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Journal of Virology, April 2000, p. 3001-3010, Vol. 74, No. 7
Division of Virology, National Institute for
Biological Standards and Control, Potters Bar, Hertfordshire,
United Kingdom
Received 4 October 1999/Accepted 21 December 1999
A 20-year-old female hypogammaglobulinemic patient received
monotypic Sabin 3 vaccine in 1962. The patient excreted type 3 poliovirus for a period of 637 days without developing any symptoms of
poliomyelitis, after which excretion appeared to have ceased spontaneously. The evolution of Sabin 3 throughout the entire period of
virus excretion was studied by characterization of seven sequential
isolates from the patient. The isolates were analyzed in terms of their
antigenic properties, virulence, sensitivity for growth at high
temperatures, and differences in nucleotide sequence from the Sabin
type 3 vaccine. The isolates followed a main lineage of evolution with
a rate of nucleotide substitution that was very similar to that
estimated for wild-type poliovirus during person-to-person
transmission. There was a delay in the appearance of antigenic variants
compared to sequential type 3 isolates from healthy vaccines, which
could be one of the possible explanations for the long-term excretion
of virus from the patient. The distribution of mutations in the
isolates identified regions of the virus possibly involved in
adaptation for growth in the human gut and virus persistence. None of
the isolates showed a full reversion of the attenuated and
temperature-sensitive phenotypes of Sabin 3. Information of this sort
will help in the assessment of the risk of spread of virulent
polioviruses from long-term excretors and in the design of therapies to
stop long-term excretion. This will make an important
contribution to the decision-making process on when to stop
vaccination once wild poliovirus has been eradicated.
0022-538X/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Evolution of the Sabin Strain of Type 3 Poliovirus
in an Immunodeficient Patient during the Entire 637-Day Period of
Virus Excretion
*
Corresponding author. Mailing address: Division of
Virology, National Institute for Biological Standards and Control,
Blanche Lane, Potters Bar, Hertfordshire EN6 3QG, United Kingdom.
Phone: (44) 1707 654753. Fax: (44) 1707 646 730. E-mail:
jmartin{at}nibsc.ac.uk.
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