Evidence map›Paper›PMID 41555038›Full record

ArticleNature microbiology2026

Higher stability of novel live-attenuated oral poliovirus type 2 (nOPV2) despite the emergence of a neurovirulent double recombinant strain in Uganda.

Phionah Tushabe, Manasi Majumdar, Sarah Carlyle, Lester Shulman, Alfred Ssekagiri, Marie-Line Joffret, Dimitra Klapsa, Jeroen Cremer, Kafayat O Arowolo, Erika Bujaki and 37 more

Abstract read
In one paragraph

Article in Nature microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

47 authors.

Phionah Tushabe *Uganda Virus Research Institute (UVRI), Entebbe, Uganda.ORCID http://orcid.org/0000-0002-0729-5505
Manasi Majumdar *Medicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK.
Sarah CarlyleMedicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK.
Lester ShulmanSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Alfred SsekagiriUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Marie-Line JoffretInstitut Pasteur, Paris, France.
Dimitra KlapsaMedicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK.
Jeroen CremerNational Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Kafayat O ArowoloMedicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK.ORCID http://orcid.org/0000-0001-7972-3284
Erika BujakiMedicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK.
Henry BukenyaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
EPI Laboratory team
Mary Bridget NantezaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Irene TuryahabweUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Prossy NamuwulyaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Molly BirungiUganda Virus Research Institute (UVRI), Entebbe, Uganda.
James Peter ElikuUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Francis AineUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Mayi TibanagwaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Lucy NakabazziUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Joseph GaiziUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Arnold Mugagga SsebuumaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Rajab DhatemwaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Charles OkiaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Mary NyachwoUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Mary Bridget NantezaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Irene TuryahabweUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Prossy NamuwulyaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Molly BirungiUganda Virus Research Institute (UVRI), Entebbe, Uganda.
James Peter ElikuUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Francis AineUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Mayi TibanagwaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Lucy NakabazziUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Joseph GaiziUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Arnold Mugagga SsebuumaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Rajab DhatemwaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Charles OkiaUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Mary NyachwoUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Kaija M HawesBill and Melinda Gates Foundation, Seattle, WA, USA.
Barnabas BakamutumahoUganda Virus Research Institute (UVRI), Entebbe, Uganda.
Erwin DuizerNational Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Mael BessaudInstitut Pasteur, Paris, France.
Ananda S BandyopadhyayBill and Melinda Gates Foundation, Seattle, WA, USA.
Andrew MacadamMedicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK.
Charles R ByabamazimaWorld Health Organization Regional Office for Africa (AFRO), Harare, Zimbabwe.
Javier Martin *Medicines and Healthcare products Regulatory Agency (MHRA), Hertfordshire, UK. Javier.Martin@mhra.gov.uk.ORCID http://orcid.org/0000-0001-5326-7081
Josephine Bwogi *Uganda Virus Research Institute (UVRI), Entebbe, Uganda.ORCID http://orcid.org/0000-0001-6975-7106

Funding

Bill and Melinda Gates Foundation (Bill & Melinda Gates Foundation) INV-043859World Health Organization 001World Health Organization (WHO) GPLN/OMD/LoA/2023/3
6 · The paper itself

Abstract

The novel oral poliovirus vaccine type 2 (nOPV2) was developed to reduce the risk of circulating vaccine-derived poliovirus outbreaks by incorporating genetic modifications to enhance genetic stability and reduce reversion to virulence while retaining protection. Here we report the characterization of 231 nOPV2 isolates from Uganda during a 1-year period following nOPV2 use. Whole-genome sequencing revealed that most isolates retained nOPV2's genetic modifications, with limited mutations in the VP1 region indicating no relevant virus transmission. However, a double recombinant strain identified in a sewage sample lost all key nOPV2 modifications through recombination with enterovirus C strains upstream and downstream of the capsid coding region. This resulted in high neurovirulence comparable to that of wild-type 2 poliovirus. Despite this, the strain did not spread widely, probably due to high vaccination coverage. These findings underscore the enhanced genetic stability of nOPV2 and its reduced risk of reversion compared with Sabin monovalent OPV2 (mOPV2), while highlighting the importance of surveillance to detect rare recombination events. Continued use of nOPV2 and inactivated polio vaccine, combined with robust immunization and monitoring, remains essential for achieving and sustaining global polio eradication.

Indexed as

PoliomyelitisPoliovirusPoliovirus Vaccine, OralRecombination, GeneticAnimalsCapsid ProteinsGenome, ViralGenomic InstabilityHumansUgandaVaccines, AttenuatedVirulenceWhole Genome SequencingCapsid ProteinsPoliovirus Vaccine, OralVaccines, Attenuated

Identifiers

PMID41555038
PMCPMC12872467

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.