Environmental sewage surveillance detected epidemic wildtype poliovirus type 3 in 23 of 269 samples, demonstrating virus circulation in risk areas up to three weeks before the first clinical case.
Observational (n=269)
Sewage surveillance can detect wild poliovirus circulation early in an epidemic, even before clinical cases are reported.
To examine the extent of wild poliovirus circulation during the 1992-3 epidemic in the Netherlands caused by poliovirus type 3, 269 samples from sewage pipelines at 120 locations were examined for the presence of poliovirus. The epidemic virus strain was found in 23 samples, all from locations inside the risk area which contained communities that refuse vaccination for religious reasons. By sewage investigation, the wildtype virus was shown to be present in the early phase of the epidemic at two locations, one week before patients were reported from that area. The wild type 3 poliovirus was also detected retrospectively in a river water sample collected for other reasons three weeks before notification of the first poliomyelitis case, at a site a few kilometres upstream the home village of this patient. Oral poliovirus vaccine (OPV) virus was found at 28 locations inside or at the border of the risk area. Trivalent OPV was offered to unvaccinated or incompletely-vaccinated persons living in this region as part of the measures to control the epidemic.
Avoort et al. (Thu,) conducted a observational in Poliovirus type 3 outbreak (n=269). Environmental sewage surveillance was evaluated on Detection of epidemic wildtype poliovirus type 3. Environmental sewage surveillance detected epidemic wildtype poliovirus type 3 in 23 of 269 samples, demonstrating virus circulation in risk areas up to three weeks before the first clinical case.
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