14th ICID - Poster Abstracts - International Society for Infectious ...
14th ICID - Poster Abstracts - International Society for Infectious ...
14th ICID - Poster Abstracts - International Society for Infectious ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
When citing these abstracts please use the following reference:<br />
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.<br />
Please note that the official publication of the <strong>International</strong> Journal of <strong>Infectious</strong> Diseases 2010, Volume 14, Supplement 1<br />
is available electronically on http://www.sciencedirect.com<br />
Final Abstract Number: 83.016<br />
Session: Vaccines and Vaccine Development<br />
Date: Thursday, March 11, 2010<br />
Time: 12:30-13:30<br />
Room: <strong>Poster</strong> & Exhibition Area/Ground Level<br />
Type: <strong>Poster</strong> Presentation<br />
A vaccine derived poliovirus case in an immunocompromised argentinian child<br />
M. E. Burgos 1 , S. Elkik 1 , P. Barbosa 1 , M. Oleastro 1 , C. Freire 2 , A. Parra 1 , M. Caparelli 3 , C.<br />
Sarkis 4<br />
1 Hospital Garrahan, Buenos Aires, Argentina, 2 Servicio de Neurovirosis Dpto. Virología . IENEI-<br />
NLIS “Dr. Carlos G. Malbran”, Buenos Aires, Argentina, 3 Ministerio de Salud, Buenos Aires,<br />
Argentina, 4 Hospital Garrahan , Capital Federal, Argentina, Argentina<br />
Background: Although poliomyelitis caused by wild-type poliovirus has been almost eradicated,<br />
especially in developed countries, vaccine associated paralytic poliomyelitis (VAPP) cases still<br />
continue to occur in Latin American countries. In Argentina, where OPV routine immunization<br />
policy is ongoing, the last wild poliovirus (WPV) case was registered in 1984. Since then, the<br />
several polio cases reported were VAPP and Vaccine Derived Poliovirus (VDPV) (first iVDPV<br />
case was detected in 1998).<br />
Methods: To report a polio case caused by a VDPV in an immunodeficient patient diagnosed<br />
with polyclonal agammaglobulinemia.<br />
Results: In May 2009 a 15 month-old patient was hospitalized in our institution <strong>for</strong> acute flaccid<br />
monoparesis in his left lower limb with areflexia, with residual paralysis 60 days after onset. The<br />
patient had a history of recurrent infections (sepsis meningitis and pneumonia).Vaccination<br />
calendar was completed <strong>for</strong> his age (DPt/Hib-HB & OPV: 3 doses). The child received OPV3, 8<br />
months be<strong>for</strong>e.<br />
LCR 8 cells / prot 25 mg/100 mL / Glu 50 mg/ml with negative cultures (bacteria -<br />
mycobacterium, fungi). EMG showed pre-ganglionic injury. Spine MRI showed focal<br />
intramedullary cone and lower thoracic spinal cord with hyperintense signal in T2 left hemicord.<br />
The major capsid protein (VP1) of the Sabin virus T1 isolated in feces showed a 96.5% genetic<br />
similarity to Sabin 1 vaccine strain (a 3.5% genetic divergence in this region).<br />
Conclusion: The occurrence of iVDPVs appears to be very rare; the majority of patients stopped<br />
excretion of the virus after a certain period or have died. The overriding factor <strong>for</strong> the emergence<br />
of all VDPVs is the same as <strong>for</strong> WPV circulation, i.e., low routine OPV coverage rates in children.<br />
Thus, a community can become susceptible to the emergence of all types of VDPV producing an<br />
impact in the public health of the population. New polio vaccination strategies should be<br />
considered to avoid future VDPV cases and to be aligned WHO end- game strategies.