Acessibilidade / Reportar erro

Temporal association between the isolation of Sabin-related poliovirus vaccine strains and the Guillain-Barré syndrome

Abstract

Thirty eight paralysis cases classified as Guillain-Barré syndrome (GBS) in Brazil were analysed. In all these cases Sabin-related poliovirus vaccine strains were isolated. In most of the cases the last vaccine dose was given months or years before the onset of GBS, suggesting a persistent infection or the transmission of the Sabin-related strains to the patients. The isolation of Sabin-related strains from GBS cases some days or weeks after the onset of the disease, demonstrated a temporal association between the isolation of the strains and the disease. Although the isolates from the GBS cases may not be the etiological agent of the disease, this study strongly indicates that infections caused by Sabin-related vaccine strains can trigger the GBS in certain cases.

Sabin vaccine; Poliovirus; Guillain-Barré syndrome; vaccine-associated


BRIEF COMMUNICATION

Temporal association between the isolation of Sabin-related poliovirus vaccine strains and the Guillain-Barré syndrome

F. Friedrich; A. M. B. Filippis; H. G. Schatzmayr

Correspondence to Correspondence to: Fabian Friedrich Departamento de Virologia, Instituto Oswaldo Cruz, FIOCRUZ 21040-360 Rio de Janeiro, RJ, Brasil Phone and FAX: 00 55 21 270 6397

SUMMARY

Thirty eight paralysis cases classified as Guillain-Barré syndrome (GBS) in Brazil were analysed. In all these cases Sabin-related poliovirus vaccine strains were isolated. In most of the cases the last vaccine dose was given months or years before the onset of GBS, suggesting a persistent infection or the transmission of the Sabin-related strains to the patients. The isolation of Sabin-related strains from GBS cases some days or weeks after the onset of the disease, demonstrated a temporal association between the isolation of the strains and the disease. Although the isolates from the GBS cases may not be the etiological agent of the disease, this study strongly indicates that infections caused by Sabin-related vaccine strains can trigger the GBS in certain cases.

Keywords: Sabin vaccine; Poliovirus; Guillain-Barré syndrome - vaccine-associated.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

ACKNOWLEDGEMENTS

We thank the epidemiologists (Polio Group) of the Health Ministry of Brazil for the very useful informations about the patients.

Recebido para publicação em 24/10/1995.

Aceito para publicação em 11/12/1995.

This work was supported by the Expanded Program on Immunization, Pan American Health Organization, and also by CNPq and Capes.

  • 1. ALMOND, J.W. - The attenuation of poliovirus neurovirulence. Ann. Rev. Microbiol., 41: 153-180, 1987.
  • 2. BORZAKIAN, S.; PELLETIER, I.; CALVEZ, V. & COLBČRE-GARAPIN, F. - Precise missense and silent point mutations are fixed in the genomes of poliovirus mutants from persistently infected cells. J. Virol., 67: 2914-2917, 1993.
  • 3. COLBČRE-GARAPIN, F.; CHRISTODOULOU, C.; CRAINIC, R. & PELLETIER, I. - Persistent poliovirus infection of human neuroblastoma cells. Proc. nat. Acad. Sci. (Wash.), 86: 7590-7594, 1989.
  • 4. FILIPPIS, A.M.B.; SCHATZMAYR, H.G.; FERREIRA, F.C. et al. - Intratypic differentiation of polioviruses isolated from suspected cases of poliomyelitis in Brazil during the period of 1990 to 1993. Mem. Inst. Oswaldo Cruz, 89: 513-518, 1994.
  • 5. FRIEDRICH, F.; FILIPPIS, A.M.B.; FERREIRA, F.C.; SCHATZMAYR, H.G. & DA SILVA, E.E. - Genomic characterization of type 1 Sabin-related polioviruses isolated in Brazil. Acta virol., 39: 23-29, 1995.
  • 6. FRIEDRICH, F.; FILIPPIS, A.M B.; FERREIRA, F.C. et al. - Poliovirus type 1 isolated from a vaccine-associated case of paralytic poliomyelitis in Brazil. Braz. J. med. biol. Res., 29: 15-18, 1996.
  • 7. FRIEDRICH, F.; FILIPPIS, A.M.B.; FERREIRA, F.C.; SCHATZMAYR, H.G. & DA SILVA, E.E. - Genomic characterization of type 2 polioviruses isolated from vaccine-associated cases in Brazil. Braz. J. med. biol. Res., 28: 733-742, 1995.
  • 8. FRIEDRICH, F.; FILIPPIS, A.M.B.; FERREIRA, F.C.; SCHATZMAYR, H.G. & DA SILVA, E.E. - Genomic characterization of type 3 polioviruses isolated from vaccine-associated poliomyelitis cases in Brazil. Braz. J. med. biol. Res., 28: 195-200, 1995.
  • 9. JAROUSSE, N.; GRANT, R.A.; HOGLE, J.M. et al. - A single amino acid change determines persistence of a chimeric Theiler's virus. J. Virol., 68: 3364-3368, 1994.
  • 10. KINNUNEN, E.; FÄRKKILÄ, M.; HOVI, T., JUNTUNEN, J. & WECKSTRÖM, P.; - Incidence of Guillain-Barré syndrome during a nationwide oral poliovirus vaccine campaign. Neurology, 39: 1034-1036, 1989.
  • 11. LENEMAN, F. - The Guillain-Barré syndrome. Arch. intern. Med., 118: 139-144, 1966.
  • 12. MELNICK, J.L. & HORAUD, F. - Albert B. Sabin. Biologicals, 21: 299-303, 1993.
  • 13. NKOWANE, B.M.; WASSILAK, S.G.F.; ORENSTEIN, W.A. et al. - Vaccine-associated paralytic poliomyelitis in the United States: 1973 through 1984. J. Amer. med. Ass., 257: 1335-1340, 1987.
  • 14. PELLETIER, I.; COURDEC, T.; BORZAKIAN, S. et al. - Characterization of persistent poliovirus mutants selected in human neuroblastoma cells. Virology, 180: 729-737, 1991.
  • 15. RACANIELLO, V.R. - Poliovirus neurovirulence. Advanc. Virus Res., 34: 217-246, 1988.
  • 16. ROPPER, A.H. - The Guillain-Barré syndrome. New Engl. J. Med., 326: 1130-1136, 1992.
  • 17. UHARI, M.; RANTALA, H. & NIEMELA, M. - Cluster of chilhood Guillain-Barré cases after an oral poliovaccine campaign. Lancet, 2: 440-441, 1989.
  • 18
    W. H. O. - The relation between acute persisting spinal paralysis and poliomyelitis vaccine: results of a ten-year enquiry. Bull. Wld. Hlth. Org., 60: 231-242, 1982.
  • Correspondence to:

    Fabian Friedrich
    Departamento de Virologia, Instituto Oswaldo Cruz, FIOCRUZ
    21040-360 Rio de Janeiro, RJ, Brasil
    Phone and FAX: 00 55 21 270 6397
  • Publication Dates

    • Publication in this collection
      22 Sept 2006
    • Date of issue
      Feb 1996

    History

    • Accepted
      11 Dec 1995
    • Received
      24 Oct 1995
    Instituto de Medicina Tropical de São Paulo Av. Dr. Enéas de Carvalho Aguiar, 470, 05403-000 - São Paulo - SP - Brazil, Tel. +55 11 3061-7005 - São Paulo - SP - Brazil
    E-mail: revimtsp@usp.br