Poliovirus Excretion Among Persons With Primary Immune Deficiency Disorders: Summary of a Seven-Country Study Series

Background. Persons with primary immune deficiency disorders (PID), especially those disorders affecting the B-cell system, are at substantially increased risk of paralytic poliomyelitis and can excrete poliovirus chronically. However, the risk of prolonged or chronic excretion is not well character...

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Bibliographic Details
Published in:The Journal of infectious diseases 2014-11, Vol.210 (suppl_1), p.S368-S372
Main Authors: Li, Li, Ivanova, Olga, Driss, Nadia, Tiongco-Recto, Marysia, da Silva, Rajiva, Shahmahmoodi, Shohreh, Sazzad, Hossain M. S., Mach, Ondrej, Kahn, Anna-Lea, Sutter, Roland W.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Africa
Asia
Child
Child, Preschool
Common variable immunodeficiency
Disorders
Epidemiology
Excretion
Female
Health surveillance
Humans
Immunocompromised Host
Immunologic Deficiency Syndromes
Immunologic Deficiency Syndromes - complications
Infant
Life Sciences
Male
Microbiology and Parasitology
Oral poliovirus vaccines
Physiological immunosuppression
Poliomyelitis
Poliomyelitis - epidemiology
Poliomyelitis - virology
Poliovirus
Poliovirus - isolation & purification
Poliovirus vaccines
RISK ASSESSMENT, MITIGATION, AND PREVENTION
Russia
Virology
Virus Shedding
Young Adult
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Summary:Background. Persons with primary immune deficiency disorders (PID), especially those disorders affecting the B-cell system, are at substantially increased risk of paralytic poliomyelitis and can excrete poliovirus chronically. However, the risk of prolonged or chronic excretion is not well characterized in developing countries. We present a summary of a country study series on poliovirus excretion among PID cases. Methods. Cases with PID from participating institutions were enrolled during the first year and after obtaining informed consent were tested for polioviruses in stool samples. Those cases excreting poliovirus were followed on a monthly basis during the second year until 2 negative stool samples were obtained. Results. A total of 562 cases were enrolled in Bangladesh, China, Iran, Philippines, Russia, Sri Lanka, and Tunisia during 2008-2013. Of these, 17 (3%) shed poliovirus, including 2 cases with immunodeficient vaccine-derived poliovirus. Poliovirus was detected in a single sample from 5/17 (29%) cases. One case excreted for more than 6 months. None of the cases developed paralysis during the study period. Conclusions. Chronic polioviruses excretion remains a rare event even among individuals with PID. Nevertheless, because these individuals were not paralyzed they would have been missed by current surveillance; therefore, surveillance for polioviruses among PID should be established.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jiu065