RE: "TRANSMISSIBILITY AND PERSISTENCE OF ORAL POLIO VACCINE VIRUSES: IMPLICATIONS FOR THE GLOBAL POLIOMYELITIS ERADICATION INITIATIVE"

Subhash C. Arya

Centre for Logistical Research and Innovation M-122 (of part 2), Greater Kailash-II New Delhi-110048, India

In a recent issue of the American Journal of Epidemiology, Fine and Carneiro (1Go) succinctly reviewed the role of oral polio vaccine in the historical success of the global poliomyelitis eradication initiative.

I would like to point out that apart from other sources of polioviruses in 21st century (1Go), persisting poliovirus RNA in the central nervous system of patients with postpolio syndrome (PPS) could constitute a significant source of a large, potentially infectious virus pool. Poliovirus-specific genomic sequences were detected during the amplification of genomic sequences in the conserved part of the 5'-untranslated region as well as in the poliovirus-specific VP1 region in five of the 10 patients with PPS and in none of the 23 controls in Lyon, France (2Go). PPS that begins 25 or 30 years after an attack of poliomyelitis could be a problem after the year 2025 or 2030. Wild poliovirus-associated PPS apart, even the attenuated oral polio vaccine strains might persist for decades in humans with vaccine-associated poliomyelitis!

Editor's note: Drs. Fine and Carneiro were asked whether they wished to respond to this letter but chose not to do so.

REFERENCES

  1. Fine PEM, Carneiro IAM. Transmissibility and persistence of oral polio vaccine viruses: implications for the global polio- myelitis eradication initiative. Am J Epidemiol 1999;150:1001–21.[Abstract]
  2. Leparc-Goffart I, Julien J, Fuchs F, et al. Evidence of presence of poliovirus genomic sequences in the cerebrospinal fluid from patients with postpolio syndrome. J Clin Microbiol 1996;34:2023–6.[Abstract]




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