Detection of vaccine-derived poliovirus circulation by environmental surveillance in the absence of clinical cases

Odoom, John Kofi; Obodai, Evangeline; Boateng, Gifty; Diamenu, Stanley; Attiku, Keren; Avevor, Patrick Mawupemor; Duker, Ewurabena; Boahene, Bismarck; Eshun, Miriam; Gberbie, Emmanuel; Opare, Joseph

doi:10.1080/21645515.2020.1852009

Cited by 11 publications

(15 citation statements)

References 11 publications

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“…ES plays a key role in the confirmation of eradication of WPV from the remaining polio‐endemic countries of Pakistan and Afghanistan and contributes to the detection of PV in the final stages of eradication 28,29 . GPLN confirmed the isolation of type 2 VDPV from environmental samples in London, UK on June 22, 2022, isolated from environmental samples only; however, associated cases of paralysis have not been reported 30 …”

Section: Discussionmentioning

confidence: 97%

“…28,29 GPLN confirmed the isolation of type 2 VDPV from environmental samples in London, UK on June 22, 2022, isolated from environmental samples only; however, associated cases of paralysis have not been reported. 30 A useful criterion for the satisfactory overall performance of the ES is the detection of NPEVs in samples, that is, NPEV should be detected in at least 30% of concentrated sewage from grab samples, as stated in the WHO Guidelines for ES PV circulation. 31 In this study, 624 sewage samples were collected in Guangzhou T A B L E 1 Detection of PVs in sewage samples and the composition of virus isolates before and after two vaccine switches in 2016 and 2020. from 2009 to 2021, and the overall sample positivity rate for NPEV was 78.37%, much higher than the 30% threshold.…”

Section: Discussionmentioning

confidence: 99%

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Dynamic changes in polioviruses identified by environmental surveillance in Guangzhou, 2009–2021

Chen

Zhang

et al. 2023

Journal of Medical Virology

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Polio cases can be missed by acute flaccid paralysis (AFP) case surveillance alone, emphasizing the importance of environmental surveillance (ES). In this study, to investigate the serotype distribution and epidemiological trends of poliovirus (PV), we characterized PV isolated from domestic sewage in Guangzhou City, Guangdong Province, China from 2009 to 2021. A total of 624 sewage samples were collected from the Liede Sewage Treatment Plant, and the positive rates of PV and non-polio enteroviruses were 66.67% (416/624) and 78.37% (489/624), respectively. After sewage sample treatment, each sewage sample was inoculated in six replicate tubes of three cell lines, and 3370 viruses were isolated during the 13-year surveillance period. Among these, 1086 isolates were identified as PV, including type 1 PV (21.36%), type 2 PV (29.19%), and type 3 PV (49.48%). Based on VP1 sequences, 1057 strains were identified as Sabin-like, 21 strains were high-mutant vaccines, and eight strains were vaccine-derived poliovirus (VDPV). The numbers and serotypes of PV isolates in sewage were influenced by the vaccine switch strategy. After type 2 OPV was removed from the trivalent oral PV (OPV) vaccine and a bivalent OPV (bOPV) was adopted in May 2016, the last type 2 PV strain was isolated from sewage, with no detection thereafter. Type 3 PV isolates increased significantly and became the dominant serotype. Before and after the second vaccine switch in January 2020, that is, from the first dose of IPV and second-fourth doses of bOPV to the first two doses of IPV and third-fourth doses of bOPV, there was also a statistical difference in PV positivity rates in sewage samples. Seven type 2 VDPVs and one type 3 VDPV were identified in sewage samples in 2009-2021, and phylogenetic analysis indicated that all VDPVs isolated from ES in Guangdong are newly discovered VDPVs, different from VDPV previously discovered in China, and were classified as ambiguous VDPV. It is noteworthy that no VDPV cases were reported in AFP case surveillance in the same period. In conclusion, continued PV ES

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Dynamic changes in polioviruses identified by environmental surveillance in Guangzhou, 2009–2021

Chen

Zhang

et al. 2023

Journal of Medical Virology

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“…It is worth mentioning that our samples were taken prior to the current outbreak on the African continent . Although the African Regional Certification Commission certified Africa as polio-free in 2020, a recent WPV1 case in Malawi (2021) [ 25 , 26 ] and continuous VDPV circulation (2018 in Mozambique and 2019 in Ghana) [ 11 , 13 , 27 ] highlight the need to tailor current surveillance strategies (including ES, which has not been implemented in our country) to timely monitor the emergence/re-emergence of polioviruses.…”

Section: Discussionmentioning

confidence: 99%

Environmental Monitoring for Enteroviruses in Maputo, Mozambique—2018

et al. 2022

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Due to the possibility of wild poliovirus importation from endemic regions and the high circulation of vaccine-derived poliovirus type 2 in the African region, Mozambique implemented a surveillance program to monitor the circulation of enteroviruses in the environment. From January to November 2018, a period that immediately preceded the cVDPV outbreak in Africa, 63 wastewater samples were collected from different areas in Maputo city. A total of 25 samples (39.7%) were positive based on cell culture isolation. Non-polio enteroviruses were found in 24 samples (24/25; 96%), whereas 1 Sabin-related poliovirus was isolated. Neither wild nor vaccine-derived poliovirus was detected. High circulation of EVB species was detected. Environmental surveillance in the One Health approach, if effectively applied as support to acute flaccid paralysis, can be a powerful aid to the public health system to monitor poliovirus besides non-polio enteroviruses in polio-free areas.

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“…Notably, the basic immunization program with one dose of IPV and two doses of bOPV (1IPV + 2bOPV) induces relatively low levels of immunity to PV2. Currently, outbreaks of VDPV continue to occur in several countries and regions, with more cases of poliomyelitis being caused by VDPV than by WPV globally, and the incidence of VDPV, among which VDPV2 is most serious, is increasing [10][11][12][13][14][15] . Therefore, it is necessary to explore the immunogenicity and safety of different polio immunization programs, including the immunization time and effect of booster immunization, to provide scientific support for the improvement of polio sequential immunization schedules and to help eliminate polio or maintain polio-free status.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the immunization effectiveness of bOPV booster immunization and IPV revaccination

Zhao

Huang

et al. 2023

npj Vaccines

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To provide a basis for further optimization of the polio sequential immunization schedule, this study evaluated the effectiveness of booster immunization with one dose of bivalent oral poliovirus vaccine (bOPV) at 48 months of age after different primary polio immunization schedules. At 48 months of age, one dose of bOPV was administered, and their poliovirus types 1–3 (PV1, PV2, and PV3, respectively)-specific neutralizing antibody levels were determined. Participants found to be negative for any type of PV-specific neutralizing antibody at 24, 36, or 48 months of age were re-vaccinated with inactivated polio vaccine (IPV). The 439 subjects who received a bOPV booster immunization at the age of 48 months had lower PV2-specific antibody levels compared with those who received IPV. One dose of IPV during basic polio immunization induced the lowest PV2-specific antibody levels. On the basis of our findings, to ensure that no less than 70% of the vaccinated have protection efficiency, we recommend the following: if basic immunization was conducted with 1IPV + 2bOPV (especially Sabin strain-based IPV), a booster immunization with IPV is recommended at 36 months of age, whereas if basic immunization was conducted with 2IPV + 1bOPV, a booster immunization with IPV is recommended at 48 months of age. A sequential immunization schedule of 2IPV + 1bOPV + 1IPV can not only maintain high levels of antibody against PV1 and PV3 but also increases immunity to PV2 and induces early intestinal mucosal immunity, with relatively good safety. Thus, this may be the best sequential immunization schedule for polio in countries or regions at high risk for polio.

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Detection of vaccine-derived poliovirus circulation by environmental surveillance in the absence of clinical cases

Cited by 11 publications

References 11 publications

Dynamic changes in polioviruses identified by environmental surveillance in Guangzhou, 2009–2021

Dynamic changes in polioviruses identified by environmental surveillance in Guangzhou, 2009–2021

Environmental Monitoring for Enteroviruses in Maputo, Mozambique—2018

Evaluation of the immunization effectiveness of bOPV booster immunization and IPV revaccination

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