Faecal microbiota transplantation donor stools need screening for poliovirus

We read with interest the recent report describing faecal microbiota transplantation (FMT) as an effective treatment for certain gastrointestinal diseases, such as Clostridium difficile infection,1 with its high burden and increasing frequency.2 In FMT, donor stools are screened for infectious diseases prior to use.3 Screening protocols are still developing. The protocol of Cammarota et al recognises as risky 'recent (<6 months) history of vaccination with a live attenuated virus, if there is a possible risk of transmission'.1 We contend that this precaution needs extension to include donors who are chronic poliovirus excreters.

Many countries used live attenuated oral poliovirus vaccine (OPV).4 In the USA, the OPV recommendation for routine immunisation ended 1 January 2000.5 A small proportion of OPV recipients, those with primary immune deficiencies (PIDs), are chronic faecal excreters of virulent vaccine-derived poliovirus. There were 73 described cases between...

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