Emergence of Vaccine-Derived Polioviruses during Ebola Virus Disease Outbreak, Guinea, 2014-2015

• Published in: Emerging infectious diseases Vol. 24; no. 1; pp. 65 - 74
• Main Authors: Fernandez-Garcia, Maria Dolores, Majumdar, Manasi, Kebe, Ousmane, Fall, Aichatou D, Kone, Moussa, Kande, Mouctar, Dabo, Moustapha, Sylla, Mohamed Salif, Sompare, Djenou, Howard, Wayne, Faye, Ousmane, Martin, Javier, Ndiaye, Kader
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.01.2018; Centers for Disease Control and Prevention
• Subjects: acute flaccid paralysis; Amino Acid Substitution; Base Sequence; Disease Outbreaks; Ebola hemorrhagic fever; Ebola outbreak; Emergence of Vaccine-Derived Polioviruses during Ebola Virus Disease Outbreak, Guinea, 2014–2015; Feces - virology; Genetic aspects; Genome, Viral; Global Health; Guinea; Guinea - epidemiology; Hemorrhagic Fever, Ebola - complications; Hemorrhagic Fever, Ebola - epidemiology; Humans; Immunocompromised Host; Phylogeny; Poliomyelitis; Poliomyelitis - epidemiology; Poliomyelitis - virology; Poliovirus - genetics; Poliovirus Vaccine, Oral; Polioviruses; Public Health; Risk factors; Vaccination; vaccine-derived poliovirus; vaccines; Viral Proteins - genetics; Viral Proteins - metabolism; viruses; Guinea; acute flaccid paralysis; Ebola outbreak; viruses; Guinea; vaccines; vaccine-derived poliovirus; vaccination
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2401.171174

During the 2014-2015 outbreak of Ebola virus disease in Guinea, 13 type 2 circulating vaccine-derived polioviruses (cVDPVs) were isolated from 6 polio patients and 7 healthy contacts. To clarify the genetic properties of cVDPVs and their emergence, we combined epidemiologic and virologic data for polio cases in Guinea. Deviation of public health resources to the Ebola outbreak disrupted polio vaccination programs and surveillance activities, which fueled the spread of neurovirulent VDPVs in an area of low vaccination coverage and immunity. Genetic properties of cVDPVs were consistent with their capacity to cause paralytic disease in humans and capacity for sustained person-to-person transmission. Circulation ceased when coverage of oral polio vaccine increased. A polio outbreak in the context of the Ebola virus disease outbreak highlights the need to consider risks for polio emergence and spread during complex emergencies and urges awareness of the challenges in polio surveillance, vaccination, and diagnosis.