Top 5 Takeaways

1. A rare case of type 3 Vaccine-Derived Poliovirus (VDPV3) was detected in an infant with a primary immunodeficiency disorder (PID) in Chongqing, China.
2. Surveillance for poliovirus in PID patients has led to increased detection of immunodeficiency-related VDPV (iVDPV) cases, highlighting the importance of integrated poliovirus surveillance.
3. Children with PIDs can excrete VDPVs, posing challenges to global polio eradication efforts, as their immune systems cannot effectively clear the vaccine virus.
4. The child with PID, despite receiving oral poliovirus vaccine (OPV), experienced severe complications due to a genetic mutation in the ZAP70 gene, leading to a rare form of severe combined immunodeficiency (SCID).
5. This case underscores the need for comprehensive iVDPV surveillance, including acute flaccid paralysis (AFP), environmental, and iVDPV surveillance, to achieve and maintain a polio-free world.

Original Article Author and Citation

Corresponding Author:

Zhi-Yong Zhang, zzy510214@126.com.

Suggested Citation:

Yao N, Liu Y, Xu J, et al. Detection of a Highly Divergent Type 3 Vaccine-Derived Poliovirus in a Child with a Severe Primary Immunodeficiency Disorder — Chongqing, China, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1148–1150. DOI:http://dx.doi.org/10.15585/mmwr.mm7136a2 .

Summary

The article discusses a case of VDPV3 in a 1-year-old boy with SCID from Chongqing, China. Despite OPV administration, the child’s PID led to prolonged virus excretion and severe health complications. This case highlights the importance of surveillance in PID patients to prevent polio eradication efforts’ disruption.

Methods

A pilot iVDPV surveillance program in China was used to detect this VDPV3 case. Stool specimens from children with newly diagnosed PIDs were tested for poliovirus. The child’s medical history and genetic background were also considered in the analysis.

Discussion

The case illustrates the complexities in polio eradication, especially among children with PIDs. It raises concerns about the effectiveness of current surveillance methods and the need for their enhancement to prevent the spread of polioviruses from nonparalyzed iVDPV patients.

Conclusion

This case of VDPV3 in a PID patient demonstrates the critical role of comprehensive poliovirus surveillance in achieving global polio eradication. It calls for heightened awareness among healthcare professionals and the integration of AFP, environmental, and iVDPV surveillance systems.

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