title: Detection of vaccine-derived polioviruses in Mexico using environmental surveillance.
abstract: BACKGROUND
  Early detection and control of vaccine-derived poliovirus (VDPV) emergences are essential to secure the gains of polio eradication.
  
  
  METHODS
  Serial sewage samples were collected in 4 towns of Mexico before, throughout, and after the May 2010 oral poliovirus vaccine (OPV) mass immunization campaign. Isolation and molecular analysis of polioviruses from sewage specimens monitored the duration of vaccine-related strains in the environment and emergence of vaccine-derived polioviruses in a population partially immunized with inactivated poliovirus vaccine (IPV).
  
  
  RESULTS
  Sabin strains were identified up to 5-8 weeks after the campaign in all towns; in Aguascalientes, 1 Sabin 3 was isolated 16 weeks after the campaign, following 7 weeks with no Sabin strains detected. In Tuxtla Gutiérrez, type 2 VDPV was isolated from 4 samples collected before and during the campaign, and type 1 VDPV from 1 sample collected 19 weeks afterward. During 2009-2010, coverage in 4 OPV campaigns conducted averaged only 57% and surveillance for acute flaccid paralysis (AFP) was suboptimal (AFP rate<1 per 100,000 population<15 years of age) in Tuxtla Gutierrez.
  
  
  CONCLUSIONS
  VDPVs may emerge and spread in settings with inadequate coverage with IPV/OPV vaccination. Environmental surveillance can facilitate early detection in these settings.
authors.affiliation: Centro Nacional para la Salud de la Infancia y Adolescencia, México DF.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Esteves-Jaramillo
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention.
authors.forename: Concepción F
authors.initials: CF
authors.lastname: Estívariz
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Silvia
authors.initials: S
authors.lastname: Peñaranda
authors.affiliation: Centro Nacional para la Salud de la Infancia y Adolescencia, México DF.
authors.forename: Vesta L
authors.initials: VL
authors.lastname: Richardson
authors.affiliation: Centro Nacional para la Salud de la Infancia y Adolescencia, México DF.
authors.forename: Jesús
authors.initials: J
authors.lastname: Reyna
authors.affiliation: Centro Nacional para la Salud de la Infancia y Adolescencia, México DF.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Coronel
authors.affiliation: Pan American Health Organization, Washington, District of Columbia.
authors.forename: Veronica
authors.initials: V
authors.lastname: Carrión
authors.affiliation: Pan American Health Organization, Washington, District of Columbia.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Landaverde
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention.
authors.forename: Steven G F
authors.initials: SG
authors.lastname: Wassilak
authors.affiliation: Instituto de Diagnóstico y Referencia Epidemiológico, México DF.
authors.forename: Elda E
authors.initials: EE
authors.lastname: Pérez-Sánchez
authors.affiliation: Instituto de Diagnóstico y Referencia Epidemiológico, México DF.
authors.forename: Irma
authors.initials: I
authors.lastname: López-Martínez
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Cara C
authors.initials: CC
authors.lastname: Burns
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pallansch
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008800:Mexico; D017955:Poliovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage*; D012722:Sewage / Q000821:virology*; D013997:Time Factors
chemical_list: D011055:Poliovirus Vaccine, Oral; D012722:Sewage
keywords: environmental surveillance; inactivated poliovirus vaccine; polio; vaccine-derived poliovirus