Asymptomatic immunodeficiency-associated vaccine-derived poliovirus infections in two UK children

Anika Singanayagam; Dimitra Klapsa; Shirelle Burton-Fanning; Julian Hand; Thomas Wilton; Laura Stephens; Ryan Mate; Benjamin Shillitoe; Cristina Celma; Mary Slatter; Terry Flood; Robin Gopal; Javier Martin; Maria Zambon

doi:10.1038/s41467-023-39094-0

Asymptomatic immunodeficiency-associated vaccine-derived poliovirus infections in two UK children

Anika Singanayagam^*, Dimitra Klapsa, Shirelle Burton-Fanning, Julian Hand, Thomas Wilton, Laura Stephens, Ryan Mate, Benjamin Shillitoe, Cristina Celma, Mary Slatter, Terry Flood, Robin Gopal, Javier Martin, Maria Zambon^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Increasing detections of vaccine-derived poliovirus (VDPV) globally, including in countries previously declared polio free, is a public health emergency of international concern. Individuals with primary immunodeficiency (PID) can excrete polioviruses for prolonged periods, which could act as a source of cryptic transmission of viruses with potential to cause neurological disease. Here, we report on the detection of immunodeficiency-associated VDPVs (iVDPV) from two asymptomatic male PID children in the UK in 2019. The first child cleared poliovirus with increased doses of intravenous immunoglobulin, the second child following haematopoetic stem cell transplantation. We perform genetic and phenotypic characterisation of the infecting strains, demonstrating intra-host evolution and a neurovirulent phenotype in transgenic mice. Our findings highlight a pressing need to strengthen polio surveillance. Systematic collection of stool from asymptomatic PID patients who are at high risk for poliovirus excretion could improve the ability to detect and contain iVDPVs.

Original language	English
Article number	3413
Journal	Nature Communications
Volume	14
Issue number	1
DOIs	https://doi.org/10.1038/s41467-023-39094-0
Publication status	Published - Dec 2023

Bibliographical note

Funding Information:
We thank all members of the clinical and health protection teams involved in the care of the patients involved and members of the UKHSA Colindale polio reference service laboratory teams involved in processing and analysing samples. We thank Cherstyn Hurley for generating the graphics used in Fig. . A.S. is supported by an NIHR Academic Clinical Lectureship.

Publisher Copyright:
© 2023, Crown.

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Singanayagam, A., Klapsa, D., Burton-Fanning, S., Hand, J., Wilton, T., Stephens, L., Mate, R., Shillitoe, B., Celma, C., Slatter, M., Flood, T., Gopal, R., Martin, J., & Zambon, M. (2023). Asymptomatic immunodeficiency-associated vaccine-derived poliovirus infections in two UK children. Nature Communications, 14(1), Article 3413. https://doi.org/10.1038/s41467-023-39094-0

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abstract = "Increasing detections of vaccine-derived poliovirus (VDPV) globally, including in countries previously declared polio free, is a public health emergency of international concern. Individuals with primary immunodeficiency (PID) can excrete polioviruses for prolonged periods, which could act as a source of cryptic transmission of viruses with potential to cause neurological disease. Here, we report on the detection of immunodeficiency-associated VDPVs (iVDPV) from two asymptomatic male PID children in the UK in 2019. The first child cleared poliovirus with increased doses of intravenous immunoglobulin, the second child following haematopoetic stem cell transplantation. We perform genetic and phenotypic characterisation of the infecting strains, demonstrating intra-host evolution and a neurovirulent phenotype in transgenic mice. Our findings highlight a pressing need to strengthen polio surveillance. Systematic collection of stool from asymptomatic PID patients who are at high risk for poliovirus excretion could improve the ability to detect and contain iVDPVs.",

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Asymptomatic immunodeficiency-associated vaccine-derived poliovirus infections in two UK children

Abstract

Bibliographical note

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