Role of environmental poliovirus surveillance in global polio eradication and beyond

National Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland.
Epidemiology and Infection (Impact Factor: 2.54). 08/2011; 140(1):1-13. DOI: 10.1017/S095026881000316X
Source: PubMed


Environmental poliovirus surveillance (ENV) means monitoring of poliovirus (PV) transmission in human populations by examining environmental specimens supposedly contaminated by human faeces. The rationale is based on the fact that PV-infected individuals, whether presenting with disease symptoms or not, shed large amounts of PV in the faeces for several weeks. As the morbidity:infection ratio of PV infection is very low, this fact contributes to the sensitivity of ENV which under optimal conditions can be better than that of the standard acute flaccid paralysis (AFP) surveillance. The World Health Organization has included ENV in the new Strategic Plan of the Global Polio Eradication Initiative for years 2010-2012 to be increasingly used in PV surveillance, supplementing AFP surveillance. In this paper we review the feasibility of using ENV to monitor wild PV and vaccine-derived PV circulation in human populations, based on global experiences in defined epidemiological situations.

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Available from: Lester M Shulman
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    • "Viruses in sewage are thought to reflect the viruses circulating in the human population, originating from asymptomatic and symptomatic persons (22). Hence, environmental surveillance studies are extremely useful to determine the circulation of viruses in the human population (22,23) and to obtain sequence information of the circulating strains. "
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    • "However, both methods are time consuming which take 14–15 days and are unsuitable for the detection of non-cytopathogenic virus. Although, an RT-PCR based method in direct examination of specimens is more sensitive, but virus isolation in cell culture still remains the standard method for the identification of PV in sewage [Fong and Lipp, 2005; Hovi et al., 2012]. "
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    ABSTRACT: Systematic environmental surveillance for poliovirus circulation has been conducted in Egypt since 2000. The surveillance has revealed three independent importations of wild-type poliovirus. In addition, several vaccine-derived polioviruses have been detected in various locations in Egypt. In addition to acute flaccid paralysis (AFP) surveillance, environmental surveillance can be used to monitor the wild poliovirus and vaccine-derived poliovirus circulation in populations in support of polio eradication initiatives.
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