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Am J Dis Child. 1970;119(6):546. doi:10.1001/archpedi.1970.02100050548017.
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To the Editor.—The case report, "Paralytic Poliomyelitis in an Unimmunized Child: Apparent Result of a Vaccine-Derived Poliovirus" by Cesario and others (Amer J Dis Child118:895, 1969) is a careful report of clinical and laboratory studies with factual material with which no one could disagree.

A 5-year-old child developed clinical polio, was found to have type 2 in his stool, and antibodies rose against the strain. Quite acceptably the patient had type 2 poliomyelitis.

Laboratory tests showed that the isolate, by way of Wecker and temperature markers, was a "vaccine-like" strain. His sister also harbored a fecal infection which was type 2 but showed marks of an "intermediate strain (which)... was possibly a vaccine derived strain." One may justifiably conclude that with intimate household exposure the virus isolates were identical even though they had different marker characteristics; it is unlikely that the type 2 viruses were simultaneously acquired


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