Abstract
Background
Oral polio vaccine can rarely lead to Vaccine-associated paralytic poliomyelitis (VAPP).
Case characteristics
A 2-year-old child with asymmetric paralysis of lower limbs following first booster of oral polio vaccine; type 2 Vaccine-derived poliovirus (VDPV) isolated. Subsequently, the child was diagnosed to have common variable immunodeficiency.
Outcome
Paralysis gradually improved on follow-up; monthly intravenous immunoglobulin therapy started for primary immunodeficiency.
Message
We need to evaluate children with VAPP for underlying immunodeficiency.
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References
McKinney RE, Katz SL, Wilfert CM. Chronic enteroviral meningoencephalitis in agammaglobulinemic patients. Rev Infect Dis. 1987;9:334–56.
Alexander JP, Gary HE, Pallansch MA. Duration of poliovirus excretion and its implications for acute flaccid paralysis surveillance: a review of the literature. J Infect Dis. 1997;175S1:176–82.
Dowdle WR, Birmingham ME. The biologic principles of poliovirus eradication. J Infect Dis. 1997;175S1:S286–92.
World Health Organization. India polio status, as on 1 August 2014. Available from: www.searo.who.int/india/topics/poliomyelitis/polio-frequently-asked-statistics_04aug%202014.pdf?ua=1. Accessed February 12, 2017
Key OM, Wright PF, Agol VI, Delpeyroux F, Shimizu H, Nathanson N, et al. Circulating vaccine-derived polioviruses: current state of knowledge. Bull World Health Organ. 2004;82:16–23.
Centre for Disease Control and prevention. Update on vaccine-derived polioviruses. Mortal Wkly Rep. 2006;55:1093–7.
Wyatt V. Risk of live poliovirus in immunodeficient children. J Pediatr. 1975;87:152–3.
Kew OM, Sutter RW, Nottay BK. Prolonged replication of a type 1 vaccine derived poliovirus in an immunodeficient patient. J Clin Microbiol. 1998:2893–9.
Martin J, Dunn G, Hull R, Paterl V, Minor P. Evolution of the strain of type 3 poliovirus in an immunodeficient patient during the entire.637-day period of virus excretion. J Virol. 2000;74:3001–10.
Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP); Jog P, Kamath SS, et al. Introduction of inactivated poliovirus vaccine in National Immunization program and polio end game strategy. Indian Pediatr. 2016;53(Suppl.1):566–9.
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Gomber, S., Arora, V. & Dewan, P. Vaccine associated paralytic poliomyelitis unmasking common variable immunodeficiency. Indian Pediatr 54, 241–242 (2017). https://doi.org/10.1007/s13312-017-1038-x
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DOI: https://doi.org/10.1007/s13312-017-1038-x