Epidemiology of the silent polio outbreak in Rahat, Israel, based on modeling of environmental surveillance data
- PMID: 30337479
- PMCID: PMC6233100
- DOI: 10.1073/pnas.1808798115
Epidemiology of the silent polio outbreak in Rahat, Israel, based on modeling of environmental surveillance data
Abstract
Israel experienced an outbreak of wild poliovirus type 1 (WPV1) in 2013-2014, detected through environmental surveillance of the sewage system. No cases of acute flaccid paralysis were reported, and the epidemic subsided after a bivalent oral polio vaccination (bOPV) campaign. As we approach global eradication, polio will increasingly be detected only through environmental surveillance. We developed a framework to convert quantitative polymerase chain reaction (qPCR) cycle threshold data into scaled WPV1 and OPV1 concentrations for inference within a deterministic, compartmental infectious disease transmission model. We used this approach to estimate the epidemic curve and transmission dynamics, as well as assess alternate vaccination scenarios. Our analysis estimates the outbreak peaked in late June, much earlier than previous estimates derived from analysis of stool samples, although the exact epidemic trajectory remains uncertain. We estimate the basic reproduction number was 1.62 (95% CI 1.04-2.02). Model estimates indicate that 59% (95% CI 9-77%) of susceptible individuals (primarily children under 10 years old) were infected with WPV1 over a little more than six months, mostly before the vaccination campaign onset, and that the vaccination campaign averted 10% (95% CI 1-24%) of WPV1 infections. As we approach global polio eradication, environmental monitoring with qPCR can be used as a highly sensitive method to enhance disease surveillance. Our analytic approach brings public health relevance to environmental data that, if systematically collected, can guide eradication efforts.
Keywords: environmental surveillance; mathematical model; poliovirus; silent transmission; vaccination.
Conflict of interest statement
The authors declare no conflict of interest.
Figures
Similar articles
-
Modeling the spread of polio in an IPV-vaccinated population: lessons learned from the 2013 silent outbreak in southern Israel.BMC Med. 2016 Jun 23;14(1):95. doi: 10.1186/s12916-016-0637-z. BMC Med. 2016. PMID: 27334457 Free PMC article.
-
Field study of fecal excretion as a decision support tool in response to silent reintroduction of wild-type poliovirus 1 into Israel.J Clin Virol. 2015 May;66:51-5. doi: 10.1016/j.jcv.2015.03.005. Epub 2015 Mar 10. J Clin Virol. 2015. PMID: 25866337
-
Laboratory challenges in response to silent introduction and sustained transmission of wild poliovirus type 1 in Israel during 2013.J Infect Dis. 2014 Nov 1;210 Suppl 1:S304-14. doi: 10.1093/infdis/jiu294. J Infect Dis. 2014. PMID: 25316849 Review.
-
Progress Toward Poliomyelitis Eradication - Pakistan, January 2016-September 2017.MMWR Morb Mortal Wkly Rep. 2017 Nov 24;66(46):1276-1280. doi: 10.15585/mmwr.mm6646a4. MMWR Morb Mortal Wkly Rep. 2017. PMID: 29166363 Free PMC article.
-
Polio eradication in India: progress, but environmental surveillance and vigilance still needed.Vaccine. 2013 Feb 18;31(9):1268-75. doi: 10.1016/j.vaccine.2012.12.060. Epub 2013 Jan 7. Vaccine. 2013. PMID: 23306357 Review.
Cited by
-
Public Health Surveillance of Pediatric Polio in Pakistan: A Cohort Study.Cureus. 2024 Jul 25;16(7):e65356. doi: 10.7759/cureus.65356. eCollection 2024 Jul. Cureus. 2024. PMID: 39184633 Free PMC article.
-
Optimization and performance analytics of global aircraft-based wastewater surveillance networks.medRxiv [Preprint]. 2024 Aug 4:2024.08.02.24311418. doi: 10.1101/2024.08.02.24311418. medRxiv. 2024. PMID: 39132478 Free PMC article. Preprint.
-
The Israeli health system's rapid responses during the COVID-19 pandemic.Isr J Health Policy Res. 2024 Mar 4;13(1):11. doi: 10.1186/s13584-024-00596-x. Isr J Health Policy Res. 2024. PMID: 38438926 Free PMC article.
-
An interpretative review of the wastewater-based surveillance of the SARS-CoV-2: where do we stand on its presence and concern?Front Microbiol. 2024 Jan 22;15:1338100. doi: 10.3389/fmicb.2024.1338100. eCollection 2024. Front Microbiol. 2024. PMID: 38318336 Free PMC article. Review.
-
Is it time to switch to a formulation other than the live attenuated poliovirus vaccine to prevent poliomyelitis?Front Public Health. 2024 Jan 8;11:1284337. doi: 10.3389/fpubh.2023.1284337. eCollection 2023. Front Public Health. 2024. PMID: 38259741 Free PMC article. Review.
References
-
- Routh J, Oberste S, Patel M. Poliomyelitis. In: Roush SW, Baldy LM, editors. Manual for the Surveillance of Vaccine-Preventable Diseases. Centers for Disease Control and Prevention; Atlanta: 2017.
-
- Anis E, et al. Insidious reintroduction of wild poliovirus into Israel, 2013. Euro Surveill. 2013;18:20586. - PubMed
-
- Roberts L. Israel’s silent polio epidemic breaks all the rules. Science. 2013;342:679–680. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials