Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 6;11(7):1211.
doi: 10.3390/vaccines11071211.

Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR-WHO Collaborative Study Phase-I

Madhu Chhanda Mohanty  1 , Mukesh Desai  2 , Ahmad Mohammad  3 , Amita Aggarwal  4 , Geeta Govindaraj  5 , Sagar Bhattad  6 , Harsha Prasada Lashkari  7 , Liza Rajasekhar  8 , Harish Verma  9 , Arun Kumar  3 , Unnati Sawant  1 , Swapnil Yashwant Varose  1 , Prasad Taur  2 , Reetika Malik Yadav  10 , Manogat Tatkare  1 , Mevis Fernandes  1 , Umair Bargir  10 , Sanjukta Majumdar  4 , Athulya Edavazhippurath  11 , Jyoti Rangarajan  6 , Ramesh Manthri  8 , Manisha Ranjan Madkaikar  10
Affiliations

Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR-WHO Collaborative Study Phase-I

Madhu Chhanda Mohanty et al. Vaccines (Basel). .

Abstract

The emergence of vaccine-derived polioviruses (VDPVs) in patients with Primary Immunodeficiency (PID) is a threat to the polio-eradication program. In a first of its kind pilot study for successful screening and identification of VDPV excretion among patients with PID in India, enteroviruses were assessed in stool specimens of 154 PID patients across India in a period of two years. A total of 21.42% of patients were tested positive for enteroviruses, 2.59% tested positive for polioviruses (PV), whereas 18.83% of patients were positive for non-polio enteroviruses (NPEV). A male child of 3 years and 6 months of age diagnosed with Hyper IgM syndrome was detected positive for type1 VDPV (iVDPV1) with 1.6% nucleotide divergence from the parent Sabin strain. E21 (19.4%), E14 (9%), E11 (9%), E16 (7.5%), and CVA2 (7.5%) were the five most frequently observed NPEV types in PID patients. Patients with combined immunodeficiency were at a higher risk for enterovirus infection as compared to antibody deficiency. The high susceptibility of PID patients to enterovirus infection emphasizes the need for enhanced surveillance of these patients until the use of OPV is stopped. The expansion of PID surveillance and integration with a national program will facilitate early detection and follow-up of iVDPV excretion to mitigate the risk for iVDPV spread.

Keywords: AFP surveillance; Global Polio Eradication Initiative (GPEI); Oral Polio Vaccine (OPV); combined immunodeficiency (CID); enteroviruses; iVDPV surveillance; immunodeficiency-related vaccine-derived polioviruses (iVDPV); inborn errors of immunity (IEI); polio eradication; primary immunodeficiency disorder (PID); prolonged excretion.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Age wise distribution of EV-positive PID patients enrolled in the study: The PID patients enrolled in the study during Dec 2019 to Dec 2021 were divided in to groups as per EV excretion. EV—Enteroviruses, NPEV—Non-polio enteroviruses, PV—Polioviruses, PID—Primary immunodeficiency disorders.
Figure 2
Figure 2
Detection rate of NPEVs among PID patients enrolled in the study. EV—Enteroviruses, NPEV—Non-polio enteroviruses, E—Echoviruses, CVA—Coxsakievirus A.
Figure 3
Figure 3
Enterovirus positivity among IVIg receiving and non-receiving PID patients enrolled in the study. EV—Enteroviruses, IVIg—Intravenous Immunoglobulin, NPEV—Non-polio enteroviruses, PV—Polioviruses.
Figure 4
Figure 4
Immunodeficiency category wise distribution of PID cases enrolled in the study.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bigouette J.P., Wilkinson A.L., Tallis G., Burns C.C., Wassilak S.G.F., Vertefeuille J.F. Progress toward Polio Eradication—Worldwide, January 2019–June 2021. MMWR Morb. Mortal. Wkly. Rep. 2021;70:1129–1135. doi: 10.15585/mmwr.mm7034a1. - DOI - PMC - PubMed
    1. WHO Detection of Circulating Vaccine Derived Polio Virus 2 (cVDPV2) in Environmental Samples—The United Kingdom of Great Britain and Northern Ireland and the United States of America. [(accessed on 20 January 2023)]. Available online: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON408.
    1. Guo J., Bolivar-Wagers S., Srinivas N., Holubar M., Maldonado Y. Immunodeficiency-related vaccine-derived poliovirus (iVDPV) cases: A systematic review and implications for polio eradication. Vaccine. 2015;33:1235–1242. doi: 10.1016/j.vaccine.2015.01.018. - DOI - PMC - PubMed
    1. Macklin G., Diop O.M., Humayun A., Shahmahmoodi S., El-Sayed Z.A., Triki H., Rey G., Avagyan T., Grabovac V., Jorba J., et al. Update on Immunodeficiency-Associated Vaccine-Derived Polioviruses—Worldwide, July 2018–December 2019. MMWR Morb. Mortal. Wkly. Rep. 2020;69:913–917. doi: 10.15585/mmwr.mm6928a4. - DOI - PMC - PubMed
    1. Tangye S.G., Al-Herz W., Bousfiha A., Cunningham-Rundles C., Franco J.L., Holland S.M., Klein C., Morio T., Oksenhendler E., Picard C., et al. Human Inborn Errors of Immunity: 2022 Update on the Classification from the International Union of Immunological Societies Expert Committee. J. Clin. Immunol. 2022;42:1473–1507. doi: 10.1007/s10875-022-01289-3. - DOI - PMC - PubMed

LinkOut - more resources