Contribution of second stool specimen to increased sensitivity of poliovirus detection in India, 1998-2000.
Acute flaccid paralysis (AFP) surveillance data from India were analysed to examine sensitivity of poliovirus isolation from stool specimens and the added sensitivity obtained from collection of a second stool specimen. Analysis was restricted to Indian AFP cases, 1998-2000, with two adequate stool specimens. The proportion of cases confirmed with wild poliovirus isolation by the second specimen only was calculated, regardless of specimen quality. Overall specimen sensitivity (1998-2000) was 81% using the first specimen, 78% using the second, and 96% using both. Sensitivity increased from 1998 to 2000, with slightly higher sensitivity each year for the first specimen. The second specimen increased sensitivity by 15% overall and contributed more when the first specimen was collected late or was in poor condition. As wild poliovirus disappears, increased sensitivity provided by a second stool specimen may reduce the risk of missing circulating virus.
Kohler
K A
KA
Global Immunization Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Deshpande
J M
JM
Gary
H E
HE
Banerjee
K
K
Zuber
P L F
PL
Hlady
W G
WG
D005243:Feces / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D010264:Paraplegia / Q000453:epidemiology*; D011051:Poliomyelitis / Q000453:epidemiology*; D017955:Poliovirus / Q000302:isolation & purification* / Q000472:pathogenicity*; D011159:Population Surveillance; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013048:Specimen Handling