In an immunodeficient patient, the Sabin 1 poliovirus vaccine strain evolved over 649 days into a neurovirulent and non-temperature-sensitive phenotype through complex genetic recombination and mutation.
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May indicate neurovirulent reversion risk during prolonged shedding in immunodeficient hosts; leaves open surveillance needs for eradication.
Odoom et al. (2008) studied this question.
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