Bioterrorism and Surveillance for Infectious Diseases - Lessons from Poliovirus and Enteric Virus Surveillance

Abstract

Early recognition and rapid response are crucial for control of infectious diseases introduced by bio-error, bio-terror or Mother Nature. Early recognition requires surveillance. Surveillance includes methods for identifying the presence of infectious agents or the symptoms caused by the presence of such agents. Overlapping of different surveillance strategies improves the chances for success. Results from enteric virus surveillance of acute viral gastroenteritis in sentinel children wards and outbreaks and environmental surveillance for polio and non-polio enteroviruses in Israel are presented to exemplify surveillance for infectious disease agents and for use as yardsticks for evaluating response to intervention and to introduction of new vaccination programs and for their potential for evaluating acute gastroenteris syndromic surveillance.

Intensified environmental surveillance supporting the response to wild poliovirus type 1 silent circulation in Israel, 2013

“…Over the years, the environmental surveillance programme has detected several introductions of WPV into Gaza and Israel, but subsequent circulation in the local community occurred only once in Gaza in 1994-45 [7][8][9]. In addition, it has detected two lineages of highly diverged type 2 VDPV in the Tel Aviv sewage system, excreted by single individuals [9][10][11], demonstrating the high sensitivity of environmental surveillance for monitoring large populations.…”

“…In addition, it has detected two lineages of highly diverged type 2 VDPV in the Tel Aviv sewage system, excreted by single individuals [9][10][11], demonstrating the high sensitivity of environmental surveillance for monitoring large populations. Laboratory methods for sample treatment and poliovirus isolation, including the plaque formation approach, are also a major factor in the sensitivity of the environmental surveillance, as reviewed by Hovi et al [3].…”

Ancient Diseases-Microbial Impact

“…Polio is a communicable disease spreads through human-to-human contact, generally entering the body through oral route due to fecal contaminated food or water, causing paralysis of essential muscles, which usually controls the swallowing, heartbeat, and respiration [9]. Silent poliovirus circulation can be detected by sewage surveillance before appearance of the first case of irreversible poliomyelitis [10].…”

Molecular epidemiology of silent introduction and sustained transmission of wild poliovirus type 1, Israel, 2013

“…Individuals in populations with high vaccination coverage are generally protected from disease [3,4]. In such countries, detection of poliovirus importation, subsequent transmission and interruption of chains of transmission requires a high level of integration of multiple surveillance strategies performed in parallel over extended periods of time to increase reliability and strengthen interpretation of data [5].…”