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.
Highlights
Environmental sampling of wastewater and wastewaterimpacted surface waters analyzed for poliovirus (PV), as a supplement to acute flaccid paralysis (AFP) surveillance, plays an important role in the detection of wild PV (WPV)Nicolette A
The disappearance of the PV type 2 Sabin vaccine strain after its removal from the live attenuated oral poliovirus vaccine (OPV) in April 2016 has been monitored via environmental surveillance and this will be useful in
No correlation existed between MS2 recovery and positive or negative PV detection in bag-mediated filtration system (BMFS) (p = 0.81, 0.27, and 0.54 for SL PV type 1 (SL1), SL PV type 2 (SL2), and SL PV type 3 (SL3), respectively) and two-phase (p = 0.23, 0.11, and 0.62 for SL1, SL2, and SL3, respectively) samples when measured using the WHO algorithm
Summary
Environmental sampling of wastewater and wastewaterimpacted surface waters analyzed for poliovirus (PV), as a supplement to acute flaccid paralysis (AFP) surveillance, plays an important role in the detection of wild PV (WPV)Nicolette A. Extended author information available on the last page of the article and vaccine-derived PV (VDPV) transmission (Asghar et al 2014; Cowger et al 2017; Hovi et al 2012). Environmental surveillance can assist in determining where PV is circulating in locations where AFP surveillance fails to detect poliovirus paralytic cases and whether performance is substandard or meeting indicators (World Health Organization [WHO] 2015). Environmental surveillance has demonstrated the elimination of WPV in Egypt (El Bassioni et al 2003; Hovi et al 2005) and India (Chowdhary and Dhole 2008; Deshpande et al 2003; Shukla et al 2013) in support of AFP surveillance data, and the resurgence of WPV circulation in previously documented polio-free areas (Manor et al 1999, 2007; Anis et al 2013). The disappearance of the PV type 2 Sabin vaccine strain after its removal from the live attenuated oral poliovirus vaccine (OPV) in April 2016 has been monitored via environmental surveillance and this will be useful in
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