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Tushabe P, Bwogi J, Eliku JP, Aine F, Birungi M, Gaizi J, Nakabazzi L, Kabaliisa T, Turyahabwe I, Namuwulya P, Nanteza MB, Bukenya H, Kanyesigye C, Katushabe E, Ampeire I, Kisakye A, Bakamutumaho B, Byabamazima CR. Environmental surveillance detects circulating vaccine-derived poliovirus type 2 that was undetected by acute flaccid paralysis surveillance in 2021 in Uganda. Arch Virol 2023; 168:140. [PMID: 37059887 PMCID: PMC10104764 DOI: 10.1007/s00705-023-05759-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/14/2023] [Indexed: 04/16/2023]
Abstract
The success of the global polio eradication initiative is threatened by the genetic instability of the oral polio vaccine, which can result in the emergence of pathogenic vaccine-derived polioviruses following prolonged replication in the guts of individuals with primary immune deficiencies or in communities with low vaccination coverage. Through environmental surveillance, circulating vaccine-derived poliovirus type 2 was detected in Uganda in the absence of detection by acute flaccid paralysis (AFP) surveillance. This underscores the sensitivity of environmental surveillance and emphasizes its usefulness in supplementing AFP surveillance for poliovirus infections in the race towards global polio eradication.
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Affiliation(s)
- Phionah Tushabe
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda.
| | - Josephine Bwogi
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - James Peter Eliku
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Francis Aine
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Molly Birungi
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Joseph Gaizi
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Lucy Nakabazzi
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Theopista Kabaliisa
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Irene Turyahabwe
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Prossy Namuwulya
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Mary Bridget Nanteza
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Henry Bukenya
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | | | - Edson Katushabe
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | | | - Annet Kisakye
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Barnabas Bakamutumaho
- Expanded Programme on Immunization Laboratory, Uganda Virus Research Institute, Entebbe, Uganda
| | - Charles R Byabamazima
- WHO Inter-Country Support Team Office for Eastern and Southern Africa (IST/ESA), Harare, Zimbabwe
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Kilaru P, Hill D, Anderson K, Collins MB, Green H, Kmush BL, Larsen DA. Wastewater Surveillance for Infectious Disease: A Systematic Review. Am J Epidemiol 2022; 192:305-322. [PMID: 36227259 PMCID: PMC9620728 DOI: 10.1093/aje/kwac175] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 08/25/2022] [Accepted: 10/05/2022] [Indexed: 02/07/2023] Open
Abstract
Wastewater surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be a valuable source of information regarding SARS-CoV-2 transmission and coronavirus disease 2019 (COVID-19) cases. Although the method has been used for several decades to track other infectious diseases, there has not been a comprehensive review outlining all of the pathogens that have been surveilled through wastewater. Herein we identify the infectious diseases that have been previously studied via wastewater surveillance prior to the COVID-19 pandemic. Infectious diseases and pathogens were identified in 100 studies of wastewater surveillance across 38 countries, as were themes of how wastewater surveillance and other measures of disease transmission were linked. Twenty-five separate pathogen families were identified in the included studies, with the majority of studies examining pathogens from the family Picornaviridae, including polio and nonpolio enteroviruses. Most studies of wastewater surveillance did not link what was found in the wastewater to other measures of disease transmission. Among those studies that did, the value reported varied by study. Wastewater surveillance should be considered as a potential public health tool for many infectious diseases. Wastewater surveillance studies can be improved by incorporating other measures of disease transmission at the population-level including disease incidence and hospitalizations.
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Affiliation(s)
- Pruthvi Kilaru
- Department of Public Health, Syracuse University, Syracuse, New York, United States,Des Moines University College of Osteopathic Medicine, Des Moines, Iowa, United States
| | - Dustin Hill
- Department of Public Health, Syracuse University, Syracuse, New York, United States,Graduate Program in Environmental Science, State University of New York College of Environmental Science and Forestry, Syracuse, New York, United States
| | - Kathryn Anderson
- Department of Medicine, State University of New York Upstate Medical University, Syracuse, New York, United States
| | - Mary B Collins
- Department of Environmental Studies, State University of New York College of Environmental Science, Syracuse, New York, United States
| | - Hyatt Green
- Department of Environmental Biology, State University of New York College of Environmental Science, Syracuse, New York, United States
| | - Brittany L Kmush
- Department of Public Health, Syracuse University, Syracuse, New York, United States
| | - David A Larsen
- Correspondence to Dr. Dave Larsen, Department of Public Health, Syracuse University, 430C White Hall, Syracuse, NY 13244 ()
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3
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Belgasmi H, Miles SJ, Sayyad L, Wong K, Harrington C, Gerloff N, Coulliette-Salmond AD, Guntapong R, Tacharoenmuang R, Ayutthaya AIN, Apostol LNG, Valencia MLD, Burns CC, Benito GR, Vega E. CaFÉ: A Sensitive, Low-Cost Filtration Method for Detecting Polioviruses and Other Enteroviruses in Residual Waters. FRONTIERS IN ENVIRONMENTAL SCIENCE 2022; 10:10.3389/fenvs.2022.914387. [PMID: 35928599 PMCID: PMC9344547 DOI: 10.3389/fenvs.2022.914387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Acute flaccid paralysis (AFP) surveillance has been used to identify polio cases and target vaccination campaigns since the inception of the Global Poliovirus Eradication Initiative (GPEI) in 1988. To date, only Afghanistan and Pakistan have failed to interrupt wild poliovirus transmission. Circulation of vaccine-derived polioviruses (VDPV) continues to be a problem in high-risk areas of the Eastern Mediterranean, African, and Southeast Asian regions. Environmental surveillance (ES) is an important adjunct to AFP surveillance, helping to identify circulating polioviruses in problematic areas. Stools from AFP cases and contacts (>200,000 specimens/year) and ES samples (>642 sites) are referred to 146 laboratories in the Global Polio Laboratory Network (GPLN) for testing. Although most World Health Organization supported laboratories use the two-phase separation method due to its simplicity and effectiveness, alternative simple, widely available, and cost-effective methods are needed. The CAFÉ (Concentration and Filtration Elution) method was developed from existing filtration methods to handle any type of sewage or residual waters. At $10-20 US per sample for consumable materials, CAFÉ is cost effective, and all equipment and reagents are readily available from markets and suppliers globally. The report describes the results from a parallel study of CAFÉ method with the standard two-phase separation method. The study was performed with samples collected from five countries (Guatemala, Haïti, Thailand, Papua New Guinea, and the Philippines), run in three laboratories-(United States, Thailand and in the Philippines) to account for regional and sample-to-sample variability. Samples from each site were divided into two 500 ml aliquots and processed by both methods, with no other additional concentration or manipulation. The results of 338 parallel-tested samples show that the CAFÉ method is more sensitive than the two-phase separation method for detection of non-polio enteroviruses (p-value < 0.0001) and performed as well as the two-phase separation method for polioviruses detection with no significant difference (p-value > 0.05). The CAFÉ method is a robust, sensitive, and cost-effective method for isolating enteroviruses from residual waters.
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Affiliation(s)
- Hanen Belgasmi
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Stacey Jeffries Miles
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - Chelsea Harrington
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nancy Gerloff
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Angela D Coulliette-Salmond
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
- U.S Public Health Service, Rockville, MD, United States
| | - Ratigorn Guntapong
- Department of Medical Science, Enteric Viruses Section, National Institute of Health, Nonthaburi, Thailand
| | - Ratana Tacharoenmuang
- Department of Medical Science, Enteric Viruses Section, National Institute of Health, Nonthaburi, Thailand
| | | | | | | | - Cara C. Burns
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gloria-Rey Benito
- Pan American Health Organization, World Health Organization, Washington, DC, United States
| | - Everardo Vega
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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4
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Krzysztoszek A, Gad B, Diedrich S, Böttcher S, Wieczorek M. Investigation of airport sewage to detect importation of poliovirus, Poland, 2017 to 2020. Euro Surveill 2022; 27:2100674. [PMID: 35713024 PMCID: PMC9205162 DOI: 10.2807/1560-7917.es.2022.27.24.2100674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
BackgroundPolioviruses are human pathogens which may easily be imported via travellers from endemic areas and countries where oral polio vaccine (OPV) is still routinely used to polio-free countries. Risk of reintroduction strictly depends on polio immunisation coverage. Sustaining a polio-free status requires strategies that allow rapid detection and control of potential poliovirus reintroductions.AimThe aim of this study was to apply environmental surveillance at an international airport in Poland to estimate the probability of poliovirus importation via air transport.MethodsBetween 2017 and 2020, we collected 142 sewage samples at Warsaw Airport. After sewage concentration, virus was isolated in susceptible cell cultures. Poliovirus isolates were characterised by intratypic differentiation and sequencing.ResultsSeven samples were positive for polioviruses. All isolates were characterised as Sabin-like polioviruses type 3 (SL-3). No wild or vaccine-derived polioviruses were found. The number of mutations accumulated in most isolates suggested a limited circulation in humans. Only one SL-3 isolate contained seven mutations, which is compatible with more than half a year of circulation.ConclusionSince OPV was withdrawn from the immunisation schedule in Poland in 2016, detection of SL-3 in airport sewage may indicate the events of importation from a region where OPV is still in use. Our study shows that environmental surveillance, including airport sewage investigation, has the capacity to detect emerging polioviruses and monitor potential exposure to poliovirus importation. Poliovirus detection in sewage samples indicates the need for sustaining a high level of polio immunisation coverage in the population.
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Affiliation(s)
- Arleta Krzysztoszek
- Department of Virology, National Institute of Public Health NIH - National Institute of Research, Warsaw, Poland
| | - Beata Gad
- Department of Virology, National Institute of Public Health NIH - National Institute of Research, Warsaw, Poland
| | - Sabine Diedrich
- Regional Reference Laboratory for Poliomyelitis, Robert Koch Institute, Berlin, Germany
| | - Sindy Böttcher
- Regional Reference Laboratory for Poliomyelitis, Robert Koch Institute, Berlin, Germany
| | - Magdalena Wieczorek
- Department of Virology, National Institute of Public Health NIH - National Institute of Research, Warsaw, Poland
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5
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Coulliette-Salmond AD, Alleman MM, Wilnique P, Rey-Benito G, Wright HB, Hecker JW, Miles S, Peñaranda S, Lafontant D, Corvil S, Francois J, Rossignol E, Stanislas M, Gue E, Faye PC, Castro CJ, Schmidt A, Ng TFF, Burns CC, Vega E. Haiti Poliovirus Environmental Surveillance. Am J Trop Med Hyg 2020; 101:1240-1248. [PMID: 31701857 DOI: 10.4269/ajtmh.19-0469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Poliovirus (PV) environmental surveillance was established in Haiti in three sites each in Port-au-Prince and Gonaïves, where sewage and fecal-influenced environmental open water channel samples were collected monthly from March 2016 to February 2017. The primary objective was to monitor for the emergence of vaccine-derived polioviruses (VDPVs) and the importation and transmission of wild polioviruses (WPVs). A secondary objective was to compare two environmental sample processing methods, the gold standard two-phase separation method and a filter method (bag-mediated filtration system [BMFS]). In addition, non-polio enteroviruses (NPEVs) were characterized by next-generation sequencing using Illumina MiSeq to provide insight on surrogates for PVs. No WPVs or VDPVs were detected at any site with either concentration method. Sabin (vaccine) strain PV type 2 and Sabin strain PV type 1 were found in Port-au-Prince, in March and April samples, respectively. Non-polio enteroviruses were isolated in 75-100% and 0-58% of samples, by either processing method during the reporting period in Port-au-Prince and Gonaïves, respectively. Further analysis of 24 paired Port-au-Prince samples confirmed the detection of a human NPEV and echovirus types E-3, E-6, E-7, E-11, E-19, E-20, and E-29. The comparison of the BMFS filtration method to the two-phase separation method found no significant difference in sensitivity between the two methods (mid-P-value = 0.55). The experience of one calendar year of sampling has informed the appropriateness of the initially chosen sampling sites, importance of an adequate PV surrogate, and robustness of two processing methods.
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Affiliation(s)
- Angela D Coulliette-Salmond
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary M Alleman
- Polio Eradication Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pierre Wilnique
- Division of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Gloria Rey-Benito
- Pan American Health Organization, World Health Organization, Washington, District of Columbia
| | | | | | | | - Silvia Peñaranda
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Donald Lafontant
- Division of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Salomon Corvil
- Division of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Jeannot Francois
- Expanded Programme on Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Emmanuel Rossignol
- National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Magalie Stanislas
- National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Edmond Gue
- Pan American Health Organization, World Health Organization Region of the Americas, Port-au-Prince, Haiti
| | - Papa C Faye
- Pan American Health Organization, World Health Organization Region of the Americas, Port-au-Prince, Haiti
| | - Christina J Castro
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee.,Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Terry Fei Fan Ng
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cara C Burns
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Everardo Vega
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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6
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Zhou NA, Fagnant-Sperati CS, Komen E, Mwangi B, Mukubi J, Nyangao J, Hassan J, Chepkurui A, Maina C, van Zyl WB, Matsapola PN, Wolfaardt M, Ngwana FB, Jeffries-Miles S, Coulliette-Salmond A, Peñaranda S, Shirai JH, Kossik AL, Beck NK, Wilmouth R, Boyle DS, Burns CC, Taylor MB, Borus P, Meschke JS. Feasibility of the Bag-Mediated Filtration System for Environmental Surveillance of Poliovirus in Kenya. FOOD AND ENVIRONMENTAL VIROLOGY 2020; 12:35-47. [PMID: 31679104 PMCID: PMC7052051 DOI: 10.1007/s12560-019-09412-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 10/15/2019] [Indexed: 05/24/2023]
Abstract
The bag-mediated filtration system (BMFS) was developed to facilitate poliovirus (PV) environmental surveillance, a supplement to acute flaccid paralysis surveillance in PV eradication efforts. From April to September 2015, environmental samples were collected from four sites in Nairobi, Kenya, and processed using two collection/concentration methodologies: BMFS (> 3 L filtered) and grab sample (1 L collected; 0.5 L concentrated) with two-phase separation. BMFS and two-phase samples were analyzed for PV by the standard World Health Organization poliovirus isolation algorithm followed by intratypic differentiation. BMFS samples were also analyzed by a cell culture independent real-time reverse transcription polymerase chain reaction (rRT-PCR) and an alternative cell culture method (integrated cell culture-rRT-PCR with PLC/PRF/5, L20B, and BGM cell lines). Sabin polioviruses were detected in a majority of samples using BMFS (37/42) and two-phase separation (32/42). There was statistically more frequent detection of Sabin-like PV type 3 in samples concentrated with BMFS (22/42) than by two-phase separation (14/42, p = 0.035), possibly due to greater effective volume assayed (870 mL vs. 150 mL). Despite this effective volume assayed, there was no statistical difference in Sabin-like PV type 1 and Sabin-like PV type 2 detection between these methods (9/42 vs. 8/42, p = 0.80 and 27/42 vs. 32/42, p = 0.18, respectively). This study demonstrated that BMFS can be used for PV environmental surveillance and established a feasible study design for future research.
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Affiliation(s)
- Nicolette A Zhou
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
| | - Christine S Fagnant-Sperati
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
| | - Evans Komen
- Centre for Viral Research, Kenya Medical Research Institute, Mbagathi Road, P.O. Box 54628, Nairobi, 00200, Kenya
| | - Benlick Mwangi
- Centre for Viral Research, Kenya Medical Research Institute, Mbagathi Road, P.O. Box 54628, Nairobi, 00200, Kenya
| | - Johnstone Mukubi
- Centre for Viral Research, Kenya Medical Research Institute, Mbagathi Road, P.O. Box 54628, Nairobi, 00200, Kenya
| | - James Nyangao
- Centre for Viral Research, Kenya Medical Research Institute, Mbagathi Road, P.O. Box 54628, Nairobi, 00200, Kenya
| | - Joanne Hassan
- Centre for Viral Research, Kenya Medical Research Institute, Mbagathi Road, P.O. Box 54628, Nairobi, 00200, Kenya
| | - Agnes Chepkurui
- Centre for Viral Research, Kenya Medical Research Institute, Mbagathi Road, P.O. Box 54628, Nairobi, 00200, Kenya
| | - Caroline Maina
- Kenya Ministry of Health, Afya House, Cathedral Road, P.O. Box 30016, Nairobi, 00100, Kenya
| | - Walda B van Zyl
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
| | - Peter N Matsapola
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
| | - Marianne Wolfaardt
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
| | - Fhatuwani B Ngwana
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
| | - Stacey Jeffries-Miles
- IHRC, Inc. (contracting agency to the Division of Viral Diseases, Centers for Diseases Control and Prevention, Atlanta, GA 30329, USA), 2 Ravinia Drive, Suite 1200, Atlanta, GA, 30329, USA
| | - Angela Coulliette-Salmond
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop H17-6, Atlanta, GA, 30329, USA
| | - Silvia Peñaranda
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop H17-6, Atlanta, GA, 30329, USA
| | - Jeffry H Shirai
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
| | - Alexandra L Kossik
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
| | - Nicola K Beck
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA
| | - Robyn Wilmouth
- PATH, 2201 Westlake Ave, Suite 200, Seattle, WA, 98121, USA
| | - David S Boyle
- PATH, 2201 Westlake Ave, Suite 200, Seattle, WA, 98121, USA
| | - Cara C Burns
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop H17-6, Atlanta, GA, 30329, USA
| | - Maureen B Taylor
- Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia, 0007, South Africa
| | - Peter Borus
- Centre for Viral Research, Kenya Medical Research Institute, Mbagathi Road, P.O. Box 54628, Nairobi, 00200, Kenya
| | - John Scott Meschke
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98105, USA.
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7
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Estívariz CF, Pérez-Sánchez EE, Bahena A, Burns CC, Gary HE, García-Lozano H, Rey-Benito G, Peñaranda S, Castillo-Montufar KV, Nava-Acosta RS, Meschke JS, Oberste MS, Lopez-Martínez I, Díaz-Quiñonez JA. Field Performance of Two Methods for Detection of Poliovirus in Wastewater Samples, Mexico 2016-2017. FOOD AND ENVIRONMENTAL VIROLOGY 2019; 11:364-373. [PMID: 31571037 PMCID: PMC10389298 DOI: 10.1007/s12560-019-09399-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/29/2019] [Indexed: 06/10/2023]
Abstract
To enhance our ability to monitor poliovirus circulation and certify eradication, we evaluated the performance of the bag-mediated filtration system (BMFS) against the two-phase separation (TPS) method for concentrating wastewater samples for poliovirus detection. Sequential samples were collected at two sites in Mexico; one L was collected by grab and ~ 5 L were collected and filtered in situ with the BMFS. In the laboratory, 500 mL collected by grab were concentrated using TPS and the sample contained in the filter of the BMFS was eluted without secondary concentration. Concentrates were tested for the presence of poliovirus and non-poliovirus enterovirus (NPEV) using Global Poliovirus Laboratory Network standard procedures. Between February 16, 2016, and April 18, 2017, 125 pairs of samples were obtained. Collectors spent an average (± standard deviation) of 4.3 ± 2.2 min collecting the TPS sample versus 73.5 ± 30.5 min collecting and filtering the BMFS sample. Laboratory processing required an estimated 5 h for concentration by TPS and 3.5 h for elution. Sabin 1 poliovirus was detected in 37 [30%] samples with the TPS versus 24 [19%] samples with the BMFS (McNemar's mid p value = 0.004). Sabin 3 poliovirus was detected in 59 [47%] versus 49 (39%) samples (p = 0.043), and NPEV was detected in 67 [54%] versus 40 [32%] samples (p < 0.001). The BMFS method without secondary concentration did not perform as well as the TPS method for detecting Sabin poliovirus and NPEV. Further studies are needed to guide the selection of cost-effective environmental surveillance methods for the polio endgame.
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Affiliation(s)
- Concepción F Estívariz
- Global Immunization Division, Global Health Center, Centers for Control Disease and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
| | - Elda E Pérez-Sánchez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - Anita Bahena
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - Cara C Burns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Howard E Gary
- Global Immunization Division, Global Health Center, Centers for Control Disease and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Herlinda García-Lozano
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - Gloria Rey-Benito
- Immunization Unit, Pan American Health Organization, 525 23rd Street NW, Washington, DC, 20037, USA
| | - Silvia Peñaranda
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Katy V Castillo-Montufar
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - Raúl S Nava-Acosta
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - John Scott Meschke
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98195, USA
| | - M Steven Oberste
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Irma Lopez-Martínez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - José A Díaz-Quiñonez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
- División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad De México, Mexico
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8
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González MM, Fonseca MC, Rodríguez CA, Giraldo AM, Vila JJ, Castaño JC, Padilla L, Sarmiento L. Environmental Surveillance of Polioviruses in Armenia, Colombia before Trivalent Oral Polio Vaccine Cessation. Viruses 2019; 11:E775. [PMID: 31450757 PMCID: PMC6783851 DOI: 10.3390/v11090775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/17/2019] [Accepted: 08/18/2019] [Indexed: 11/16/2022] Open
Abstract
Although acute flaccid paralysis (AFP) surveillance is the "gold standard" for detecting cases of polio, environmental surveillance can provide supplementary information in the absence of paralytic poliomyelitis cases. This study aimed to detect the introduction and/or circulation of wild poliovirus or vaccine-derived polioviruses (VDPV) in wastewater, covering a significant population of Armenia, Colombia, before trivalent oral polio vaccine (OPV) cessation. Between March and September 2015, 24 wastewater samples were collected from eight study sites in eight communes of Armenia, Colombia. Virus detection and characterization were performed using both cell culture (i.e., RD or L20B cells) and RT-PCR. Polioviruses were isolated in 11 (45.8%) of 24 wastewater samples. All isolates were identified as Sabin strains (type 1 = 9, type 3 = 2) by intratypic differentiation. Type 2 poliovirus was not detected in any of the samples. No wild poliovirus or VDPV was detected among the isolates. Non-polio enterovirus was identified in 8.3% (2/24) of the samples. This study revealed the excretion of Sabin poliovirus from OPV-immunized individuals, as well as the absence of VDPV and wild poliovirus in wastewaters of Armenia, Colombia. This confirms that environmental surveillance is an effective method, as an additional support to AFP surveillance, to monitor poliovirus during the OPV-to-IPV (inactivated polio vaccine) transition period.
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Affiliation(s)
- María Mercedes González
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia.
| | - Magile C Fonseca
- Enterovirus Laboratory, Department of Virology, Pedro Kourí Institute of Tropical Medicine, Havana 11400, Cuba
| | - Carlos Andrés Rodríguez
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Alejandra María Giraldo
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - José Joaquín Vila
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Jhon Carlos Castaño
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Leonardo Padilla
- Center of Biomedical Research, Faculty of Health Sciences, Universidad del Quindío, Armenia 630003, Colombia
| | - Luis Sarmiento
- Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmo 21428, Sweden.
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Environmental Surveillance for Poliovirus and Other Enteroviruses: Long-Term Experience in Moscow, Russian Federation, 2004⁻2017. Viruses 2019; 11:v11050424. [PMID: 31072058 PMCID: PMC6563241 DOI: 10.3390/v11050424] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/24/2019] [Accepted: 05/07/2019] [Indexed: 11/17/2022] Open
Abstract
Polio and enterovirus surveillance may include a number of approaches, including incidence-based observation, a sentinel physician system, environmental monitoring and acute flaccid paralysis (AFP) surveillance. The relative value of these methods is widely debated. Here we summarized the results of 14 years of environmental surveillance at four sewage treatment plants of various capacities in Moscow, Russia. A total of 5450 samples were screened, yielding 1089 (20.0%) positive samples. There were 1168 viruses isolated including types 1–3 polioviruses (43%) and 29 different types of non-polio enteroviruses (51%). Despite using the same methodology, a significant variation in detection rates was observed between the treatment plants and within the same facility over time. The number of poliovirus isolates obtained from sewage was roughly 60 times higher than from AFP surveillance over the same time frame. All except one poliovirus isolate were Sabin-like polioviruses. The one isolate was vaccine-derived poliovirus type 2 with 17.6% difference from the corresponding Sabin strain, suggesting long-term circulation outside the scope of the surveillance. For some non-polio enterovirus types (e.g., Echovirus 6) there was a good correlation between detection in sewage and incidence of clinical cases in a given year, while other types (e.g., Echovirus 30) could cause large outbreaks and be almost absent in sewage samples. Therefore, sewage monitoring can be an important part of enterovirus surveillance, but cannot substitute other approaches.
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10
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Díaz-Ortega JL, Cruz-Hervert LP, Ferreira-Guerrero E, Ferreyra-Reyes LD, Delgado-Sánchez G, de Lourdes García-García M. [Vaccination coverage and proportion of incomplete vaccination schedule in children under seven years of age in Mexico]. SALUD PUBLICA DE MEXICO 2019; 60:338-346. [PMID: 29746751 DOI: 10.21149/8812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 10/24/2017] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To assess vaccination coverage in children under seven years of age. MATERIALS AND METHODS Study based on the Halfway National Health and Nutrition Survey (Ensanut MC 2016). RESULTS Full vaccination coverage in children <1 year was 51.7%, (range: 67.6% [pentavalent (PV)] to 93.9% [BCG]), in those aged 12-23 months was 53.9% (range: 68.5% [MMR] to 98.3% [BCG]) and in those 24-35 months was 63.2% (range: 85.3% [pneumococcal]) to 98.6% [BCG]). In children aged six years, the coverage of 1 MMR dose was 97.8% and 50.7% for two doses. Only 2.2% of six year olds were not vaccinated. Variables associated with incomplete schedule were age of 2-5 months, mother being under 20 years of age or maternal language indigenous. CONCLUSIONS The vaccination program needs to improve recruitment of newborns and their follow-up until they complete their immunization schedule, taking advantage of the local contacts with health services to vaccinate them.
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Affiliation(s)
- José Luis Díaz-Ortega
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Luis Pablo Cruz-Hervert
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Elizabeth Ferreira-Guerrero
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Leticia D Ferreyra-Reyes
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Guadalupe Delgado-Sánchez
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - María de Lourdes García-García
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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11
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Matrajt G, Naughton B, Bandyopadhyay AS, Meschke JS. A Review of the Most Commonly Used Methods for Sample Collection in Environmental Surveillance of Poliovirus. Clin Infect Dis 2018; 67:S90-S97. [PMID: 30376094 PMCID: PMC6206110 DOI: 10.1093/cid/ciy638] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We performed a review of the environmental surveillance methods commonly used to collect and concentrate poliovirus (PV) from water samples. We compared the sampling approaches (trap vs grab), the process methods (precipitation vs filtration), and the various tools and chemical reagents used to separate PV from other viruses and pathogens in water samples (microporous glass, pads, polyethylene glycol [PEG]/dextran, PEG/sodium chloride, NanoCeram/ViroCap, and ester membranes). The advantages and disadvantages of each method are considered, and the geographical areas where they are currently used are discussed. Several methods have demonstrated the ability to concentrate and recover PVs from environmental samples. The details of the particular sampling conditions and locations should be considered carefully in method selection.
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Affiliation(s)
- Graciela Matrajt
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Washington
| | | | | | - John Scott Meschke
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Washington
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12
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Duintjer Tebbens RJ, Zimmermann M, Pallansch M, Thompson KM. Insights from a Systematic Search for Information on Designs, Costs, and Effectiveness of Poliovirus Environmental Surveillance Systems. FOOD AND ENVIRONMENTAL VIROLOGY 2017; 9:361-382. [PMID: 28687986 PMCID: PMC7879701 DOI: 10.1007/s12560-017-9314-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/30/2017] [Indexed: 05/20/2023]
Abstract
Poliovirus surveillance plays a critical role in achieving and certifying eradication and will play a key role in the polio endgame. Environmental surveillance can provide an opportunity to detect circulating polioviruses prior to the observation of any acute flaccid paralysis cases. We completed a systematic review of peer-reviewed publications on environmental surveillance for polio including the search terms "environmental surveillance" or "sewage," and "polio," "poliovirus," or "poliomyelitis," and compared characteristics of the resulting studies. The review included 146 studies representing 101 environmental surveillance activities from 48 countries published between 1975 and 2016. Studies reported taking samples from sewage treatment facilities, surface waters, and various other environmental sources, although they generally did not present sufficient details to thoroughly evaluate the sewage systems and catchment areas. When reported, catchment areas varied from 50 to over 7.3 million people (median of 500,000 for the 25% of activities that reported catchment areas, notably with 60% of the studies not reporting this information and 16% reporting insufficient information to estimate the catchment area population size). While numerous studies reported the ability of environmental surveillance to detect polioviruses in the absence of clinical cases, the review revealed very limited information about the costs and limited information to support quantitative population effectiveness of conducting environmental surveillance. This review motivates future studies to better characterize poliovirus environmental surveillance systems and the potential value of information that they may provide in the polio endgame.
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Affiliation(s)
| | - Marita Zimmermann
- Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL 32832
- Correspondence to: Radboud J. Duintjer Tebbens, Kid Risk, Inc., 10524 Moss Park Rd., Ste. 204-364, Orlando, FL 32832, USA,
| | - Mark Pallansch
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA 30333
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Are Circulating Type 2 Vaccine-derived Polioviruses (VDPVs) Genetically Distinguishable from Immunodeficiency-associated VDPVs? Comput Struct Biotechnol J 2017; 15:456-462. [PMID: 29276577 PMCID: PMC5671402 DOI: 10.1016/j.csbj.2017.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 12/17/2022] Open
Abstract
Public health response to vaccine-derived poliovirus (VDPV) that is transmitted from person to person (circulating VDPV [cVDPV]) differs significantly from response to virus that replicates in individuals with primary immunodeficiency (immunodeficiency-associated VDPV [iVDPV]). cVDPV outbreaks require a community immunization response, whereas iVDPV chronic infections require careful patient monitoring and appropriate individual treatment. To support poliovirus outbreak response, particularly for type 2 VDPV, we investigated the genetic distinctions between cVDPV2 and iVDPV2 sequences. We observed that simple genetic measurements of nucleotide and amino acid substitutions are sufficient for distinguishing highly divergent iVDPV2 from cVDPV2 sequences, but are insufficient to make a clear distinction between the two categories among less divergent sequences. We presented quantitative approaches using genetic information as a surveillance tool for early detection of VDPV outbreaks. This work suggests that genetic variations between cVDPV2 and iVDPV2 may reflect differences in viral micro-environments, host-virus interactions, and selective pressures during person-to-person transmission compared with chronic infections in immunodeficient patients.
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14
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Berchenko Y, Manor Y, Freedman LS, Kaliner E, Grotto I, Mendelson E, Huppert A. Estimation of polio infection prevalence from environmental surveillance data. Sci Transl Med 2017; 9:9/383/eaaf6786. [DOI: 10.1126/scitranslmed.aaf6786] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 03/17/2016] [Accepted: 12/30/2016] [Indexed: 11/02/2022]
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15
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High-Throughput Next-Generation Sequencing of Polioviruses. J Clin Microbiol 2016; 55:606-615. [PMID: 27927929 DOI: 10.1128/jcm.02121-16] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/05/2016] [Indexed: 01/30/2023] Open
Abstract
The poliovirus (PV) is currently targeted for worldwide eradication and containment. Sanger-based sequencing of the viral protein 1 (VP1) capsid region is currently the standard method for PV surveillance. However, the whole-genome sequence is sometimes needed for higher resolution global surveillance. In this study, we optimized whole-genome sequencing protocols for poliovirus isolates and FTA cards using next-generation sequencing (NGS), aiming for high sequence coverage, efficiency, and throughput. We found that DNase treatment of poliovirus RNA followed by random reverse transcription (RT), amplification, and the use of the Nextera XT DNA library preparation kit produced significantly better results than other preparations. The average viral reads per total reads, a measurement of efficiency, was as high as 84.2% ± 15.6%. PV genomes covering >99 to 100% of the reference length were obtained and validated with Sanger sequencing. A total of 52 PV genomes were generated, multiplexing as many as 64 samples in a single Illumina MiSeq run. This high-throughput, sequence-independent NGS approach facilitated the detection of a diverse range of PVs, especially for those in vaccine-derived polioviruses (VDPV), circulating VDPV, or immunodeficiency-related VDPV. In contrast to results from previous studies on other viruses, our results showed that filtration and nuclease treatment did not discernibly increase the sequencing efficiency of PV isolates. However, DNase treatment after nucleic acid extraction to remove host DNA significantly improved the sequencing results. This NGS method has been successfully implemented to generate PV genomes for molecular epidemiology of the most recent PV isolates. Additionally, the ability to obtain full PV genomes from FTA cards will aid in facilitating global poliovirus surveillance.
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A Cluster of Paralytic Poliomyelitis Cases Due to Transmission of Slightly Diverged Sabin 2 Vaccine Poliovirus. J Virol 2016; 90:5978-88. [PMID: 27099315 DOI: 10.1128/jvi.00277-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/12/2016] [Indexed: 12/14/2022] Open
Abstract
UNLABELLED Four cases of acute flaccid paralysis caused by slightly evolved (Sabin-like) vaccine polioviruses of serotype 2 were registered in July to August 2010 in an orphanage of Biysk (Altai Region, Russia). The Biysk cluster of vaccine-associated paralytic poliomyelitis (VAPP) had several uncommon, if not unique, features. (i) Until this outbreak, Sabin-like viruses (in distinction to more markedly evolved vaccine-derived polioviruses [VDPVs]) were reported to cause only sporadic cases of VAPP. Consequently, VAPP cases were not considered to require outbreak-type responses. However, the Biysk outbreak completely blurred the borderline between Sabin-like viruses and VDPVs in epidemiological terms. (ii) The outbreak demonstrated a very high disease/infection ratio, apparently exceeding even that reported for wild polioviruses. The viral genome structures did not provide any substantial hints as to the underlying reason(s) for such pathogenicity. (iii) The replacement of intestinal poliovirus lineages by other Sabin-like lineages during short intervals after the disease onsets was observed in two patients. Again, the sequences of the respective genomes provided no clues to explain these events. (iv) The polioviruses isolated from the patients and their contacts demonstrated a striking heterogeneity as well as rapid and uneven evolution of the whole genomes and their parts, apparently due to extensive interpersonal contacts in a relatively small closed community, multiple bottlenecking, and recombination. Altogether, the results demonstrate several new aspects of pathogenicity, epidemiology, and evolution of vaccine-related polioviruses and underscore several serious gaps in understanding these problems. IMPORTANCE The oral poliovirus vaccine largely contributed to the nearly complete disappearance of poliovirus-caused poliomyelitis. Being generally safe, it can, in some cases, result in a paralytic disease. Two types of such outcomes are distinguished: those caused by slightly diverged (Sabin-like) viruses on the one hand and those caused by significantly diverged VDPVs on the other. This classification is based on the number of mutations in the viral genome region encoding a viral structural protein. Until now, only sporadic poliomyelitis cases due to Sabin-like polioviruses had been described, and in distinction from the VDPV-triggered outbreaks, they did not require broad-scale epidemiological responses. Here, an unusual outbreak of poliomyelitis caused by a Sabin-like virus is reported, which had an exceptionally high disease/infection ratio. This outbreak blurred the borderline between Sabin-like polioviruses and VDPVs both in pathogenicity and in the kind of responses required, as well as underscoring important gaps in understanding the pathogenicity, epidemiology, and evolution of vaccine-derived polioviruses.
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Environmental surveillance of poliovirus in sewage water around the introduction period for inactivated polio vaccine in Japan. Appl Environ Microbiol 2015; 81:1859-64. [PMID: 25556189 DOI: 10.1128/aem.03575-14] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Environmental virus surveillance was conducted at two independent sewage plants from urban and rural areas in the northern prefecture of the Kyushu district, Japan, to trace polioviruses (PVs) within communities. Consequently, 83 PVs were isolated over a 34-month period from April 2010 to January 2013. The frequency of PV isolation at the urban plant was 1.5 times higher than that at the rural plant. Molecular sequence analysis of the viral VP1 gene identified all three serotypes among the PV isolates, with the most prevalent serotype being type 2 (46%). Nearly all poliovirus isolates exhibited more than one nucleotide mutation from the Sabin vaccine strains. During this study, inactivated poliovirus vaccine (IPV) was introduced for routine immunization on 1 September 2012, replacing the live oral poliovirus vaccine (OPV). Interestingly, the frequency of PV isolation from sewage waters declined before OPV cessation at both sites. Our study highlights the importance of environmental surveillance for the detection of the excretion of PVs from an OPV-immunized population in a highly sensitive manner, during the OPV-to-IPV transition period.
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