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Journal of Clinical Microbiology, July 1998, p. 1912-1918, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Antigenic and Molecular Characterization of Wild Type 1 Poliovirus Causing Outbreaks of Poliomyelitis in Albania and Neighboring Countries in 1996

L. Fiore,1,* D. Genovese,1 E. Diamanti,2 S. Catone,1 B. Ridolfi,1 B. Ibrahimi,2 R. konomi,2 H. G. A. M. van der Avoort,3 T. Hovi,4 R. Crainic,5 P. Simeoni,1 and C. Amato1

Laboratory of Virology, Istituto Superiore di Sanità, Rome, Italy1; Laboratory of Virology, Public Health Institute, Tirana, Albania2; Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands3; Department of Virology, National Public Health Institute, Helsinki, Finland4; and Unité de Virologie Médicale, Institut Pasteur, Paris, France5

Received 4 December 1997/Returned for modification 9 February 1998/Accepted 30 March 1998

Mass vaccination has led poliomyelitis to become a rare disease in a large part of the world, including Western Europe. However, in the past 20 years wild polioviruses imported from countries where polio is endemic have been responsible for outbreaks in otherwise polio-free European countries. We report on the characterization of poliovirus isolates from a large outbreak of poliomyelitis that occurred in Albania in 1996 and that also spread to the neighboring countries of Yugoslavia and Greece. The epidemics involved 145 subjects, mostly young adults, and caused persisting paralysis in 87 individuals and 16 deaths. The agent responsible for the outbreak was isolated from 74 patients and was identified as wild type 1 poliovirus by both immunological and molecular methods. Sequence analysis of the genome demonstrated the involvement of a single virus strain throughout the epidemics, and genotyping analysis showed 95% homology of the strain with a wild type 1 poliovirus strain isolated in Pakistan in 1995. Neutralization assays with both human sera and monoclonal antibodies were performed to analyze the antigenic structure of the epidemic strain, suggesting its peculiar antigenic characteristics. The presented data underline the current risks of outbreaks due to imported wild poliovirus and emphasize the need to improve vaccination efforts and also the need to implement surveillance in countries free of indigenous wild poliovirus.

* Corresponding author. Mailing address: Laboratory of Virology, Istituto Superiore di Sanità, V. le Regina Elena 299, 00161 Rome, Italy. Phone: 39(6)49903256. Fax: 39(6)49902082. E-mail: fiore{at}virus1.net.iss.it.

Journal of Clinical Microbiology, July 1998, p. 1912-1918, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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