Why the study?
Polio is a Public Health Emergency of International Concern, and isolation of any poliovirus requires immediate reporting and prompt response following identification of circulating vaccine-derived poliovirus cases.
The successful deployment of nOPV2 in Tajikistan interrupted a cVDPV2 outbreak and demonstrated the feasibility of its use outside the WHO African Region.
Alerts clinicians to VDPV2 circulation risk in Central Asia; leaves open optimal eradication strategies.
On January 13, 2021, a vaccine-derived poliovirus type 2 (VDPV2) was identified by the Regional Reference Laboratory for Polio in Moscow, Russia* in a specimen from a patient with acute flaccid paralysis (AFP) in Jaloliddin Balkhi district, Khatlon Region, in Tajikistan. Paralysis onset occurred on November 22, 2020. On February 6, 2021, a second, genetically linked VDPV2 paralytic case, with onset of paralysis on January 17, 2021, was confirmed from Khatlon Region in the neighboring Vakhsh district, indicating local transmission. Genetic sequencing of the isolate by the Regional Reference Laboratory for Polio in Moscow found a 20-nucleotide divergence from Sabin vaccine virus strain, and a 14-nucleotide divergence from a circulating VDPV2 (cVDPV2) reported from Khikorgangi, Pakistan on December 7, 2020, which suggests undetected circulation for approximately 12 months (1). On the basis of high-quality AFP surveillance in Tajikistan, the researchers concluded these cases likely represent recent importation (2). During 2014, the Director-General of the World Health Organization (WHO) declared polio a Public Health Emergency of International Concern under the International Health Regulations; the isolation of any poliovirus requires immediate reporting and prompt response (3).
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O’Connor et al. (2022) studied this question.
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