFP surveillance, the sensitivity of the ES system has not been well characterized. Fundamental uncertainty of ES site sensitivity makes it difficult to interpret results from ES, particularly negative results. METHODS AND FINDINGS To study ES sensitivity, we used data from Afghanistan and Pakistan to examine the probability that each ES site detected the Sabin 1, 2, or 3 components of the oral polio vaccine (OPV) as a function of virus prevalence within the same district (estimated from AFP data). Accounting for virus prevalence is essential for estimating site sensitivity because Sabin detection rates should vary with prevalence-high immediately after supplemental immunization activities (SIAs), but low in subsequent months. We found that most ES sites in Pakistan and Afghanistan are highly sensitive for detecting poliovirus relative to AFP surveillance in the same districts. For example, even when Sabin poliovirus is at low prevalence of ~0.5-3% in AFP surveillance, most ES sites have ~34-50% probability of detecting Sabin. However, there was considerable variation in ES site sensitivity and we flagged several sites for re-evaluation based on low sensitivity rankings and low wild polio virus detection rates. In these areas, adding new sites or modifying collection methods in current sites could improve sensitivity of environmental surveillance. CONCLUSIONS Relating ES detections to virus prevalence significantly improved our ability to evaluate site sensitivity compared to evaluations based solely on ES detection rates. To extend our approach to new sites and regions, we provide a preliminary framework for relating ES and AFP detection rates, and descriptions of how detection rates might relate to SIAs and natural seasonality.
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Affiliation(s)
- Steve J. Kroiss
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Maiwand Ahmadzai
- National Emergency Operations Centre for Polio Eradication, Kabul, Afghanistan
| | - Jamal Ahmed
- World Health Organization, Geneva, Switzerland
| | - Muhammad Masroor Alam
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
- World Health Organization, Islamabad, Pakistan
| | | | - Michael Famulare
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Abdirahman Mahamud
- World Health Organization, Islamabad, Pakistan
- National Emergency Operations Centre for Polio Eradication, Islamabad, Pakistan
| | - Kevin A. McCarthy
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Laina D. Mercer
- Institute for Disease Modeling, Bellevue, WA, United States of America
| | - Salman Muhammad
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Rana M. Safdar
- National Emergency Operations Centre for Polio Eradication, Islamabad, Pakistan
| | - Salmaan Sharif
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
- World Health Organization, Islamabad, Pakistan
| | - Shahzad Shaukat
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
- World Health Organization, Islamabad, Pakistan
| | - Hemant Shukla
- National Emergency Operations Centre for Polio Eradication, Kabul, Afghanistan
| | - Hil Lyons
- Institute for Disease Modeling, Bellevue, WA, United States of America
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Mobley DJ, Hayney MS. Elusive eradication: Challenges facing the worldwide eradication of polio. J Am Pharm Assoc (2003) 2018; 58:683-684. [PMID: 30415801 DOI: 10.1016/j.japh.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Perlman S, Gallagher T. Not your usual tRNA synthetase: hWARS serves as an enterovirus entry factor. J Clin Invest 2018; 128:4767-4769. [PMID: 30320601 PMCID: PMC6205376 DOI: 10.1172/jci124582] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Enteroviruses, including subtype EV-A71, infect the brain, liver, heart, and other organs, causing a myriad of human diseases. This spectrum of disease is thought to be due, in part, to differential binding to host cells, and additional knowledge of enterovirus cell entry is essential for therapeutic development. In this issue of the JCI, Yeung et al. provide evidence of a novel EV-A71 entry factor, a host-produced tryptophan tRNA synthetase (hWARS), that facilitates entry of multiple subtypes of enteroviruses. hWARS is a cytoplasmic enzyme that is essential for translation but also upregulated and secreted during inflammatory processes. The results of this study support the notion of secreted hWARS as an unconventional virus entry factor that raises interesting questions about mechanisms by which inflammation and a tRNA synthetase facilitate viral pathogenesis.
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Affiliation(s)
- Stanley Perlman
- Department of Microbiology and Immunology, University of Iowa and
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tom Gallagher
- Department of Microbiology and Immunology, Loyola University, Chicago, Illinois, USA
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Abstract
The American Academy of Pediatrics strongly supports the Polio Eradication and Endgame Strategic Plan of the Global Polio Eradication Initiative. This plan was endorsed in November 2012 by the Strategic Advisory Group of Experts on Immunization of the World Health Organization and published by the World Health Organization in April 2013. As a key component of the plan, it will be necessary to stop oral polio vaccine (OPV) use globally to achieve eradication, because the attenuated viruses in the vaccine rarely can cause polio. The plan includes procedures for elimination of vaccine-associated paralytic polio and circulating vaccine-derived polioviruses (cVDPVs). cVDPVs can proliferate when vaccine viruses are transmitted among susceptible people, resulting in mutations conferring both the neurovirulence and transmissibility characteristics of wild polioviruses. Although there are 3 different types of wild poliovirus strains, the polio eradication effort has already resulted in the global elimination of type 2 poliovirus for more than a decade. Type 3 poliovirus may be eliminated because the wild type 3 poliovirus was last detected in 2012. Thus, of the 3 wild types, only wild type 1 poliovirus is still known to be circulating and causing disease. OPV remains the key vaccine for eradicating wild polioviruses in polio-infected countries because it induces high levels of systemic immunity to prevent paralysis and intestinal immunity to reduce transmission. However, OPV is a rare cause of paralysis and the substantial decrease in wild-type disease has resulted in estimates that the vaccine is causing more polio-related paralysis annually in recent years than the wild virus. The new endgame strategic plan calls for stepwise removal of the type 2 poliovirus component from trivalent oral vaccines, because type 2 wild poliovirus appears to have been eradicated (since 1999) and yet is the main cause of cVDPV outbreaks and approximately 40% of vaccine-associated paralytic polio cases. The Endgame and Strategic Plan will be accomplished by shifting from trivalent OPV to bivalent OPV (containing types 1 and 3 poliovirus only). It will be necessary to introduce trivalent inactivated poliovirus vaccine (IPV) into routine immunization programs in all countries using OPV to provide population immunity to type 2 before the switch from trivalent OPV to bivalent OPV. The Global Polio Eradication Initiative hopes to achieve global eradication of polio by 2018 with this strategy, after which all OPV use will be stopped. Challenges expected for adding IPV into routine immunization schedules include higher cost of IPV compared with OPV, cold-chain capacity limits, more complex administration of vaccine because IPV requires injections as opposed to oral administration, and inferior intestinal immunity conferred by IPV. The goal of this report is to help pediatricians understand the change in strategy and outline ways that pediatricians can help global polio eradication efforts, including advocating for the resources needed to accomplish polio eradication and for incorporation of IPV into routine immunization programs in all countries.
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