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

Battistone, Andrea; Buttinelli, Gabriele; Fiore, Stefano; Amato, Concetta; Bonomo, Paolo; Patti, Anna Maria; Vulcano, Antonella; Barbi, Maria; Binda, Sandro; Pellegrinelli, Laura; Tanzi, Maria Luisa; Affanni, Paola; Castiglia, Paolo; Germinario, Cinzia Annatea; Mercurio, Pietro; Cicala, Antonella; Triassi, Maria; Pennino, Francesca; Fiore, Lucia

doi:10.1128/aem.00108-14

Cited by 23 publications

(17 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The frequencies of detection of different enteroviruses differed by geographical area and year, but overall, coxsackievirus type B strains were isolated more often than echoviruses. These findings are similar to the results of some studies on sewage surveillance in other countries [ 42 – 45 ]. Among coxsackievirus B strains, CVB2, CVB3, and CVB4 were the most prevalent between July 2012 and 2013 in Taiwan; however, CVB1 and CVB6 were not isolated in this study.…”

Section: Discussionsupporting

confidence: 92%

High Incidence of Mammalian Orthoreovirus Identified by Environmental Surveillance in Taiwan

et al. 2015

View full text Add to dashboard Cite

Wild poliovirus (WPV) persists in diverse locales worldwide, spreading outward from endemic areas. In response to the international threat of WPV transmission and changes in the national vaccination policy, we established an environmental surveillance system to monitor the circulation of wild and vaccine-related poliovirus in Taiwan. From July 2012 to December 2013, we collected sewage specimens every month from 10 sewage treatment plants located throughout Taiwan. The specimens were concentrated by the two-phase separation method and then inoculated into L20B, RD, and A549 cells for virus isolation. Viral isolates were identified and serotyped by immunofluorescence assay or molecular analysis. A total of 300 sewage samples were collected, and the results showed 163 samples (54.3%) were positive for virus, and 268 isolates were identified. Among these, 75 samples (25%) were positive for enterovirus (EV), but no poliovirus was found. In addition, 92 isolates were identified as enteroviruses and the most common serotypes were coxsackievirus B4, coxsackievirus B3, and coxsackievirus B2. Interestingly, 102 (34%) and 82 (27.3%) specimens were positive for mammalian orthoreovirus (MRV) and adenovirus, respectively. This study confirmed that sewage surveillance can be a useful additional modality for monitoring the possible presence of wild-type or vaccine-derived poliovirus in wastewater, and can indicate the current types of viruses circulating in the population. Furthermore, since MRV was found in children with acute necrotizing encephalopathy and meningitis, the high incidence of MRV detected by environmental surveillance warrants further investigation.

show abstract

Section: Discussionsupporting

confidence: 92%

High Incidence of Mammalian Orthoreovirus Identified by Environmental Surveillance in Taiwan

et al. 2015

View full text Add to dashboard Cite

show abstract

“…12 Since 2006, environmental surveillances for PV and other EVs have been conducted in Lombardy in accordance with WHO protocols, 12 and no wild PV or cVDPV has been detected, supporting the epidemiological data from environmental surveillances in other Italian regions. 13,14 In contrast, Sabin-like type 2 PV was isolated in Lombardy and other Italian regions in 2007 and in 2008. Because the full IPV Salk schedule was introduced in Italy in 2002, the isolation of Sabin-like PVs were probably due to the presence of individuals who came from countries that still use OPV.…”

Section: Resultsmentioning

confidence: 65%

“…Because the full IPV Salk schedule was introduced in Italy in 2002, the isolation of Sabin-like PVs were probably due to the presence of individuals who came from countries that still use OPV. 13,14 The identification of Sabin-like PV in Italy underscores the risk of virus reintroduction due to globalization and highlights the need to perform high-quality PV surveillances.…”

Section: Resultsmentioning

confidence: 99%

Surveillance of acute flaccid paralysis (AFP) in Lombardy, Northern Italy, from 1997 to 2011 in the context of the national AFP surveillance system

Pellegrinelli

Prímache

Fiore

et al. 2014

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

An Acute Flaccid Paralysis (AFP) surveillance system was set up in Lombardy (Northern Italy) in 1997 in the framework of the national AFP surveillance system, as part of the polio eradication initiative by the World Health Organization (WHO). This surveillance system can now be used to detect Poliovirus (PV) reintroductions from endemic countries. This study aimed at describing the results of the AFP surveillance in Lombardy, from 1997 to 2011. Overall, 131 AFP cases in Lombardy were reported with a mean annual incidence rate of 0.7/100 000 children <15 years of age (range: 0.3/100 000-1.1/100 000). The sensitivity of the surveillance system was optimal from 2001-2003. The monthly distribution of AFP cases was typical with peaks in November, in January, and in March. The major clinical diagnoses associated with AFP were Guillain-Barré Syndrome (GBS, 40%) and encephalomyelitis/myelitis (13%). According to the virological results, no poliomyelitis cases were caused by wild PV infections, but two Vaccine-Associated Paralytic Paralysis (VAPP) cases were reported in 1997 when the Sabin oral polio vaccine (OPV) was still being administered in Italy. Since a surveillance system is deemed sensitive if at least one case of AFP per 100,000 children <15 years of age is detected each year, our surveillance system needs some improvement and must be maintained until global poliovirus eradication will be declared.

show abstract

“…Environmental surveillance in Greece revealed echoviruses to be the most frequently isolated, followed by CVBs. CVBs have generally been reported to be the most frequently isolated EVs from environmental samples worldwide (25)(26)(27). It is noteworthy that of the 26 EV serotypes isolated from stool samples, only six were detected in sewage water samples, all belonging to species B.…”

Section: Discussionmentioning

confidence: 99%

Laboratory Surveillance of Polio and Other Enteroviruses in High-Risk Populations and Environmental Samples

Pogka

Labropoulou

Emmanouil

et al. 2017

Appl Environ Microbiol

View full text Add to dashboard Cite

In the context of poliomyelitis eradication, a reinforced supplementary laboratory surveillance of enteroviruses was implemented in Greece. Between 2008 and 2014, the Hellenic Polioviruses/Enteroviruses Reference Laboratory performed detailed supplementary surveillance of circulating enteroviruses among healthy individuals in high-risk population groups, among immigrants from countries in which poliovirus is endemic, and in environmental samples. In total, 722 stool samples and 179 sewage water samples were included in the study. No wild-type polioviruses were isolated during these 7 years of surveillance, although two imported vaccine polioviruses were detected. Enterovirus presence was recorded in 25.3 and 25.1% of stool and sewage water samples, respectively. Nonpolio enteroviruses isolated from stool samples belonged to species A, B, or C; coxsackievirus A24 was the most frequently identified serotype. Only enteroviruses of species B were identified in sewage water samples, including four serotypes of echoviruses and four serotypes of coxsackie B viruses. Phylogenetic analysis revealed close genetic relationships among virus isolates from sewage water samples and stool samples, which in most cases fell into the same cluster. To the best of our knowledge, this is the first study to compare enterovirus serotypes circulating in fecal specimens of healthy individuals and environmental samples, emphasizing the burden of enterovirus circulation in asymptomatic individuals at high risk. Given that Greece continues to receive a large number of short-term arrivals, students, migrants, and refugees from countries in which poliovirus is endemic, it is important to guarantee high-quality surveillance in order to maintain its polio-free status until global eradication is achieved. IMPORTANCE This article summarizes the results of supplementary poliovirus surveillance in Greece and the subsequent characterization of enteroviral circulation in human feces and the environment. The examination of stool samples from healthy refugees and other individuals in "high-risk" groups for poliovirus enables the identification of enterovirus cases and forms the basis for further investigation of the community-level risk of viral transmission. In addition, the examination of composite human fecal samples through environmental surveillance links poliovirus and nonpoliovirus isolates from unknown individuals to populations served by the sewage or wastewater system. Supplementary surveillance is necessary to comply with the prerequisites imposed by the World Health Organization for monitoring the emergence of vaccine-derived polioviruses, reemergence of wild polioviruses, or disappearance of all vaccine-related strains in order for countries such as Greece to maintain their polio-free status and contribute to global poliovirus eradication.

show abstract

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

Cited by 23 publications

References 79 publications

High Incidence of Mammalian Orthoreovirus Identified by Environmental Surveillance in Taiwan

High Incidence of Mammalian Orthoreovirus Identified by Environmental Surveillance in Taiwan

Surveillance of acute flaccid paralysis (AFP) in Lombardy, Northern Italy, from 1997 to 2011 in the context of the national AFP surveillance system

Laboratory Surveillance of Polio and Other Enteroviruses in High-Risk Populations and Environmental Samples

Contact Info

Product

Resources

About