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Review
. 2014 Nov 1;210 Suppl 1(Suppl 1):S294-303.
doi: 10.1093/infdis/jiu384.

Environmental surveillance for polioviruses in the Global Polio Eradication Initiative

Humayun Asghar  1 , Ousmane M Diop  2 , Goitom Weldegebriel  3 , Farzana Malik  3 , Sushmitha Shetty  4 , Laila El Bassioni  5 , Adefunke O Akande  6 , Eman Al Maamoun  5 , Sohail Zaidi  7 , Adekunle J Adeniji  6 , Cara C Burns  8 , Jagadish Deshpande  4 , M Steve Oberste  8 , Sara A Lowther  8
Affiliations
Review

Environmental surveillance for polioviruses in the Global Polio Eradication Initiative

Humayun Asghar et al. J Infect Dis. .

Abstract

This article summarizes the status of environmental surveillance (ES) used by the Global Polio Eradication Initiative, provides the rationale for ES, gives examples of ES methods and findings, and summarizes how these data are used to achieve poliovirus eradication. ES complements clinical acute flaccid paralysis (AFP) surveillance for possible polio cases. ES detects poliovirus circulation in environmental sewage and is used to monitor transmission in communities. If detected, the genetic sequences of polioviruses isolated from ES are compared with those of isolates from clinical cases to evaluate the relationships among viruses. To evaluate poliovirus transmission, ES programs must be developed in a manner that is sensitive, with sufficiently frequent sampling, appropriate isolation methods, and specifically targeted sampling sites in locations at highest risk for poliovirus transmission. After poliovirus ceased to be detected in human cases, ES documented the absence of endemic WPV transmission and detected imported WPV. ES provides valuable information, particularly in high-density populations where AFP surveillance is of poor quality, persistent virus circulation is suspected, or frequent virus reintroduction is perceived. Given the benefits of ES, GPEI plans to continue and expand ES as part of its strategic plan and as a supplement to AFP surveillance.

Keywords: disease eradication; environmental monitoring; environmental sewage; polioviruses; surveillance.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Countries that have undertaken environmental surveillance or sampling projects for polioviruses. Data are from the Global Polio Eradication Initiative.
Figure 2.
Figure 2.
Weekly results of environmental surveillance in Pakistan, by city and sampling site, 2011–2013. Abbreviations: VDPV, Vaccine-derived poliovirus; WPV, wild poliovirus; WPV-1, wild poliovirus type 1.
Figure 3.
Figure 3.
Weekly results of environmental surveillance in Nigeria, by city and sampling site, 2011–2013. Abbreviations: cVDPV2, circulating vaccine-derived poliovirus type 2; NSL, non-Sabin-like virus; WPV1, wild poliovirus type 1; WPV3, wild poliovirus type 3.
Figure 4.
Figure 4.
Weekly results of environmental surveillance in India, by city and sampling site, 2010–2011.
See this image and copyright information in PMC

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