Immunoglobulin A as a Serological Marker for the (Silent) Circulation of Poliovirus in an Inactivated Poliovirus–Vaccinated Population

• Published in: Clinical infectious diseases Vol. 34; no. 8; pp. 1067 - 1075
• Main Authors: Herremans, Tineke, Kimman, Tjeerd G., Conyn—van Spaendonck, Marina A. E., Buisman, Annemarie, de Melker, Hester, Abbink, Fritjofna, Bijkerk, Paul, Koopmans, Marion P. G.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.04.2002; University of Chicago Press
• Subjects: Antibodies; Biological and medical sciences; Biomarkers - blood; Children; Enzyme-Linked Immunosorbent Assay; Human viral diseases; Humans; Immunoglobulin A - blood; Infections; Infectious diseases; Major Articles; Medical sciences; Netherlands - epidemiology; Oral poliovirus vaccine; Poliomyelitis; Poliomyelitis - blood; Poliomyelitis - epidemiology; Poliomyelitis - immunology; Poliomyelitis - virology; Poliovirus; Poliovirus - immunology; Poliovirus - isolation & purification; Poliovirus Vaccine, Inactivated - immunology; Sensitivity and Specificity; Seroepidemiologic Studies; Serologic Tests; Vaccination; Viral diseases; Viral diseases of the nervous system; Viruses; Volunteerism; Netherlands; Human; Nervous system diseases; IgA; Immunoglobulins; Picornaviridae; Vaccination; Biological marker; Enterovirus; Acute anterior poliomyelitis; Poliovirus; Infection; Virus; Immunological investigation; Viral disease; Central nervous system disease; Attenuated strain; Spinal cord disease
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/339489

Poliovirus-specific immunoglobulin A (IgA) is detected after infection with wild-type virus or vaccination with live attenuated oral poliovirus (OPV) but not after vaccination with inactivated poliovirus (IPV). We examined whether the presence of IgA in serum can be used as a marker for poliovirus circulation in IPV-vaccinated populations in The Netherlands. In seronegative persons challenged with OPV, the sensitivity of this marker was 76%-86%. Results from a serosurvey showed a high seroprevalence (63%-73%) of IgA in the population born before vaccination was introduced in The Netherlands, which reflects natural exposure. The start of the vaccination program in 1957 corresponded to a reduction in the IgA seroprevalence in both vaccinated (2.1%-4.5%) and nonvaccinated groups (8.3%-11.7%). The presence of IgA-positive persons in the population could largely be explained by the occurrence of episodes of proven poliovirus circulation. We propose to use the detection of poliovirus-specific IgA as a tool to monitor virus circulation in IPV-vaccinated and nonvaccinated populations, to aid the poliovirus eradication process.