Poliovirus excretion among persons with primary immune deficiency disorders: Summary of a seven-country study series
Abstract
BACKGROUND: Persons with primary immune deficiency disorders (PID), especially those disorders affecting the B-cell system, are at substantially increased risk of paralytic poliomyelitis and can excrete poliovirus chronically. However, the risk of prolonged or chronic excretion is not well characterized in developing countries. We present a summary of a country study series on poliovirus excretion among PID cases. METHODS: Cases with PID from participating institutions were enrolled during the first year and after obtaining informed consent were tested for polioviruses in stool samples. Those cases excreting poliovirus were followed on a monthly basis during the second year until 2 negative stool samples were obtained. RESULTS: A total of 562 cases were enrolled in Bangladesh, China, Iran, Philippines, Russia, Sri Lanka, and Tunisia during 2008-2013. Of these, 17 (3%) shed poliovirus, including 2 cases with immunodeficient vaccine-derived poliovirus. Poliovirus was detected in a single sample from 5/17 (29%) cases. One case excreted for more than 6 months. None of the cases developed paralysis during the study period. CONCLUSIONS: Chronic polioviruses excretion remains a rare event even among individuals with PID. Nevertheless, because these individuals were not paralyzed they would have been missed by current surveillance; therefore, surveillance for polioviruses among PID should be established.
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Immunocompromised individuals may be unable to clear intestinal replication of the vaccine virus, resulting in persistent intestinal poliovirus infection and prolonged shedding.
“Immunocompetent individuals clear attenuated vaccine virus from their bodies after a limited period of shedding, unlike immunocompromised individuals, who may be unable to clear the intestinal replication of the vaccine virus, resulting in persistent intestinal poliovirus infection and prolonged shedding [105,106].”
From The Fight against Poliovirus Is Not Over (2023) · cites this paper as [105]
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Salem, I. B., Khemiri, H., Khedhiri, M., Mekki, N., Joffret, M., Driss, N., Fraj, I. B., Khaled, M. B., Mrad, I. B., Barbouche, M., et al. (2026) · Microorganisms · doi:10.3390/microorganisms14020329 · Cited by 1 · see citing works
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Promising opportunities to improve polio vaccines
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- Authors
- Li, L., Ivanova, O., Driss, N., Tiongco-Recto, M., da Silva, R., Shahmahmoodi, S., Sazzad, H. M. S., Mach, O., Kahn, A.-L., & Sutter, R. W.
- Affiliations
- Chinese Center For Disease Control and Prevention (CN)
- Chumakov Institute of Poliomyelitis and Viral Encephalitides (RU)
- Tunis El Manar University (TN)
- Tehran University of Medical Sciences (IR)
- International Centre for Diarrhoeal Disease Research (BD)
- World Health Organization (CH)
- ORCID
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-11
- Volume
- 210
- Issue
- suppl_1
- Pages
- S368-S372
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2117654306
- Cited by
- 63
- References
- 29
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 6 · 2022: 1 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 5 · 2017: 7 · 2016: 15 · 2015: 6 · 2014: 2
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Keywords
- primary immunodeficiency, B-cell disorders, paralytic poliomyelitis, vaccine-derived poliovirus, polio surveillance, fecal samples, developing countries
- MeSH terms
- Adolescent, Adult, Africa, Asia, Child, Child, Preschool, Female, Humans, Immunologic Deficiency Syndromes, Infant, Male, Poliomyelitis, Russia, Immunocompromised Host, Virus Shedding, Poliovirus, Young Adult
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