title: Laboratory challenges in response to silent introduction and sustained transmission of wild poliovirus type 1 in Israel during 2013.
abstract: Wild poliovirus type 1 (WPV1) introduction into southern Israel in early 2013 was detected by routine environmental surveillance. The virus was identified genetically as related to the South Asian (SOAS) R3A lineage endemic to Pakistan in 2012. Intensified, high-throughput environmental surveillance using advanced molecular methods played a critical role in documenting and locating sustained transmission throughout 2013 and early 2014 in the absence of any acute flaccid paralysis. It guided the public health responses, including stool-based surveillance and serosurveys, to determine the point prevalence in silent excretors and measured the effect of vaccination campaigns with inactivated polio vaccine and bivalent oral polio vaccine on stopping transmission.
authors.affiliation: Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Sheba Medical Center Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv.
authors.forename: Lester M
authors.initials: LM
authors.lastname: Shulman
authors.affiliation: Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Sheba Medical Center Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv.
authors.forename: Ella
authors.initials: E
authors.lastname: Mendelson
authors.affiliation: Division of Epidemiology Public Health Services Braun School of Public Health and Community Medicine, Hebrew University Hadassah Faculty of Medicine, Jerusalem.
authors.forename: Emilia
authors.initials: E
authors.lastname: Anis
authors.affiliation: Israel Center for Disease Control, Tel Hashomer.
authors.forename: Ravit
authors.initials: R
authors.lastname: Bassal
authors.affiliation: South District Health Office, Ministry of Health Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva.
authors.forename: Michael
authors.initials: M
authors.lastname: Gdalevich
authors.affiliation: Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Sheba Medical Center Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv.
authors.forename: Musa
authors.initials: M
authors.lastname: Hindiyeh
authors.affiliation: Public Health Services.
authors.forename: Ehud
authors.initials: E
authors.lastname: Kaliner
authors.affiliation: Division of Epidemiology Public Health Services.
authors.forename: Eran
authors.initials: E
authors.lastname: Kopel
authors.affiliation: Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Sheba Medical Center.
authors.forename: Yossi
authors.initials: Y
authors.lastname: Manor
authors.affiliation: Public Health Services Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva.
authors.forename: Jacob
authors.initials: J
authors.lastname: Moran-Gilad
authors.affiliation: Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Sheba Medical Center.
authors.forename: Daniella
authors.initials: D
authors.lastname: Ram
authors.affiliation: Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Sheba Medical Center.
authors.forename: Danit
authors.initials: D
authors.lastname: Sofer
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv Head National Committee for Monitoring Poliovirus Edith Wolfson Medical Center, Holon, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Somekh
authors.affiliation: Edith Wolfson Medical Center, Holon, Israel.
authors.forename: Diana
authors.initials: D
authors.lastname: Tasher
authors.affiliation: Central Virology Laboratory, Public Health Services, Israel Ministry of Health, Sheba Medical Center.
authors.forename: Merav
authors.initials: M
authors.lastname: Weil
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv Office of the Director General, Ministry of Health.
authors.forename: Ronni
authors.initials: R
authors.lastname: Gamzu
authors.affiliation: Public Health Services Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva.
authors.forename: Itamar
authors.initials: I
authors.lastname: Grotto
mesh_terms: D019411:Clinical Laboratory Techniques / Q000379:methods*; D004784:Environmental Monitoring; D005243:Feces / Q000821:virology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D011051:Poliomyelitis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission*; D017955:Poliovirus / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage; D012722:Sewage / Q000821:virology; D017201:Virus Shedding
chemical_list: D011055:Poliovirus Vaccine, Oral; D012722:Sewage
keywords: emergency health policy response; environmental surveillance; epidemiology; molecular analysis; silent poliovirus transmission; vaccine; wild poliovirus