Circulation of Type 2 Vaccine-Derived Poliovirus in China in 2018–2019

Abstract Background China implemented the globally synchronized switch from trivalent oral poliovirus vaccine (tOPV) to bivalent OPV (bOPV) on May 1, 2016. During April 2018 to May 2019, the first outbreak caused by type 2 circulating vaccine-derived poliovirus (cVDPV2) after the switch occurred in...

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Published in:Open forum infectious diseases Vol. 8; no. 12; p. ofab535
Main Authors: Zhao, Hehe, Ma, Xiaozhen, Tang, Haishu, Zhang, Yong, Chen, Na, Kaisaier, Wusiman, Wang, Qi, Wang, Cheng, Zhu, Shuangli, Qi, Qi, Liu, Yu, Ma, Qianli, Yang, Qing, Li, Junhan, Wang, Dongyan, Li, Xiaolei, Xiao, Jinbo, Zhu, Hui, Xu, Wenbo, Tong, Wenbin, Yan, Dongmei
Format: Journal Article
Language:English
Published: US Oxford University Press 01.12.2021
Subjects:
Major
Surveillance
Vaccines
China
cVDPV2 outbreak
surveillance
vaccination switch
eradication
ISSN:2328-8957, 2328-8957
Online Access:Get full text
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Summary:Abstract Background China implemented the globally synchronized switch from trivalent oral poliovirus vaccine (tOPV) to bivalent OPV (bOPV) on May 1, 2016. During April 2018 to May 2019, the first outbreak caused by type 2 circulating vaccine-derived poliovirus (cVDPV2) after the switch occurred in Xinjiang and Sichuan, China. Methods. We performed sequence analysis of VP1 and the whole genome to determine the genomic characteristics of type 2 cVDPVs, and carried out coverage surveys to assess the risk of viral propagation. Surveillance for environment and acute flaccid paralysis was intensified to enhance case ascertainment. Results. Comparison of the complete genomes between early (Xinjiang strain) and late strains (Sichuan strains) revealed that recombination pattern and reverse mutation of attenuation sites had been fixed early, but the mutations of the neutralizing antigenic sites were introduced over the circulation. The Markov Chain Monte Carlo tree showed that the cVDPV2 initial infection was April 2016, earlier than the switch. So, we speculated that the cVDPV2 was originated from tOPV recipients and spread among children with a low level of immunity against the type 2. Conclusions The detection of this outbreak combined acute flaccid paralysis (AFP) surveillance with environmental surveillance (ES) indicates that ES should be expanded geographically to further complement AFP surveillance.
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H. Z. and X. M. contributed equally to this manuscript.
ISSN:2328-8957
2328-8957
DOI:10.1093/ofid/ofab535