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Because many of the cases were geographically and temporally clustered and because the case isolates differed antigenically from the vaccine strain, it was initially assumed that the cases signaled the continued circulation of wild type 2 poliovirus. However, comparison of sequences encoding the major capsid protein, VP1 (903 nucleotides), revealed that the isolates were related (93 to 97% nucleotide sequence identity) to the Sabin type 2 oral poliovirus vaccine (OPV) strain and unrelated (&lt;82% nucleotide sequence identity) to the wild type 2 polioviruses previously indigenous to Egypt (last known isolate: 1979) or to any contemporary wild type 2 polioviruses found elsewhere. The rate and pattern of VP1 divergence among the circulating vaccine-derived poliovirus (cVDPV) isolates suggested that all lineages were derived from a single OPV infection that occurred around 1983 and that progeny from the initiating infection circulated for approximately a decade within Egypt along several independent chains of transmission. Complete genomic sequences of an early (1988) and a late (1993) cVDPV isolate revealed that their 5\u2032 untranslated region (5\u2032 UTR) and noncapsid- 3\u2032 UTR sequences were derived from other species C enteroviruses. Circulation of type 2 cVDPVs occurred at a time of low OPV coverage in the affected communities and ceased when OPV coverage rates increased. The potential for cVDPVs to circulate in populations with low immunity to poliovirus has important implications for current and future strategies to eradicate polio worldwide.<\/jats:p>","DOI":"10.1128\/jvi.77.15.8366-8377.2003","type":"journal-article","created":{"date-parts":[[2003,7,12]],"date-time":"2003-07-12T13:13:13Z","timestamp":1058015593000},"page":"8366-8377","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":194,"title":["Circulation of Endemic Type 2 Vaccine-Derived Poliovirus in Egypt from 1983 to 1993"],"prefix":"10.1128","volume":"77","author":[{"given":"Chen-Fu","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tary","family":"Naguib","sequence":"additional","affiliation":[{"name":"Virology Department, The Egyptian Organization for Biological Products and Vaccine Production (VACSERA), Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Ju","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Nasr","sequence":"additional","affiliation":[{"name":"Virology Department, The Egyptian Organization for Biological Products and Vaccine Production (VACSERA), Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Jorba","sequence":"additional","affiliation":[{"name":"Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Virology Department, The Egyptian Organization for Biological Products and Vaccine Production (VACSERA), Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Campagnoli","sequence":"additional","affiliation":[{"name":"Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrie","family":"van der Avoort","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Yoneyama","sequence":"additional","affiliation":[{"name":"Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Miyamura","sequence":"additional","affiliation":[{"name":"Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Pallansch","sequence":"additional","affiliation":[{"name":"Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olen","family":"Kew","sequence":"additional","affiliation":[{"name":"Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/175.Supplement_1.S176"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/175.Supplement_1.S86"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0042-6822(91)90434-D"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1006\/viro.1999.0003"},{"key":"e_1_3_2_6_2","first-page":"156","volume":"49","year":"2000","unstructured":"Centers for Disease Control and Prevention. 2000. 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