title: Environmental surveillance for polioviruses in the Global Polio Eradication Initiative.
abstract: This article summarizes the status of environmental surveillance (ES) used by the Global Polio Eradication Initiative, provides the rationale for ES, gives examples of ES methods and findings, and summarizes how these data are used to achieve poliovirus eradication. ES complements clinical acute flaccid paralysis (AFP) surveillance for possible polio cases. ES detects poliovirus circulation in environmental sewage and is used to monitor transmission in communities. If detected, the genetic sequences of polioviruses isolated from ES are compared with those of isolates from clinical cases to evaluate the relationships among viruses. To evaluate poliovirus transmission, ES programs must be developed in a manner that is sensitive, with sufficiently frequent sampling, appropriate isolation methods, and specifically targeted sampling sites in locations at highest risk for poliovirus transmission. After poliovirus ceased to be detected in human cases, ES documented the absence of endemic WPV transmission and detected imported WPV. ES provides valuable information, particularly in high-density populations where AFP surveillance is of poor quality, persistent virus circulation is suspected, or frequent virus reintroduction is perceived. Given the benefits of ES, GPEI plans to continue and expand ES as part of its strategic plan and as a supplement to AFP surveillance.
authors.affiliation: World Health Organization, Eastern Mediterranean Regional Office.
authors.forename: Humayun
authors.initials: H
authors.lastname: Asghar
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Ousmane M
authors.initials: OM
authors.lastname: Diop
authors.affiliation: World Health Organization.
authors.forename: Goitom
authors.initials: G
authors.lastname: Weldegebriel
authors.affiliation: World Health Organization.
authors.forename: Farzana
authors.initials: F
authors.lastname: Malik
authors.affiliation: Enterovirus Research Center, Mumbai, India.
authors.forename: Sushmitha
authors.initials: S
authors.lastname: Shetty
authors.affiliation: VACSERA, Cairo, Egypt.
authors.forename: Laila
authors.initials: L
authors.lastname: El Bassioni
authors.affiliation: National Polio Laboratory, Ibadan, Nigeria.
authors.forename: Adefunke O
authors.initials: AO
authors.lastname: Akande
authors.affiliation: VACSERA, Cairo, Egypt.
authors.forename: Eman
authors.initials: E
authors.lastname: Al Maamoun
authors.affiliation: National Institute of Health, Islamabad, Pakistan.
authors.forename: Sohail
authors.initials: S
authors.lastname: Zaidi
authors.affiliation: National Polio Laboratory, Ibadan, Nigeria.
authors.forename: Adekunle J
authors.initials: AJ
authors.lastname: Adeniji
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Cara C
authors.initials: CC
authors.lastname: Burns
authors.affiliation: Enterovirus Research Center, Mumbai, India.
authors.forename: Jagadish
authors.initials: J
authors.lastname: Deshpande
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: M Steve
authors.initials: MS
authors.lastname: Oberste
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Lowther
mesh_terms: D060740:Disease Eradication; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D006801:Humans; D011051:Poliomyelitis / Q000453:epidemiology* / Q000517:prevention & control* / Q000821:virology; D017955:Poliovirus / Q000302:isolation & purification*; D012722:Sewage / Q000821:virology*
chemical_list: D012722:Sewage
keywords: disease eradication; environmental monitoring; environmental sewage; polioviruses; surveillance