Outbreak of type 2 vaccine-derived poliovirus in Nigeria: Emergence and widespread circulation in an underimmunized population
Open accessAbstract
Wild poliovirus has remained endemic in northern Nigeria because of low coverage achieved in the routine immunization program and in supplementary immunization activities (SIAs). An outbreak of infection involving 315 cases of type 2 circulating vaccine-derived poliovirus (cVDPV2; >1% divergent from Sabin 2) occurred during July 2005-June 2010, a period when 23 of 34 SIAs used monovalent or bivalent oral poliovirus vaccine (OPV) lacking Sabin 2. In addition, 21 "pre-VDPV2" (0.5%-1.0% divergent) cases occurred during this period. Both cVDPV and pre-VDPV cases were clinically indistinguishable from cases due to wild poliovirus. The monthly incidence of cases increased sharply in early 2009, as more children aged without trivalent OPV SIAs. Cumulative state incidence of pre-VDPV2/cVDPV2 was correlated with low childhood immunization against poliovirus type 2 assessed by various means. Strengthened routine immunization programs in countries with suboptimal coverage and balanced use of OPV formulations in SIAs are necessary to minimize risks of VDPV emergence and circulation.
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A severe outbreak of cVDPV2 occurred in Nigeria from 2005 for more than six years, with more than 300 cases of polio.
“A severe outbreak of cVDPV2 occurred in Nigeria from 2005 for more than six years, with more than 300 cases of polio [97,98,99].”
From The Fight against Poliovirus Is Not Over (2023) · cites this paper as [97]
The Abstract and Results > Descriptive Epidemiology report 315 cVDPV2 cases in Nigeria beginning in July 2005, supporting the claim of more than 300 cases. They date the outbreak through June 2010—a five-year period—not more than six years. (LLM, conf=0.91)
Experimental — accuracy not yet measuredRare OPV-derived type 2 OPV strains with more than 0.5% sequence divergence have been implicated in poliomyelitis and some of them were shown to be the source of more diverged VDPV lineages.
“In fact, rare OPV-derived type 2 OPV strains with more than 0.5% have been implicated in poliomyelitis and some of them were shown to be the source of more diverged VDPV lineages [70].”
From Recombination between Poliovirus and Coxsackie A Viruses of Species C: A Model of Viral Genetic Plasticity and Emergence (2011) · cites this paper as [70]
The cVDPVs implicated in most outbreaks mentioned above were due to recombinant strains which were the product of genetic exchanges between OPV strains and other HEV-Cs, including the recombinant type 2 cVDPVs implicated in recent polio outbreaks in India and in Democratic Republic of Congo.
“It is striking that the cVDPVs implicated in most outbreaks mentioned above were due to recombinant strains which were the product of genetic exchanges between OPV strains and other HEV-Cs (Figures 3 and 4 and Table 1) [3,70,89,96] including the recombinant type 2 cVDPVs implicated in recent polio outbreaks in India and in Democratic Republic of Congo [95,97].”
From Recombination between Poliovirus and Coxsackie A Viruses of Species C: A Model of Viral Genetic Plasticity and Emergence (2011) · cites this paper as [70]
Une épidémie à cPVDV de type 2 a sévi au Nigéria de 2005 à 2012 avec presque 400 cas de PPA.
“Une épidémie à cPVDV de type 2 a sévi au Nigéria de 2005 à 2012 avec presque 400 cas de PPA [21].”
From Éradication de la poliomyélite et émergence de poliovirus pathogènes dérivés du vaccin: De Madagascar au Cameroun (2013) · cites this paper as [21]
Des divergences nucléotidiques allant jusqu'à 6 % au niveau de la région codant VP1 ont été observées dans le génome des souches nigérianes.
“Des divergences nucléotidiques allant jusqu'à 6 % au niveau de la région codant VP1 ont été observées dans le génome des souches nigérianes”
From Éradication de la poliomyélite et émergence de poliovirus pathogènes dérivés du vaccin: De Madagascar au Cameroun (2013) · cites this paper as [21]
Dans l'immense majorité des épidémies, les cPVDV impliqués ont un génome recombinant.
“comme dans l'immense majorité des épidémies, les cPVDV impliqués ont un génome recombinant.”
From Éradication de la poliomyélite et émergence de poliovirus pathogènes dérivés du vaccin: De Madagascar au Cameroun (2013) · cites this paper as [21]
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“Strikingly, the cVDPVs involved in most of the above epidemics were recombinant strains, the product of genetic exchange between OPV strains and other Enterovirus C [97,101,102].”
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- Authors
- Wassilak, S., Pate, M. A., Wannemuehler, K., Jenks, J., Burns, C., Chenoweth, P., Abanida, E. A., Adu, F., Baba, M., Gasasira, A., Iber, J., Mkanda, P., Williams, A. J., Shaw, J., Pallansch, M., & Kew, O.
- Affiliations
- Centers for Disease Control and Prevention (US)
- National Primary Health Care Development Agency (NG)
- University of Ibadan (NG)
- World Health Organization - Nigeria (NG)
- Corresponding author
- Wassilak, Steven
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-04
- Volume
- 203
- Issue
- 7
- Pages
- 898-909
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC3068031
- OpenAlex
- W2152306774
- Cited by
- 120
- References
- 42
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 11 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 6 · 2018: 10 · 2017: 7 · 2016: 6 · 2015: 10 · 2014: 18 · 2013: 15 · 2012: 13
- FWCI
- 11.85
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- The Journal of Infectious Diseases (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Keywords
- poliovirus outbreak, oral polio vaccine, supplementary immunization activities, routine immunization coverage, Northern Nigeria, poliovirus type 2
- MeSH terms
- Adolescent, Adult, Aged, Child, Child, Preschool, Disease Outbreaks, Female, Health Policy, Humans, Infant, Infant, Newborn, Male, Middle Aged, Mutation, Nigeria, Poliomyelitis, Vaccination, Incidence, Genome, Viral, Poliovirus, Poliovirus Vaccines, Young Adult
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