Enterovirus D68 (EV-D68) was first isolated from children with respiratory disease in 1962. No outbreaks of infection were detected until the late summer and early fall of 2014, and then in 2016 and 2018. During these epidemics of respiratory disease, some children developed polio-like paralysis. We have recently published a paper showing that isolates of EV-D68 from 1962 through 2014 are capable of infecting cells of the nervous system, disproving the hypothesis that neurotropism of the virus is a recently acquired phenotype.
Today, on World Polio Day, wild poliovirus type 3 has been declared eradicated by a commission of the World Health Organization. The last case of type 3 poliomyelitis was recorded in 2012 in Nigeria. Because wild poliovirus type 2 was declared eradicated in 2015, now only wild poliovirus type 1 continues to circulate, causing paralysis in Afghanistan and Pakistan.
Wondering why the eradication certificate (pictured) says ‘wild’ poliovirus, and not simply poliovirus? The reason is that bivalent oral poliovirus vaccine, containing types 1 and 3, continues to be used globally. After oral administration of this vaccine, vaccine-derived strains are excreted in the feces. Although wild poliovirus type 2 was declared eradicated in 2015, vaccine-derived type 2 poliovirus strains continue to circulate. These vaccine-derived viruses have so far in 2019 caused 102 cases of poliomyelitis.
In other words, we will not be able to declare that poliovirus is eradicated until we stop using the oral poliovirus vaccines. Use of the type 2 oral poliovirus vaccine was stopped in 2016, and WHO suggested that at least one dose of inactivated poliovirus vaccine (IPV) – containing all three serotypes – be included in immunization schedules. Lower IPV use than anticipated has led to continued circulation of vaccine-derived type 2 poliovirus. Compounding the problem is the use of OPV to control outbreaks of vaccine-derived paralysis, leading to introduction of more vaccine viruses into the environment.
Vaccine-derived type 1 poliomyelitis is quite rare, and so if we can vaccinate properly in Afghanistan and Pakistan, we will likely be able to eradicate this serotype. The solution to the problem of type 2 poliovirus will require a complete global switch to IPV, or the use of a new vaccine that cannot revert during replication in the gut and cause paralysis. Such vaccines are in development.
A day of reckoning could be coming for Bristol University and Professor Esther Crawley, the ethically challenged pediatrician whose work has come under official scrutiny (that is, under scrutiny from people with greater authority than me) on multiple fronts. According to the Health Research Authority, the National Health Service unit that oversees research ethics (or in this case, the lack of research ethics), Bristol’s supposedly “independent” investigation of Professor Crawley’s decision to exempt multiple studies from ethical review on the questionable grounds that they were “service evaluation” is due out this week–more than three months late. That’s on top of the massive “correction/clarification” posted in July by Archives of Disease in Childhood about the methodological violations involved in the conduct and reporting of the pediatric study of the woo-woo Lightning Process.
At Aarhus University in Denmark, Vincent speaks with Trine Mogensen, Søren Paludan, Ole Søgaard, and Madalina Carter-Timofte about their careers and their work on sensing herpesviral DNA, immunodeficiencies that predispose to severe viral infections, and the path to a cure for HIV/AIDS.
Recently I had the good fortune to visit Galveston National Laboratory (GNL, pictured), a high containment laboratory located on the campus of the University of Texas Medical Branch. Rich Condit and I were the guests of Dennis Bente, who had been asking us to visit since 2011 (see his original email below). I have previously visited four other high containment laboratories (NEIDL; Rocky Mountain Laboratories; Doherty Institute; and Australian Animal Health Laboratory; (read about these experiences here and watch our NEIDL documentary here) and following are my recollections from our visit to GNL.
Cochrane’s republication last week of its seriously problematic exercise-for-CFS systematic review has triggered an outpouring of comment about the organization’s flawed decision-making and low-quality scientific reasoning. One very smart member of the Science For ME forum, Michiel Tack, posted an excellent overview of the changes between the prior version and the one published last week.
In the second episode from the Karolinska Institute in Stockholm, Vincent speaks with Jan Albert, Petter Brodin, and Anna Smed-Sörensen about their work on enterovirus D68, systems immunology, and human pulmonary viral infection and inflammation.