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. 2003 May;69(5):2919-27.
doi: 10.1128/AEM.69.5.2919-2927.2003.

Environmental surveillance system to track wild poliovirus transmission

Jagadish M Deshpande  1 , Sushmitha J Shetty, Zaeem A Siddiqui
Affiliations

Environmental surveillance system to track wild poliovirus transmission

Jagadish M Deshpande et al. Appl Environ Microbiol. 2003 May.

Abstract

Eradication of poliomyelitis from large metropolis cities in India has been difficult due to high population density and the presence of large urban slums. Three paralytic poliomyelitis cases were reported in Mumbai, India, in 1999 and 2000 in spite of high immunization coverage and good-quality supplementary immunization activities. We therefore established a systematic environmental surveillance study by weekly screening of sewage samples from three high-risk slum areas to detect the silent transmission of wild poliovirus. In 2001, from among the 137 sewage samples tested, wild poliovirus type 1 was isolated from 35 and wild poliovirus type 3 was isolated from 1. Acute flaccid paralysis (AFP) surveillance indicated one case of paralytic poliomyelitis from the city. Phylogenetic analysis with complete VP1 sequences revealed that the isolates from environmental samples belonged to four lineages of wild polioviruses recently isolated from poliomyelitis cases in Uttar Pradesh and not to those previously isolated from AFP cases in Mumbai. Wild poliovirus thus introduced caused one case of paralytic poliomyelitis. The virus was detected in environmental samples 3 months before. It was found that wild polioviruses introduced several times during the year circulated in Mumbai for a limited period before being eliminated. Environmental surveillance was found to be sensitive for the detection of wild poliovirus silent transmission. Nucleotide sequence analysis helped identify wild poliovirus reservoir areas.

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Figures

FIG. 1.
FIG. 1.
Sewage sampling sites chosen for environmental surveillance. (a) Map of the city of Mumbai showing sewage sampling areas. (Copyright © Compare Infobase Pvt. Ltd., New Delhi, India.) (b) F ward roadside hutments. (c and d) G ward Dharavi and M ward Shivajinagar sewage sample collection sites, respectively.
FIG. 2.
FIG. 2.
AFP surveillance and environmental surveillance in Mumbai. The graph shows the weekly distribution of AFP cases reported in Mumbai in 2001.
FIG. 3.
FIG. 3.
Dendrogram showing the genetic relationship of wild poliovirus type 1 isolates from sewage samples collected from slums in Mumbai and closely related isolates from AFP cases. Wild poliovirus isolates from sewage samples are coded as follows: single letter identifying the sampling site (F, G, or M), serial number of the sewage sample, and date (day-month-year) of sample collection. Wild poliovirus isolates from AFP cases are coded according to the unique epidemiological case identification number used in the AFP surveillance system; the number includes state and district codes, year and serial number of the case, and date of isolation. The neighbor-joining tree was constructed after 1,000 puzzling steps with the Tree-Puzzle program. The scale indicates the fractional genetic distance (0.01 = 1%), and the numbers at the nodes indicate the frequency (as a percentage) at which the particular tree topology was found in the 1,000 puzzling steps. A to D indicate lineages.
FIG. 4.
FIG. 4.
Dendrogram showing the genetic relationship of wild poliovirus type 3 isolates from one sewage sample and AFP cases. Isolates are coded as described in the legend to Fig. 3. The neighbor-joining tree was constructed after 1,000 puzzling steps with the Tree-Puzzle program. The scale indicates the fractional genetic distance (0.01 = 1%), and the numbers at the nodes indicate the frequency (as a percentage) at which the particular tree topology was found in the 1,000 puzzling steps.
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