TY - JOUR
T1 - Inferring numbers of wild poliovirus excretors using quantitative environmental surveillance
AU - Perepliotchikov, Yuri
AU - Ziv-Baran, Tomer
AU - Hindiyeh, Musa
AU - Manor, Yossi
AU - Sofer, Danit
AU - Moran-Gilad, Jacob
AU - Stephens, Laura
AU - Mendelson, Ella
AU - Weil, Merav
AU - Bassal, Ravit
AU - Anis, Emilia
AU - Singer, Shepherd Roee
AU - Kaliner, Ehud
AU - Cooper, Gillian
AU - Majumdar, Manasi
AU - Markovich, Michal
AU - Ram, Daniela
AU - Grotto, Itamar
AU - Gamzu, Ronni
AU - Martin, Javier
AU - Shulman, Lester M.
N1 - Publisher Copyright:
© 2021 by the authors.
PY - 2021/8
Y1 - 2021/8
N2 - Response to and monitoring of viral outbreaks can be efficiently focused when rapid, quantitative, kinetic information provides the location and the number of infected individuals. Environmental surveillance traditionally provides information on location of populations with contagious, infected individuals since infectious poliovirus is excreted whether infections are asymptomatic or symptomatic. Here, we describe development of rapid (1 week turnaround time, TAT), quantitative RT-PCR of poliovirus RNA extracted directly from concentrated environmental surveillance samples to infer the number of infected individuals excreting poliovirus. The quantitation method was validated using data from vaccination with bivalent oral polio vaccine (bOPV). The method was then applied to infer the weekly number of excreters in a large, sustained, asymptomatic outbreak of wild type 1 poliovirus in Israel (2013) in a population where >90% of the individuals received three doses of inactivated polio vaccine (IPV). Evidence-based intervention strategies were based on the short TAT for direct quantitative detection. Furthermore, a TAT shorter than the duration of poliovirus excretion allowed resampling of infected individuals. Finally, the method documented absence of infections after successful intervention of the asymptomatic outbreak. The methodologies described here can be applied to outbreaks of other excreted viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where there are (1) significant numbers of asymptomatic infections; (2) long incubation times during which infectious virus is excreted; and (3) limited resources, facilities, and manpower that restrict the number of individuals who can be tested and re-tested.
AB - Response to and monitoring of viral outbreaks can be efficiently focused when rapid, quantitative, kinetic information provides the location and the number of infected individuals. Environmental surveillance traditionally provides information on location of populations with contagious, infected individuals since infectious poliovirus is excreted whether infections are asymptomatic or symptomatic. Here, we describe development of rapid (1 week turnaround time, TAT), quantitative RT-PCR of poliovirus RNA extracted directly from concentrated environmental surveillance samples to infer the number of infected individuals excreting poliovirus. The quantitation method was validated using data from vaccination with bivalent oral polio vaccine (bOPV). The method was then applied to infer the weekly number of excreters in a large, sustained, asymptomatic outbreak of wild type 1 poliovirus in Israel (2013) in a population where >90% of the individuals received three doses of inactivated polio vaccine (IPV). Evidence-based intervention strategies were based on the short TAT for direct quantitative detection. Furthermore, a TAT shorter than the duration of poliovirus excretion allowed resampling of infected individuals. Finally, the method documented absence of infections after successful intervention of the asymptomatic outbreak. The methodologies described here can be applied to outbreaks of other excreted viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), where there are (1) significant numbers of asymptomatic infections; (2) long incubation times during which infectious virus is excreted; and (3) limited resources, facilities, and manpower that restrict the number of individuals who can be tested and re-tested.
KW - Asymptomatic infections
KW - Composite sewage samples
KW - Inactivated poliovirus vaccine
KW - Oral poliovirus vaccine
KW - Outbreaks
KW - Poliovirus
KW - Quantitative environmental surveillance
KW - Sewage
KW - Stools
KW - Vaccination
KW - Vaccine-derived poliovirus
UR - http://www.scopus.com/inward/record.url?scp=85113309850&partnerID=8YFLogxK
U2 - 10.3390/vaccines9080870
DO - 10.3390/vaccines9080870
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 34451995
AN - SCOPUS:85113309850
SN - 2076-393X
VL - 9
JO - Vaccines
JF - Vaccines
IS - 8
M1 - 870
ER -