TABLE.
Vaccine-derived polioviruses (VDPVs) detected worldwide, January 2014–March 2015
| Category | Country | Year(s) detected* | Source of isolates (total cases or specimens)† | Serotype | No. of isolates§ | VP1 divergence from Sabin OPV strain (%) | Routine coverage with 3 doses of polio vaccine (%)¶ | Estimated duration of VDPV replication** | Current status (date of last outbreak case, last patient isolate, or last environmental sample) | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
|
| |||||||||||
| Cases | Contacts | Non-AFP source | |||||||||
| cVDPV | Madagascar | 2014 | AFP patient | 1 | 1 | 2 | — | 2.2 | 73 | 2 yrs | September 29, 2014 |
| Nigeria | 2005–2015 | Outbreaks (394 total cases)†† | 2 | 11 | — | 61 | 0.7–8.4 | 67 | 10 yrs | March 4, 2015§§ | |
| Nigeria | 2013–2014 | Importation¶¶ (22 total cases) | 2 | 18 | — | 32 | 1.2–3.9 | 67 | 3 yrs | November 3, 2014 | |
| Pakistan | 2012–2015 | Outbreaks (82 total cases) | 2 | 18 | 3 | 26 | 0.7–3.7 | 72 | 3 yrs | March 28, 2015*** | |
| South Sudan | 2014 | 2 cases | 2 | 2 | — | — | 1.0 | 50 | ~1 yr | September 12, 2014 | |
| iVDPV | Albania | 2014 | AFP patient XLA | 3 | 1 | — | — | 0.7–1.0 | 99 | 6 mos | September 12, 2014 |
| China | 2014 | AFP patient | 3 | 1 | — | — | 1.4 | 99 | ~1 yr | November 26, 2014 | |
| Iran | 2014 | Non-AFP SCID | 1 | — | — | 1 | 2.4 | 98 | 10 mos | April 15, 2014 | |
| 2014 | AFP patient XLA | 1 | 1 | — | — | 1.8 | 1.5 yrs | August 2, 2014 | |||
| 2014 | AFP patient PID | 2 | 1 | — | — | 0.7 | <1 yr | September 13, 2014 | |||
| Libya††† | 2014 | Non-AFP SCID | 2 | — | — | 1 | 0.7–1.0 | 95 | 4 mos | February 7, 2014 | |
| Tunisia | 2014 | Non-AFP SCID | 2 | — | — | 1 | 1.0 | 98 | ~1 yr | May 2014 | |
| Turkey | 2014 | Non-AFP SCID | 3 | — | — | 1 | 1.2 | 98 | 1.4 yrs | February 17, 2015 | |
| UK | 2014 | Non-AFP CVID | 2 | — | — | 1 | 17.9 | 96 | >28 yrs | June 22, 2014 | |
| aVDPV | Brazil | 2014 | Environment | 2 | — | — | 1 | 8.6 | 99 | 8 yrs | January 2014 |
| Chad | 2015 | AFP patient | 2 | 1 | — | — | 0.8 | 50 | <1 yr | January 8, 2015 | |
| China | 2014–2015 | AFP patient | 1 | 1 | — | — | 1.1 | 99 | ~1 yr | March 20, 2015 | |
| 2014–2015 | AFP patients | 2 | 4 | — | — | 0.7–2.4 | <1 yr; 2 yrs | March 21, 2015 | |||
| 2014 | Non-AFP patient | 1 | — | — | 1 | 1.1 | ~1 yr | October 2014 | |||
| DRC | 2014 | AFP patient | 2 | 1 | — | — | 1.1 | 70 | 1 yr | January 15, 2015 | |
| Egypt | 2014 | AFP patient | 2 | 1 | — | — | 1.0 | 97 | ~1 yr | April 19, 2014 | |
| 2014 | Environment | 1 | — | — | 2 | 1.1; 2.7 | 1 yr; 2.5 yrs | April 20, 2014 | |||
| 2014–2015 | Environment | 2 | — | — | 2 | 0.7 | <1 yr | February 4, 2015 | |||
| Ethiopia | 2014–2015 | AFP patient | 2 | 1 | — | — | 0.7–0.9 | 70 | <1 yr | March 5, 2015 | |
| Guinea | 2014 | AFP patient | 2 | 1 | — | — | 1.3 | 64 | ~1 yr | August 30, 2014 | |
| India | 2014–2015 | AFP patients | 2 | 4 | — | — | 0.7–1.0 | 70 | ~1 yr | February 26, 2015 | |
| Israel | 1998–2014 | Environment | 2 | — | — | 2 | >15% | 94§§§ | >15 yrs | September 22, 2014 | |
| 2014 | Environment | 2 | — | — | 1 | 0.7 | <1 yr | January 26, 2014 | |||
| Madagascar | 2015 | AFP patient | 1 | 1 | — | — | 3.9 | 73 | 2 yrs | January 31, 2015 | |
| Nigeria | 2014 | AFP patients | 2 | 2 | — | — | 0.7 | 67 | <1 yr | April 5, 2014 | |
| 2014–2015 | Environment | 2 | — | — | 8 | 0.7–1.4 | ≤1 yr | March 9, 2015 | |||
| Pakistan | 2014–2015 | AFP patients | 2 | 9 | 1 | — | 0.8–2.3 | 72 | ≤1 yr; 2 yrs | February 9, 2015 | |
| 2014–2015 | Environment | 2 | — | 6 | 0.8–1.4 | ≤1 yr | January 2015 | ||||
| Philippines | 2015 | AFP patient | 2 | 1 | — | — | 0.8 | 88 | <1 yr | December 18, 2014 | |
| Russia | 2014 | AFP patient | 3 | 1 | 3 | — | 1.1 | 98 | ~1 yr | July 10, 2014 | |
| Turkey | 2014 | AFP contact | 1 | — | 1 | — | 1.0 | 98 | ~1 yr | May 8, 2014 | |
| Uganda | 2014 | AFP patients | 2 | 2 | — | — | 0.7 | 82 | <1 yr | August 13, 2014 | |
Abbreviations: cVDPV = circulating VDPV; iVDPV = immunodeficiency-associated VDPV; aVDPV = ambiguous VDPV; OPV = oral poliovirus vaccine; IPV = inactivated poliovirus vaccine; AFP = acute flaccid paralysis; PID = primary immunodeficiency; SCID = severe combined immunodeficiency; XLA = X-linked agammaglobulinemia; CVID = common variable immunodeficiency; DRC = Democratic Republic of the Congo.
Total years detected and cumulative totals for previously reported cVDPV outbreaks (Nigeria and Pakistan).
Outbreaks list total cases clearly associated with cVDPVs. Some VDPV case isolates from outbreak periods might be listed as aVDPVs.
Total cases for VDPV-positive specimens from AFP cases and total VDPV-positive samples for environmental (sewage) samples.
Based on 2013 data from the World Health Organization (WHO) Vaccine Preventable Diseases Monitoring System (2014 global summary) and WHO–United Nations Children’s Fund (UNICEF) coverage estimates, available at http://www.who.int/immunization/monitoring_surveillance. National data might not reflect weaknesses at subnational levels.
Duration of cVDPV circulation was estimated from extent of VP1 nucleotide divergence from the corresponding Sabin OPV strain; duration of immunodeficiency-associated VDPV replication was estimated from clinical record by assuming that exposure was from initial receipt of OPV; duration of ambiguous VDPV replication was estimated from sequence data.
Count does not include 29 cases with <10 substitutions in VP1 detected before 2010.
The most recent isolate was from an environmental sample.
Importation from Chad.
The most recent isolate was from an environmental sample.
The VDPV was detected and characterized in Germany where the patient had gone for treatment.
Value for routine IPV immunization in 2013. Israel conducted two rounds with bivalent OPV in response to detection of imported wild poliovirus type 1 from environmental samples.