Emerg Infect Dis. 2017 Oct;23(10):1664-1670. doi: 10.3201/eid2310.170724.
Prolonged excretion of poliovirus can occur in immunodeficient patients who receive oral polio vaccine, which may lead to propagation of highly divergent vaccine-derived polioviruses (VDPVs), posing a concern for global polio eradication. This study aimed to estimate the proportion of primary immunodeficient children with enterovirus infection and to identify the long-term polio/nonpolio enterovirus excreters in a tertiary care unit in Mumbai, India. During September 2014-April 2017, 151 patients received diagnoses of primary immunodeficiency (PID). We isolated 8 enteroviruses (3 polioviruses and 5 nonpolio enteroviruses) in cell culture of 105 fecal samples collected from 42 patients. Only 1 patient with severe combined immunodeficiency was identified as a long-term VDPV3 excreter (for 2 years after identification of infection). Our results show that the risk of enterovirus excretion among children in India with PID is low; however, systematic screening is necessary to identify long-term poliovirus excreters until the use of oral polio vaccine is stopped.
免疫缺陷患者口服脊髓灰质炎疫苗后,可能会出现脊髓灰质炎病毒排泄时间延长的情况,从而导致高度变异的疫苗衍生脊髓灰质炎病毒(VDPV)的传播,这对全球消灭脊髓灰质炎工作构成了威胁。本研究旨在评估原发性免疫缺陷儿童中肠病毒感染的比例,并确定印度孟买一家三级护理中心的长期脊髓灰质炎/非脊髓灰质炎肠病毒排泄者。2014 年 9 月至 2017 年 4 月,共有 151 名患者被诊断为原发性免疫缺陷(PID)。我们从 42 名患者的 105 份粪便样本中分离出 8 株肠道病毒(3 株脊灰病毒和 5 株非脊灰肠道病毒)。仅在一名严重联合免疫缺陷患者中发现了长期 VDPV3 排泄者(在感染确认后持续排泄 2 年)。我们的结果表明,印度 PID 儿童肠道病毒排泄的风险较低;然而,在停止使用口服脊髓灰质炎疫苗之前,有必要进行系统筛查,以确定长期脊髓灰质炎病毒排泄者。