Problems of live virus vaccine-associated poliomyelitis a paralytic case with isolation of all three poliovirus types.

The case of a 4-month-old girl is described who developed a paralytic polio-like syndrome 3 weeks after oral polio vaccination (OPV). All three poliovirus types could be isolated (9 days after onset of disease polio type 2, and 33 days after onset of disease types 1 and 3, respectively). In order to classify these isolates as Sabin (vaccine)-like (SL) or non-Sabin-like (non-SL), several markers were tested in three laboratories [intratypic serodifferentiation, reproductive capacity at supraoptimal temperature (RTC), Al(OH)3 gel elution assay, and oligonucleotide mapping]. The results of the marker determinations were not uniform, but--summarizing all data--it seems plausible to associate the disease with the OPV. The significance of marker determinations in proving a vaccine-induced poliomyelitis is discussed in the light of this clinical case. Some comments are made on poliovirus vaccination policy in developed countries.