scholarly journals Epidemiology of the silent polio outbreak in Rahat, Israel, based on modeling of environmental surveillance data

2018 ◽  
Vol 115 (45) ◽  
pp. E10625-E10633 ◽  
Author(s):  
Andrew F. Brouwer ◽  
Joseph N. S. Eisenberg ◽  
Connor D. Pomeroy ◽  
Lester M. Shulman ◽  
Musa Hindiyeh ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Disease Surveillance ◽  
Quantitative Polymerase Chain Reaction ◽  
Vaccination Campaign ◽  
Polio Eradication ◽  
Environmental Data ◽  
Transmission Model ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
Polio Vaccination

Israel experienced an outbreak of wild poliovirus type 1 (WPV1) in 2013–2014, detected through environmental surveillance of the sewage system. No cases of acute flaccid paralysis were reported, and the epidemic subsided after a bivalent oral polio vaccination (bOPV) campaign. As we approach global eradication, polio will increasingly be detected only through environmental surveillance. We developed a framework to convert quantitative polymerase chain reaction (qPCR) cycle threshold data into scaled WPV1 and OPV1 concentrations for inference within a deterministic, compartmental infectious disease transmission model. We used this approach to estimate the epidemic curve and transmission dynamics, as well as assess alternate vaccination scenarios. Our analysis estimates the outbreak peaked in late June, much earlier than previous estimates derived from analysis of stool samples, although the exact epidemic trajectory remains uncertain. We estimate the basic reproduction number was 1.62 (95% CI 1.04–2.02). Model estimates indicate that 59% (95% CI 9–77%) of susceptible individuals (primarily children under 10 years old) were infected with WPV1 over a little more than six months, mostly before the vaccination campaign onset, and that the vaccination campaign averted 10% (95% CI 1–24%) of WPV1 infections. As we approach global polio eradication, environmental monitoring with qPCR can be used as a highly sensitive method to enhance disease surveillance. Our analytic approach brings public health relevance to environmental data that, if systematically collected, can guide eradication efforts.

scholarly journals Reported Polio cases in Pakistan during 2019

2020 ◽  
Vol 7 (3) ◽  
pp. 3693-3696
Author(s):  
Tauseef Ahmad ◽  
Haroon Haroon ◽  
Taha Hussein Musa ◽  
Muhammad Khan ◽  
Mukhtiar Baig ◽  
...  
Keyword(s):  
Local Community ◽  
Polio Eradication ◽  
Vaccination Program ◽  
Annual Number ◽  
Online Search ◽  
Khyber Pakhtunkhwa ◽  
Wild Poliovirus ◽  
Government Documents ◽  
Polio Vaccination ◽  
Eradicate Polio

This report describes polio cases, vaccination uncertainty and challenges, and the way forward to eradicate polio from Pakistan. Numerous articles, government and non-government documents, and survey reports were studied and an online search was made to collect information on polio in Pakistan. Once again the polio vaccination program has been stopped and accused by the local community in Pakistan as a result an increase has been seen in polio cases in the last year. In 2019, a total of 117 wild poliovirus (WPV) and 18 circulating vaccine-derived poliovirus (cVDPV2) cases were reported from the country. The majority of cases were from the Khyber Pakhtunkhwa (KP) province as a result of polio vaccination uncertainty and many challenges faced by the vaccination program in the region. Pakistan reported their highest annual number of WPV cases as compared to last few years. This increase is not only an alarming threat for the country but also a key challenge for the global polio eradication movement. Increase awareness and raising immunization to over 100% in some areas especially in the remote area where every year many children missed vaccination to achieve global polio eradication goals.  

Polio vaccination, political authority and the Nigerian state

2017 ◽  
Author(s):  
Elisha P. Renne
Keyword(s):  
Oral Polio Vaccine ◽  
Polio Eradication ◽  
Political Authority ◽  
Sub Saharan Africa ◽  
Childhood Diseases ◽  
Vaccination Programs ◽  
Wild Poliovirus ◽  
Polio Vaccination ◽  
International Ngos ◽  
Vaccination Campaigns

Vaccination campaigns rely on the political authority of the state to carry out public health programs for the benefit of its citizens. In sub-Saharan Africa where vaccination programs were introduced by health officials during colonial rule, subsequent postcolonial programs, such as interventions which focus on a single disease and are supported mainly by western international NGOs, may be viewed with suspicion by some. Rather than strengthening state control of its citizens, vaccination campaigns such as the Global Polio Eradication Initiative as implemented in northern Nigeria, may undermine state authority and control. With its initial focus on polio vaccination rather than on childhood diseases which parents considered more life-threatening, the initiative highlighted the federal government’s failure to provide basic primary health care. That the GPEI was funded by western international NGOs also led some Muslim parents, religious leaders, and medical professionals to question the safety of the oral polio vaccine and to refuse vaccination for their children. However, in 2013 their actions have been tempered by programs providing monetary awards to state governments and foodstuffs to cooperating mothers and in September 2015, WHO announced the interruption of wild poliovirus in Nigeria.

scholarly journals Detection of Imported Wild Polioviruses and of Vaccine-Derived Polioviruses by Environmental Surveillance in Egypt

2012 ◽  
Vol 78 (15) ◽  
pp. 5406-5409 ◽  
Author(s):  
Soile Blomqvist ◽  
Laila El Bassioni ◽  
Eman M. El Maamoon Nasr ◽  
Anja Paananen ◽  
Svetlana Kaijalainen ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Environmental Surveillance ◽  
Wild Type ◽  
Wild Poliovirus ◽  
Afp Surveillance

ABSTRACTSystematic 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.

Genetic Epidemiology Reveals 3 Chronic Reservoir Areas With Recurrent Population Mobility Challenging Poliovirus Eradication in Pakistan

2019 ◽  
Vol 71 (7) ◽  
pp. e58-e67 ◽  
Author(s):  
Ribqa Akhtar ◽  
Nayab Mahmood ◽  
Muhammad Masroor Alam ◽  
Muhammad Naeem ◽  
Syed Sohail Zahoor Zaidi ◽  
...  
Keyword(s):  
Genetic Relatedness ◽  
Immunization Coverage ◽  
Polio Eradication ◽  
Genomic Diversity ◽  
Environmental Surveillance ◽  
Population Mobility ◽  
Coding Region ◽  
Wild Poliovirus ◽  
Effective Combination

Abstract Background Pakistan is among 3 countries endemic for wild poliovirus type 1 (WPV1) circulation that are still struggling for eradication of poliomyelitis. Active clinical and environmental surveillance with meticulous laboratory investigations provide insights into poliovirus transmission patterns and genomic diversity to inform decisions for strategic operations required to achieve eradication. Methods We analyzed epidemiological and virological data to comprehend the current epidemiological status of WPV1 in Pakistan during 2015–2017. Stool specimens of patients with acute flaccid paralysis (AFP) and sewage samples collected from 60 environmental sites were tested. Viral culturing, intratypic differentiation by real-time polymerase chain reaction, and nucleic acid sequencing of the VP1 region of the poliovirus genome to determine genetic relatedness among WPV1 strains were applied. Results Poliovirus isolates were grouped into 11 distinct clusters, which had ≥95% nucleotide homology in the VP1 coding region. Most of the poliovirus burden was shared by 3 major reservoirs: Karachi, Peshawar, and Quetta block (64.2% in 2015, 75.4% in 2016, and 76.7% in 2017). Conclusions Environmental surveillance reveals importations and pockets of unimmunized children that dictate intensive target mop-up campaigns to contain poliovirus transmission. A decrease in the number of orphan isolates reflects effective combination of AFP and environmental surveillance in Pakistan. The genetic data reflect sustained transmission within reservoir areas, further expanded by periodic importations to areas of high immunity reflected by immediate termination of imported viruses. Improved immunization coverage with high-quality surveillance is vital for global certification of polio eradication.

scholarly journals pomp-astic Inference for Epidemic Models: Simple vs. Complex

2017 ◽  
Author(s):  
Theresa Stocks ◽  
Tom Britton ◽  
Michael Höhle
Keyword(s):  
Disease Transmission ◽  
Disease Surveillance ◽  
Partial Information ◽  
R Package ◽  
Surveillance Data ◽  
Transmission Model ◽  
Observation Process ◽  
Large Populations ◽  
The Individual

AbstractInfectious disease surveillance data often provides only partial information about the progression of the disease in the individual while disease transmission is often modelled using complex mathematical models for large populations, where variability only enters through a stochastic observation process. In this work it is shown that a rather simplistic, but truly stochastic transmission model, is competitive with respect to model fit when compared with more detailed deterministic transmission models and even preferable because the role of each parameter and its identifiability is clearly understood in the simpler model. The inference framework for the stochastic model is provided by iterated filtering methods which are readily implemented in theR package pomp. We illustrate our findings on German rotavirus surveillance data from 2001 to 2008 and calculate a model based estimate for the basic reproduction numberR0using these data.

scholarly journals Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019–2023

2020 ◽  
Vol 86 (15) ◽  
Author(s):  
Peng Chen ◽  
Yao Liu ◽  
Haiyan Wang ◽  
Guifang Liu ◽  
Xiaojuan Lin ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
World Health ◽  
Paralytic Poliomyelitis ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
The World ◽  
Afp Surveillance ◽  
Case Based

ABSTRACT The Polio Endgame Strategy 2019–2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance. IMPORTANCE Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillance, provides continued high-quality surveillance performance in achieving the GPEI and detecting the circulation of enterovirus. Given the ongoing cVDPV outbreaks in the world, we present the surveillance capacity of environmental surveillance in capturing enterovirus circulation. The final poliovirus (especially VDPV) elimination has become increasingly complex, and the case-based AFP surveillance alone will lead to difficulties in early detecting dynamics of poliovirus transmission and monitoring the extent of environmental circulation. This study goes beyond previous work to provide a detailed comprehensive evaluation of the enterovirus surveillance and can be used to formulate a set of implementation plan and performance indicators for environmental surveillance.

scholarly journals Environmental Surveillance for Polioviruses in Haïti (2017–2019): The Dynamic Process for the Establishment and Monitoring of Sampling Sites

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 505
Author(s):  
Mary M. Alleman ◽  
Angela D. Coulliette-Salmond ◽  
Pierre Wilnique ◽  
Hanen Belgasmi-Wright ◽  
Leanna Sayyad ◽  
...  
Keyword(s):  
Population Size ◽  
Dynamic Process ◽  
Sea Water ◽  
Oral Vaccine ◽  
Polio Eradication ◽  
Environmental Surveillance ◽  
Two Phase ◽  
Wild Poliovirus ◽  
Global Polio Eradication Initiative ◽  
Wastewater Samples

Haïti is at risk for wild poliovirus (WPV) importation and circulation, as well as vaccine-derived poliovirus (VDPV) emergence. Environmental surveillance (ES) for polioviruses was established in Port au Prince and Gonaïves in 2016. During 2017–2019, initial ES sites were re-evaluated, and ES was expanded into Cap Haïtien and Saint Marc. Wastewater samples and data on weather, hour of collection, and sample temperature and pH were collected every 4 weeks during March 2017–December 2019 (272 sampling events) from 21 sites in Cap Haïtien, Gonaïves, Port au Prince, and Saint Marc. Samples were processed for the detection of polio and non-polio enteroviruses using the two-phase and “Concentration and Filter Elution” methodologies. Polioviruses were serotyped and underwent intra-typic characterization. No WPV or VDPVs were isolated. Sabin-like polioviruses (oral vaccine strain) of serotypes 1 and 3 were sporadically detected. Five of six (83%), one of six (17%), five of six (83%), and two of three (67%) sites evaluated in Cap Haïtien, Gonaïves, Port au Prince, and Saint Marc, respectively, had enterovirus isolation from >50% of sampling events; these results and considerations, such as watershed population size and overlap, influence of sea water, and excessive particulates in samples, were factors in site retention or termination. The evaluation of 21 ES sampling sites in four Haïtian cities led to the termination of 11 sites. Every-four-weekly sampling continues at the remaining 10 sites across the four cities as a core Global Polio Eradication Initiative activity.

scholarly journals Evidence of the Cost-Efficiency of Scale as seen in Polio Vaccination and Surveillance Costs

2019 ◽  
Author(s):  
Brittany L. Hagedorn ◽  
Laina D. Mercer ◽  
Guillaume Chabot-Couture
Keyword(s):  
Cost Efficiency ◽  
Disease Surveillance ◽  
Economies Of Scale ◽  
Scale Up ◽  
Polio Eradication ◽  
Lessons Learned ◽  
Fixed Costs ◽  
Polio Vaccination ◽  
Program Costs ◽  
The Cost

AbstractThis analysis examined how polio program costs vary with scale for vaccination and disease surveillance, based on historical budget data published by the Global Polio Eradication Initiative (GPEI) from 2005 to 2018. We applied a linear mixed effects regression model in order to understand the cost structure of the historical GPEI budgets, with the goal that lessons learned from polio may be extended to other global disease elimination programs. Our findings demonstrate that there are economies of scale for vaccine delivery operations and for disease surveillance, which means that larger programs can leverage fixed costs and achieve better cost-efficiency as they scale. This finding should enable decision makers to create more reliable budgets, which support fundraising and optimal resource allocation. They also provide insight into how cost effectiveness changes as programs scale up during progressive disease control and elimination, as well as what level of resources are needed to sustain a program that is scaling back post-eradication and through to certification.

scholarly journals Communication Strategies for Polio Eradication in Pakistan: The Case Study of Polio Vaccination Campaign in South Punjab

2020 ◽  
Vol V (I) ◽  
pp. 15-22
Author(s):  
Malik Adnan ◽  
Sher Muhammad Malik ◽  
Muhammad Basharat Hameed
Keyword(s):  
Information Source ◽  
Vaccination Campaign ◽  
Sampling Technique ◽  
Polio Eradication ◽  
Systematic Random Sampling ◽  
The Poor ◽  
Polio Vaccination ◽  
Polio Immunization ◽  
Level Of Knowledge

This study has a plan to measure the level of knowledge and perceptions regarding polio vaccination in south Punjab, Pakistan. To examine the dominant source of awareness concerning utilized communication channels in the Polio vaccination campaign a total of 200 respondents (100 couples) were selected as the studys sample by applying the systematic random sampling technique. The findings of the study revealed that the majority of the respondents shared the poor knowledge about Polio. As it was found that, females were more conscious and responsible towards their children as compared to their counterparts. It was also found that males were the decision making authority regarding the polio vaccination of their children. The females seemed more convinced as compared to male respondents towards polio immunization. But, they had sufficient knowledge about the importance of polio vaccination. The television was the major information source of Polio vaccination among most of the respondents.

scholarly journals Inferring Numbers of Wild Poliovirus Excretors Using Quantitative Environmental Surveillance

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 870
Author(s):  
Yuri Perepliotchikov ◽  
Tomer Ziv-Baran ◽  
Musa Hindiyeh ◽  
Yossi Manor ◽  
Danit Sofer ◽  
...  
Keyword(s):  
Oral Polio Vaccine ◽  
Turnaround Time ◽  
Quantitative Detection ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Kinetic Information ◽  
Using Data ◽  
Number Of Individuals

Response to and monitoring of viral outbreaks can be efficiently focused when rapid, quantitative, kinetic information provides the location and the number of infected individuals. Environmental surveillance traditionally provides information on location of populations with contagious, infected individuals since infectious poliovirus is excreted whether infections are asymptomatic or symptomatic. Here, we describe development of rapid (1 week turnaround time, TAT), quantitative RT-PCR of poliovirus RNA extracted directly from concentrated environmental surveillance samples to infer the number of infected individuals excreting poliovirus. The quantitation method was validated using data from vaccination with bivalent oral polio vaccine (bOPV). The method was then applied to infer the weekly number of excreters in a large, sustained, asymptomatic outbreak of wild type 1 poliovirus in Israel (2013) in a population where >90% of the individuals received three doses of inactivated polio vaccine (IPV). Evidence-based intervention strategies were based on the short TAT for direct quantitative detection. Furthermore, a TAT shorter than the duration of poliovirus excretion allowed resampling of infected individuals. Finally, the method documented absence of infections after successful intervention of the asymptomatic outbreak. The methodologies described here can be applied to outbreaks of other excreted viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where there are (1) significant numbers of asymptomatic infections; (2) long incubation times during which infectious virus is excreted; and (3) limited resources, facilities, and manpower that restrict the number of individuals who can be tested and re-tested.

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