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Volume 16, Number 7—July 2010

Dispatch

Vaccine-associated Paralytic Poliomyelitis in Immunodeficient Children, Iran, 1995–2008

Shohreh Shahmahmoodi, Setareh Mamishi, Asghar Aghamohammadi, Nessa Aghazadeh, Hamideh Tabatabaie, Mohammad Mehdi Gooya, Seyed Mohsen Zahraei, Taha Mousavi, Maryam Yousefi, Kobra Farrokhi, Masoud Mohammadpour, Mahmoud Reza Ashrafi, Rakhshandeh Nategh, and Nima ParvanehComments to Author 
Author affiliations: Tehran University of Medical Sciences, Tehran, Iran (S. Shahmahmoodi, S. Mamishi, A. Aghamohammadi, N. Aghazadeh, H. Tabatabaie, M. Yousefi, K. Farrokhi, M. Mohammadpour, R. Nategh, N. Parvaneh); Ministry of Health Center for Disease Control and Management, Tehran (M.M. Gooya, S.M. Zahraei, T. Mousavi); Pediatrics Center of Excellence, Tehran (S. Mamishi, A. Aghamohammadi, M. Mohammadpour, M.R. Ashrafi, N. Parvaneh)

Main Article

Table 1

Age at time of paralysis onset, vaccination history, and characterization of isolated polioviruses, for patients with vaccine-associated paralytic poliomyelitis, Iran, 1995–2008*

Patient no.
Age, mo/sex at VAPP onset
OPV, no. doses
Time intervals Poliovirus type
Viral protein 1 nt divergence,† %
Last OPV and
VAPP onset
Virus shedding from VAPP onset
VAPP onset and death
1 17/F 0‡ 0 1.2 mo 8 d iVDPV type 2 2.2
2 7/M 4 1.1 mo 3 mo 4 mo iVDPV type 2 1.1–1.5
3 10/M 4 3.3 mo 2 wk 1 mo iVDPV type 2 1.7
4 15/M 4 9 mo 5 mo 11 mo iVDPV type 3 2
5 5/F 2 3.2 mo 5 d 1 mo iVDPV type 2, iVDPV type 1 Type 2: 1.7–2; type 1: 1.7
6 20/M 4 1.1 mo 3 d NA§ iVDPV type 2 1.2

*VAPP, vaccine-associated paralytic poliomyelitis; OPV, oral polio vaccine; iVDPV, immunodeficiency-associated vaccine-derived polioviruses.
†From the prototype Sabin strain.
‡Inactivated polio vaccine was administered. Contact case-patient of a healthy OPV-vaccinated sibling.
§Alive to date, has residual paralysis.

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