Evidence map›Paper›PMID 42559139›Full record

ArticleFrontiers in medicine2026

Case Report: Prolonged nOPV2 shedding in an immunocompetent child from Tunisia border with Algeria, North African region.

Sondes Haddad-Boubaker, Haifa Khemiri, Wasfi Fares, Najla Mekki, Chaima Alibi, Imen Ben Salem, Henda Touzi, Zina Meddeb, Ines Ben Mrad, Mahrez Yahyaoui and 4 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Sondes Haddad-BoubakerLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Haifa KhemiriLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Wasfi FaresLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Najla MekkiLaboratory of Transmission, Control and Immunobiology of Infection (LR 11 IPT 02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Chaima AlibiLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Imen Ben SalemLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Henda TouziLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Zina MeddebLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Ines Ben MradBasic Health Care Directorate, Ministry of Health Tunis, Tunis, Tunisia.
Mahrez YahyaouiBasic Health Care Directorate, Ministry of Health Tunis, Tunis, Tunisia.
Javier MartinNational Institute for Biological Standards and Control, South Mimms, United Kingdom.
Imen Ben MustaphaLaboratory of Transmission, Control and Immunobiology of Infection (LR 11 IPT 02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Ahlem GzaraBasic Health Care Directorate, Ministry of Health Tunis, Tunis, Tunisia.
Henda TrikiLaboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for in the Eastern Mediterranean Region, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Following the detection of vaccine-derived poliovirus type 2 (cVDPV2) in Algeria in 2022, enhanced surveillance activities along the Tunisian border identified novel Oral Poliovirus type 2 Vaccine (nOPV2) excretion in an apparently healthy nomadic child. Immunological investigations showed no evidence of major humoral, cellular, or phagocytic immune deficiency. To investigate the kinetics of viral shedding and characterize the complete genome of the isolated strain in this case report, longitudinal follow-up stool samples were collected and analyzed using cell culture inoculation, real-time RT-PCRs, and whole-genome sequencing. Virus was detected over a 76 to 126-days observation period. Assuming vaccination occurred in December 2022, the total duration of shedding may have extended up to approximately 138 to 188 days (4 to 7 months) post-vaccination. Despite prolonged replication, the viruses showed limited within-host evolution and retained the major engineered attenuation features of nOPV2, with no evidence of domain V reversion, cre replacement, or recombination, and only limited VP1 divergence which allows its classification as nOPV2 category 8 strains. Our findings underscore the need to further investigate the potential for prolonged excretion and molecular evolution of nOPV2-like strains in immunocompetent individuals. Furthermore, targeted surveillance of high-risk and mobile populations, including migrants and nomadic communities, is essential to strengthen epidemiological security and support global poliovirus eradication initiatives.

Indexed as

complete genomecVDPV2kineticsnomadicnOPV2prolonged excretion

Identifiers

PMID42559139
PMCPMC13439408

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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.