QUANTITATIVE RELATIONSHIP OF PREEXISTING HOMOTYPIC ANTIBODIES TO EXCRETION OF POLIOVIRUS TYPES 1, 2 AND 3 FOLLOWING THE FEEDING OF TRIVALENT ATTENUATED POLIOVIRUS VACCINE1

Abstract

Glezen, W. P., R. H. McColIough, G. A. Lamb and T. D. Y. Chin (NCDC, 2002 W. 39th St., Kansas City, Kansas 66103). Quantitative relationship of preexisting homotypic antibodies to the excretion of poliovirus types 1, 2 and 3 following the feeding of trivalent attenuated poliovirus vaccine. Amer. J Epid., 1969, 90: 146–156.—This study confirms and extends the data on the quantitative relationship of preexisting homotypic antibodies to the excretion of poliovirus following the feeding of attenuated poliovirus vaccine. Trivalent attenuated vaccine was given to 200 school children who previously had received inactivated poliovirus vaccine. Distinct patterns of virus excretion for each of the three virus types developed after each of two feedings of trivalent vaccine administered eight weeks apart. Poliovirus type 1 was the predominant virus recovered from the pharyngeal samples and it is suggested that the propensity of this virus to multiply in the pharynx may have epidemiologic significance. If wild strains share this property it may enhance the ability of poliovirus type 1 to spread among susceptible extrafamilial contacts—especially in upper and middle socioeconomic populations. The fecal excretion of poliovirus type 1 was inversely related to preexisting circulating antibody levels; however, the excretion of types 2 and 3 seemed less affected by circulating homotypic antibody. Poliovirus type 2 was the most common virui isolated from feces during the first two weeks after the first feeding; three-fourths of the stool samples yielded this virus in the first week and almost two-thirds in the second week. After this period it was infrequently recovered from the stools and it was least often detected after the second feeding. Poliovirus type 3 was remarkable in the way that the infection persisted in the lower alimentary tract. Almost 10 per cent of the children were still excreting this virus in feces eight weeks after the first feeding and over 5 per cent had persistent infection five weeks after the second feeding. The persistent infection of the lower intestines would allow for repeated opportunities for spread of the virus from infected persons to their susceptible contacts by the fecal-oral route.