title: Contribution of second stool specimen to increased sensitivity of poliovirus detection in India, 1998-2000.
abstract: 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.
authors.affiliation: Global Immunization Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Kohler
authors.forename: J M
authors.initials: JM
authors.lastname: Deshpande
authors.forename: H E
authors.initials: HE
authors.lastname: Gary
authors.forename: K
authors.initials: K
authors.lastname: Banerjee
authors.forename: P L F
authors.initials: PL
authors.lastname: Zuber
authors.forename: W G
authors.initials: WG
authors.lastname: Hlady
mesh_terms: 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