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Surveillance Open Access
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Abstract

Background

Polioviruses are human pathogens which may easily be imported via travellers from endemic areas and countries where oral polio vaccine (OPV) is still routinely used to polio-free countries. Risk of reintroduction strictly depends on polio immunisation coverage. Sustaining a polio-free status requires strategies that allow rapid detection and control of potential poliovirus reintroductions.

Aim

The aim of this study was to apply environmental surveillance at an international airport in Poland to estimate the probability of poliovirus importation via air transport.

Methods

Between 2017 and 2020, we collected 142 sewage samples at Warsaw Airport. After sewage concentration, virus was isolated in susceptible cell cultures. Poliovirus isolates were characterised by intratypic differentiation and sequencing.

Results

Seven samples were positive for polioviruses. All isolates were characterised as Sabin-like polioviruses type 3 (SL-3). No wild or vaccine-derived polioviruses were found. The number of mutations accumulated in most isolates suggested a limited circulation in humans. Only one SL-3 isolate contained seven mutations, which is compatible with more than half a year of circulation.

Conclusion

Since OPV was withdrawn from the immunisation schedule in Poland in 2016, detection of SL-3 in airport sewage may indicate the events of importation from a region where OPV is still in use. Our study shows that environmental surveillance, including airport sewage investigation, has the capacity to detect emerging polioviruses and monitor potential exposure to poliovirus importation. Poliovirus detection in sewage samples indicates the need for sustaining a high level of polio immunisation coverage in the population.

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/content/10.2807/1560-7917.ES.2022.27.24.2100674
2022-06-16
2022-06-30
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.24.2100674
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References

  1. Wilder-Smith A, Leong WY, Lopez LF, Amaku M, Quam M, Khan K, et al. Potential for international spread of wild poliovirus via travelers. BMC Med. 2015;13(1):133.  https://doi.org/10.1186/s12916-015-0363-y  PMID: 26044336 
  2. Dowdle WR, Birmingham ME. The biologic principles of poliovirus eradication. J Infect Dis. 1997;175(Suppl 1):S286-92.  https://doi.org/10.1093/infdis/175.Supplement_1.S286  PMID: 9203732 
  3. Kopel E, Kaliner E, Grotto I. Lessons from a public health emergency--importation of wild poliovirus to Israel. N Engl J Med. 2014;371(11):981-3.  https://doi.org/10.1056/NEJMp1406250  PMID: 25207764 
  4. Blomqvist S, El Bassioni L, El Maamoon Nasr EM, Paananen A, Kaijalainen S, Asghar H, et al. Detection of imported wild polioviruses and of vaccine-derived polioviruses by environmental surveillance in Egypt. Appl Environ Microbiol. 2012;78(15):5406-9.  https://doi.org/10.1128/AEM.00491-12  PMID: 22582070 
  5. Anis E, Kopel E, Singer SR, Kaliner E, Moerman L, Moran-Gilad J, et al. Insidious reintroduction of wild poliovirus into Israel, 2013. Euro Surveill. 2013;18(38):20586.  https://doi.org/10.2807/1560-7917.ES2013.18.38.20586  PMID: 24084337 
  6. Jarzabek Z, Zabicka J, John A, Howlett J, Dunn G, Wood DJ. Application of monoclonal antibody panels in the virological and epidemiological review of poliomyelitis in Poland, 1981-1990. Bull World Health Organ. 1992;70(3):327-33. PMID: 1322249 
  7. Yakovenko ML, Gmyl AP, Ivanova OE, Eremeeva TP, Ivanov AP, Prostova MA, et al. The 2010 outbreak of poliomyelitis in Tajikistan: epidemiology and lessons learnt. Euro Surveill. 2014;19(7):20706.  https://doi.org/10.2807/1560-7917.ES2014.19.7.20706  PMID: 24576474 
  8. Khetsuriani N, Perehinets I, Nitzan D, Popovic D, Moran T, Allahverdiyeva V, et al. Responding to a cVDPV1 outbreak in Ukraine: Implications, challenges and opportunities. Vaccine. 2017;35(36):4769-76.  https://doi.org/10.1016/j.vaccine.2017.04.036  PMID: 28528761 
  9. Zurbriggen S, Tobler K, Abril C, Diedrich S, Ackermann M, Pallansch MA, et al. Isolation of sabin-like polioviruses from wastewater in a country using inactivated polio vaccine. Appl Environ Microbiol. 2008;74(18):5608-14.  https://doi.org/10.1128/AEM.02764-07  PMID: 18641161 
  10. World Health Organization (WHO). Polio laboratory manual. 4th ed. Geneva: WHO; 2004. Available from: https://apps.who.int/iris/handle/10665/68762
  11. Kilpatrick DR, Iber JC, Chen Q, Ching K, Yang SJ, De L, et al. Poliovirus serotype-specific VP1 sequencing primers. J Virol Methods. 2011;174(1-2):128-30.  https://doi.org/10.1016/j.jviromet.2011.03.020  PMID: 21440569 
  12. Kumar S, Stecher G, Li M, Knyaz C, Tamura K. MEGA X: Molecular Evolutionary Genetics Analysis across computing platforms. Mol Biol Evol. 2018;35(6):1547-9.  https://doi.org/10.1093/molbev/msy096  PMID: 29722887 
  13. Chouikha A, Rezig D, Driss N, Abdelkhalek I, Ben Yahia A, Touzi H, et al. Circulation and molecular epidemiology of enteroviruses in paralyzed, immunodeficient and healthy individuals in Tunisia, a country with a polio-free status for decades. Viruses. 2021;13(3):380.  https://doi.org/10.3390/v13030380  PMID: 33673590 
  14. World Health Organization (WHO). Guidelines for environmental surveillance of poliovirus circulation. Geneva: WHO; 2003. Available from: https://apps.who.int/iris/handle/10665/67854
  15. Roivainen M, Blomqvist S, Al-Hello H, Paananen A, Delpeyroux F, Kuusi M, et al. Highly divergent neurovirulent vaccine-derived polioviruses of all three serotypes are recurrently detected in Finnish sewage. Euro Surveill. 2010;15(19):19566.  https://doi.org/10.2807/ese.15.19.19566-en  PMID: 20483108 
  16. Esteves-Jaramillo A, Estívariz CF, Peñaranda S, Richardson VL, Reyna J, Coronel DL, et al. Detection of vaccine-derived polioviruses in Mexico using environmental surveillance. J Infect Dis. 2014;210(Suppl 1):S315-23.  https://doi.org/10.1093/infdis/jiu183  PMID: 25316850 
  17. Majumdar M, Klapsa D, Wilton T, Akello J, Anscombe C, Allen D, et al. Isolation of vaccine-like poliovirus strains in sewage samples from the United Kingdom. J Infect Dis. 2018;217(8):1222-30.  https://doi.org/10.1093/infdis/jix667  PMID: 29309594 
  18. Delogu R, Battistone A, Buttinelli G, Fiore S, Fontana S, Amato C, et al. Poliovirus and other enteroviruses from environmental surveillance in Italy, 2009-2015. Food Environ Virol. 2018;10(4):333-42.  https://doi.org/10.1007/s12560-018-9350-8  PMID: 29948963 
  19. Benschop KSM, van der Avoort HG, Jusic E, Vennema H, van Binnendijk R, Duizer E. Polio and measles down the drain: environmental enterovirus surveillance in the Netherlands, 2005 to 2015. Appl Environ Microbiol. 2017;83(13):e00558-17.  https://doi.org/10.1128/AEM.00558-17  PMID: 28432101 
  20. Pogka V, Labropoulou S, Emmanouil M, Voulgari-Kokota A, Vernardaki A, Georgakopoulou T, et al. Laboratory surveillance of polio and other enteroviruses in high-risk populations and environmental samples. Appl Environ Microbiol. 2017;83(5):e02872-16.  https://doi.org/10.1128/AEM.02872-16  PMID: 28039136 
  21. Ivanova OE, Yarmolskaya MS, Eremeeva TP, Babkina GM, Baykova OY, Akhmadishina LV, et al. Environmental surveillance for poliovirus and other enteroviruses: long-term experience in Moscow, Russian Federation, 2004-2017. Viruses. 2019;11(5):424.  https://doi.org/10.3390/v11050424  PMID: 31072058 
  22. Tao Z, Wang Z, Lin X, Wang S, Wang H, Yoshida H, et al. One-year Survey of human enteroviruses from sewage and the factors affecting virus adsorption to the suspended solids. Sci Rep. 2016;6(1):31474.  https://doi.org/10.1038/srep31474  PMID: 27510810 
  23. Figas A, Wieczorek M, Żuk-Wasek A, Litwińska B. Isolation of Sabin-like polioviruses from sewage in Poland. Pol J Microbiol. 2018;67(1):89-96.  https://doi.org/10.5604/01.3001.0011.6147  PMID: 30015429 
  24. Battistone A, Buttinelli G, Fiore S, Amato C, Bonomo P, Patti AM, et al. Sporadic isolation of sabin-like polioviruses and high-level detection of non-polio enteroviruses during sewage surveillance in seven Italian cities, after several years of inactivated poliovirus vaccination. Appl Environ Microbiol. 2014;80(15):4491-501.  https://doi.org/10.1128/AEM.00108-14  PMID: 24814793 
  25. Civil Aviation Authority (ULC). Statystyki wg kierunków – państwa. [Statistics by direction - countries]. Warsaw: ULC. [Accessed: 31 May 2022]. Polish. Available from: https://ulc.gov.pl/pl/regulacja-rynku/3727-statystyki-wg-kierunkow-panstwa
  26. Rezapkin GV, Douthitt M, Dragunsky E, Chumakov KM. Reevaluation of nucleotide sequences of wild-type and attenuated polioviruses of type 3. Virus Res. 1999;65(2):111-9.  https://doi.org/10.1016/S0168-1702(99)00108-2  PMID: 10581384 
  27. Yakovenko ML, Cherkasova EA, Rezapkin GV, Ivanova OE, Ivanov AP, Eremeeva TP, et al. Antigenic evolution of vaccine-derived polioviruses: changes in individual epitopes and relative stability of the overall immunological properties. J Virol. 2006;80(6):2641-53.  https://doi.org/10.1128/JVI.80.6.2641-2653.2006  PMID: 16501074 
  28. Żuk P, Żuk P, Lisiewicz-Jakubaszko J. The anti-vaccine movement in Poland: The socio-cultural conditions of the opposition to vaccination and threats to public health. Vaccine. 2019;37(11):1491-4.  https://doi.org/10.1016/j.vaccine.2019.01.073  PMID: 30755366 
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