@article{mbs:/content/journal/jgv/10.1099/vir.0.18974-0, author = "Buttinelli, Gabriele and Donati, Valentina and Fiore, Stefano and Marturano, Jill and Plebani, Alessandro and Balestri, Paolo and Soresina, Anna Rosa and Vivarelli, Rossella and Delpeyroux, Francis and Martin, Javier and Fiore, Lucia", title = "Nucleotide variation in Sabin type 2 poliovirus from an immunodeficient patient with poliomyelitis", journal= "Journal of General Virology", year = "2003", volume = "84", number = "5", pages = "1215-1221", doi = "https://doi.org/10.1099/vir.0.18974-0", url = "https://www.microbiologyresearch.org/content/journal/jgv/10.1099/vir.0.18974-0", publisher = "Microbiology Society", issn = "1465-2099", type = "Journal Article", abstract = "The molecular and antigenic properties of a Sabin-like type 2 poliovirus, isolated from the stool samples of a 2-year-old agammaglobulinaemic child who developed paralysis 1 year after receiving the third dose of oral poliovirus vaccine, were analysed. The virus revealed 0·88 % genome variation in the VP1 region compared with the standard reference strain, compatible with replication of the virus in the intestine over approximately 1 year. The typical mutations in the 5′NCR and VP1 associated with reversion to neurovirulence for Sabin type 2 poliovirus were found. Despite this, the virus was characterized by both PCR and ELISA tests as Sabin-like and showed temperature sensitivity and neurovirulence in transgenic mice typical of the Sabin type 2 vaccine strain. Gammaglobulin replacement therapy led rapidly to virus clearance, which, when combined with treatment with the antiviral drug pleconaril, stopped virus excretion; no further virus shedding occurred. This is the first case of poliomyelitis and long-term excretion from an immunodeficient patient to be reported in Italy through the active ‘Acute Flaccid Paralysis' surveillance system.", }