The emergence of the circulating vaccine-derived poliovirus type 2 in multiple countries requires active surveillance : current scenario and counteracting strategies

Mohapatra, Ranjan K. and Kutikuppala, L V Simhachalam and Seidel, Veronique and Ansari, Azaj and Mishra, Snehasish and Kandi, Venkataramana (2023) The emergence of the circulating vaccine-derived poliovirus type 2 in multiple countries requires active surveillance : current scenario and counteracting strategies. International Journal of Surgery. ISSN 1743-9191 (https://doi.org/10.1097/JS9.0000000000000099)

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Abstract

Dear Editor, On April 11, 2022, a child less than two years old living in the Tamanrasset province of South Algeria showed signs of acute flaccid paralysis (AFP). On July 8, 2022, this was notified by the WHO through the Global Polio Laboratory Network (GPLN) as a case of circulating vaccine-derived poliovirus type 2 (cVDPV2) [1]. In the past few months, several genetically-linked Sabin-like type 2 (SL-2) poliovirus isolates have been detected numerous times in the US and the UK [2]. Since last February, the GPLN in London has been consistently detecting SL-2 isolates in sewage samples. The latter showed enough mutations to be classified as type 2 vaccine-derived poliovirus (VDPV2) and, due to the evidence of community transmission, were classified as circulating VDPV2 (cVDPV2) [2]. No human cases of VDPV2 have been documented in the UK as of September 5, 2022. Only one case of VDPV2 was reported in an unvaccinated paralytic individual. This was the first poliomyelitis case reported in that country since 2013 that was not linked to recent international travel. In the US, the virus isolates detected in environmental samples were found to be genetically-related to those reported in the sewage samples from London and those from Jerusalem, Israel [2]. In the case of the child who showed AFP in Algeria, the cVDPV2 isolates were detected in the stool samples. This was the first case of cVDPV2 in that country. Genome sequencing showed that the isolated virus was genetically-related to one strain previously isolated in Kano, Nigeria. The child had not received the polio vaccine and had never travelled outside the Tamanrasset province. Public health investigations are currently underway in that region to identify any more AFP cases [1].

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