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.

Polio Eradication—Within Our Reach?

2017 ◽  
pp. 1-32
Author(s):  
David Besanko ◽  
Sarah Gillis ◽  
Sisi Shen
Keyword(s):  
Infectious Disease ◽  
Public Good ◽  
Polio Eradication ◽  
Global Strategy ◽  
Global Public Good ◽  
List Type ◽  
Global Public Health ◽  
Wild Poliovirus ◽  
Global Polio Eradication Initiative ◽  
Epidemiological Characteristics

The years 2011, 2012, and 2013 witnessed both significant developments and setbacks in global polio eradication efforts. On the positive side, January 13, 2012, marked a full year since India had detected a case of wild poliovirus. On the negative side, polio continued to be endemic in three countries-Pakistan, Afghanistan, and Nigeria-and in those countries the goal of eliminating polio seemed more challenging than ever. Between December 2012 and January 2013, sixteen polio workers were killed in Pakistan, and in February 2013, nine women vaccinating children against polio in Kano, Nigeria, were shot dead by gunmen suspected of belonging to a radical Islamist sect. In addition, after a 95 percent decline in polio cases in 2010, the number of cases in Nigeria rebounded in 2011. Recognizing that polio was unlikely to be eliminated in these countries in the near term, the Global Polio Eradication Initiative moved its target date for eradication from 2013 to 2018.These setbacks sparked a debate about the appropriate strategy for global eradication of polio. Indeed, some experts believed that recent setbacks were not caused by poor management but were instead the result of epidemiological characteristics and preconditions that might render polio eradication unachievable. These experts argued that global health efforts should focus on the control or elimination of polio rather than on the eradication of the disease.This case presents an overview of polio and the Global Polio Eradication Initiative and recounts the successful effort to eradicate smallpox. The case enables a rich discussion of the current global strategy to eradicate polio, as well as the issue of whether eradication is the appropriate global public health objective. More generally, the case provides a concrete example of a particular type of global public good, namely infectious disease eradication.After analyzing and discussing the case, students will be able to: Understand the nature of a global public good Perform a back-of-the-envelope benefit-cost analysis of polio eradication Discuss the appropriate strategy for eradicating an infectious disease Apply game theory to analyzing which countries would be likely to contribute funds toward global polio eradication Discuss the role of private organizations in the provision of global public goods

scholarly journals Environmental Surveillance for Polioviruses in the Global Polio Eradication Initiative

2014 ◽  
Vol 210 (suppl 1) ◽  
pp. S294-S303 ◽  
Author(s):  
H. Asghar ◽  
O. M. Diop ◽  
G. Weldegebriel ◽  
F. Malik ◽  
S. Shetty ◽  
...  
Keyword(s):  
Polio Eradication ◽  
Environmental Surveillance ◽  
Global Polio Eradication Initiative

scholarly journals Environmental Surveillance of Polioviruses in Armenia, Colombia before Trivalent Oral Polio Vaccine Cessation

Viruses ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 775
Author(s):  
María Mercedes González ◽  
Magile C. Fonseca ◽  
Carlos Andrés Rodríguez ◽  
Alejandra María Giraldo ◽  
José Joaquín Vila ◽  
...  
Keyword(s):  
Transition Period ◽  
Virus Detection ◽  
Oral Polio Vaccine ◽  
Supplementary Information ◽  
Paralytic Poliomyelitis ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
Polio Vaccine ◽  
Afp Surveillance ◽  
Wastewater Samples

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.

scholarly journals Feasibility of Quantitative Environmental Surveillance in Poliovirus Eradication Strategies

2012 ◽  
Vol 78 (11) ◽  
pp. 3800-3805 ◽  
Author(s):  
W. J. Lodder ◽  
A. M. Buisman ◽  
S. A. Rutjes ◽  
J. C. Heijne ◽  
P. F. Teunis ◽  
...  
Keyword(s):  
Plaque Assay ◽  
Warning System ◽  
Oral Polio Vaccine ◽  
Polio Eradication ◽  
Elderly Persons ◽  
Environmental Surveillance ◽  
Serotype 1 ◽  
Global Polio Eradication Initiative ◽  
Afp Surveillance ◽  
Asymptomatic Individuals

ABSTRACTThe progress of the Global Polio Eradication Initiative is monitored by acute flaccid paralysis (AFP) surveillance supplemented with environmental surveillance in selected areas. To assess the sensitivity of environmental surveillance, stools from (re)vaccinated elderly persons with a low seroprevalence and from wastewater were concurrently collected and analyzed in the Netherlands over a prolonged period of time. A total number of 228 healthy individuals with different levels of immunity were challenged with monovalent oral polio vaccine serotype 1 or 3. Poliovirus concentrations were determined by the titration of fecal suspensions on poliovirus-sensitive L20B cells and of sewage concentrates by L20B monolayer plaque assay. Almost half of the individuals (45%) shed poliovirus on day 3 after challenge, which peaked (57%) on day 8 with an average poliovirus excretion of 1.3 × 105TCID50per g of feces and gradually decreased to less than 5% on day 42. The virus concentrations in sewage peaked on days 6 to 8 at approximately 100 PFU per liter, remained high until day 14, and subsequently decreased to less than 10 PFU per liter on day 29. The estimated poliovirus concentration in sewage approximated the measured initial virus excretion in feces, within 1 log10variation, resulting in a sensitivity of detection of 100 infected but mostly asymptomatic individuals in tens of thousands of individuals. An additional second peak observed in sewage may indicate secondary transmission missed by enterovirus or AFP surveillance in patients. This enables the detection of circulating poliovirus by environmental surveillance, supporting its feasibility as an early warning system.

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.

PARALLEL DILEMMAS: POLIO TRANSMISSION AND POLITICAL VIOLENCE IN NORTHERN NIGERIA

Africa ◽  
2014 ◽  
Vol 84 (3) ◽  
pp. 466-486 ◽  
Author(s):  
Elisha P. Renne
Keyword(s):  
Federal Government ◽  
Political Violence ◽  
Polio Eradication ◽  
Northern Nigeria ◽  
Wild Poliovirus ◽  
Polio Immunization ◽  
Eradication Campaign ◽  
Global Polio Eradication Initiative ◽  
Low Levels ◽  
Parental Opposition

ABSTRACTNigeria is one of three countries where polio continues to be endemic. In northern Nigeria, areas with low levels of polio immunization due to persistent parental opposition as well as implementation and infrastructural problems have contributed to wild poliovirus transmission. Furthermore, political violence associated with Islamic groups opposed to the federal government has also hampered the conclusion of the Global Polio Eradication Initiative (GPEI) efforts. This violence, which began in Borno State and has spread to other parts of northern Nigeria, occurs precisely where poliovirus transmission continues. These two related aspects – parallel dilemmas of low immunization and political violence – confound the conclusion of GPEI efforts in Nigeria. This situation also raises ethical questions both about the final stages of eradication efforts and about military actions to contain ongoing violence. The Nigerian government's attempts to suppress opposition to the polio eradication campaign by threatening non-compliant parents with arrest and by closing down media outlets may frighten some parents into compliance but can also breed resentment and resistance, just as military and police activities, such as house-to-house sweeps and widespread arrests, may encourage sympathy for Islamic insurgents. This situation suggests that the possible solution of one problem – the ending of wild poliovirus transmission – depends upon a solution of the other, i.e. the cessation of violent anti-government activities.

scholarly journals Environmental Surveillance of Polioviruses in Rio de Janeiro, Brazil, in Support to the Activities of Global Polio Eradication Initiative

2015 ◽  
Vol 8 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Joseane Simone de Oliveira Pereira ◽  
Lidiane Rodrigues da Silva ◽  
Amanda de Meireles Nunes ◽  
Silas de Souza Oliveira ◽  
Eliane Veiga da Costa ◽  
...  
Keyword(s):  
Rio De Janeiro ◽  
Polio Eradication ◽  
Environmental Surveillance ◽  
Global Polio Eradication Initiative

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 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.

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