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Zhang M, Yang J, Bai Y, Zhu H, Wang C, Zhang L, Xu J, Lu M, Zhang X, Xiao Z, Ma Y, Wang Y, Li X, Wang D, Zhu S, Yan D, Xu W, Zhang Y, Zhang Y. Epidemiological survey and genetic characterization of type 3 vaccine-derived poliovirus isolated from a patient with four doses of inactivated polio vaccine in Henan Province, China. Infect Dis Poverty 2022; 11:124. [PMID: 36514167 DOI: 10.1186/s40249-022-01028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Vaccine-derived poliovirus (VDPV) is a potential threat to polio eradication because they can reintroduce into the general population and cause paralytic polio outbreaks, a phenomenon that has recently emerged as a prominent public health concern at the end of global polio eradication. This study aimed to describe the epidemiology and genetic characteristics of the first VDPV identified from a patient with acute flaccid paralysis (AFP), with four doses of inactivated polio vaccine immunization in Henan Province, China in 2017. METHODS The patient was diagnosed with type 3 VDPV. Subsequently, a series of epidemiological approaches was implemented, including a retrospective search of AFP cases, rate of vaccination assessment, study of contacts, and supplementary immunization activities. Fecal samples were collected, viral isolation was performed, and the viral isolates were characterized using full-length genomic sequencing and bioinformatic analysis. RESULTS Phylogenetic analysis showed that the viral isolates from the patient were different from other reported genetic clusters of type 3 VDPV worldwide. They were identified as a Sabin 3/Sabin 1 recombinant VDPV with a crossover site in the P2 region. Nucleotide substitutions, including U → C (472) and C → U (2493), have been identified, both of which are frequently observed as reversion mutations in neurovirulent type 3 poliovirus. A unique aspect of this case is that the patient had been vaccinated with four doses of inactive polio vaccine, and the serum neutralizing antibody for Sabin types 1 and 3 were 1∶16 and 1∶512, respectively. Thus, the patient was speculated to have been infected with type 3 VDPV, and the virus continued to replicate and be excreted for at least 41 d. CONCLUSIONS The existence of this kind of virus in human population is a serious risk and poses a severe challenge in maintaining a polio-free status in China. To the best of our knowledge, this is the first report of VDPV identified in the Henan province of China. Our results highlight the importance of maintaining a high-level vaccination rate and highly sensitive AFP case surveillance system in intercepting VDPV transmission.
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Affiliation(s)
- Mingyu Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Jianhui Yang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Yiran Bai
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Hui Zhu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Changshuang Wang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Lu Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Jin Xu
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Mingxia Lu
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Xiaoxiao Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Zhanpei Xiao
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Yating Ma
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Yan Wang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China
| | - Xiaolei Li
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Dongyan Wang
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Dongmei Yan
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071, People's Republic of China
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory and National Health Commission Key Laboratory for Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China. .,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071, People's Republic of China.
| | - Yanyang Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, Henan, People's Republic of China.
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Link-Gelles R, Lutterloh E, Ruppert PS, Backenson PB, St George K, Rosenberg ES, Anderson BJ, Fuschino M, Popowich M, Punjabi C, Souto M, McKay K, Rulli S, Insaf T, Hill D, Kumar J, Gelman I, Jorba J, Ng TFF, Gerloff N, Masters NB, Lopez A, Dooling K, Stokley S, Kidd S, Oberste MS, Routh J, Brister B, Bullows JE, Burns CC, Castro CJ, Cory J, Dybdahl‐Sissoko N, Emery BD, English R, Frolov AD, Getachew H, Henderson E, Hess A, Mason K, Mercante JW, Miles SJ, Liu H, Marine RL, Momin N, Pang H, Perry D, Rogers SL, Short B, Sun H, Tobolowsky F, Yee E, Hughes S, Hygiene M, Omoregie E, Hygiene M, Rosen JB, Hygiene M, Zucker JR, Hygiene M, Alazawi M, Bauer U, Godinez A, Hanson B, Heslin E, McDonald J, Mita‐Mendoza NK, Meldrum M, Neigel D, Suitor R, Larsen DA, Egan C, Faraci N, Feumba GS, Gray T, Lamson D, Laplante J, McDonough K, Migliore N, Moghe A, Ogbamikael S, Plitnick J, Ramani R, Rickerman L, Rist E, Schoultz L, Shudt M, Krauchuk J, Medina E, Lawler J, Boss H, Barca E, Ghazali DB, Goyal T, Marinelli SJ, Roberts JA, Russo GB, Thakur KT, Yang VQ. Public health response to a case of paralytic poliomyelitis in an unvaccinated person and detection of poliovirus in wastewater-New York, June-August 2022. Am J Transplant 2022; 22:2470-2474. [PMID: 36196495 DOI: 10.1111/ajt.16677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Ruth Link-Gelles
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Emily Lutterloh
- New York State Department of Health, State University of New York at Albany, Albany, New York, USA.,Department of Epidemiology and Biostatistics, State University of New York at Albany, Albany, New York, USA
| | | | - P Bryon Backenson
- New York State Department of Health, State University of New York at Albany, Albany, New York, USA.,Department of Epidemiology and Biostatistics, State University of New York at Albany, Albany, New York, USA
| | - Kirsten St George
- Wadsworth Center, New York State Department of Health, Albany, New York, USA.,Department of Biomedical Science, State University of New York at Albany, Albany, New York, USA
| | - Eli S Rosenberg
- New York State Department of Health, State University of New York at Albany, Albany, New York, USA.,Department of Epidemiology and Biostatistics, State University of New York at Albany, Albany, New York, USA
| | - Bridget J Anderson
- New York State Department of Health, State University of New York at Albany, Albany, New York, USA
| | - Meghan Fuschino
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Michael Popowich
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Chitra Punjabi
- Rockland County Department of Health, Pomona, New York, USA
| | - Maria Souto
- Rockland County Department of Health, Pomona, New York, USA
| | - Kevin McKay
- Rockland County Department of Health, Pomona, New York, USA
| | - Samuel Rulli
- Rockland County Department of Health, Pomona, New York, USA
| | - Tabassum Insaf
- New York State Department of Health, State University of New York at Albany, Albany, New York, USA
| | - Dustin Hill
- Department of Public Health, Syracuse University, Syracuse, New York, USA
| | - Jessica Kumar
- New York State Department of Health, State University of New York at Albany, Albany, New York, USA
| | - Irina Gelman
- Orange County Department of Health, Goshen, New York, USA
| | - Jaume Jorba
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Terry Fei Fan Ng
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Nancy Gerloff
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Nina B Masters
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Adriana Lopez
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Kathleen Dooling
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Shannon Stokley
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Sarah Kidd
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - M Steven Oberste
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
| | - Janell Routh
- 2022 CDC Domestic Poliovirus Emergency Response Team, State University of New York at Albany, Albany, New York, USA
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Link-Gelles R, Lutterloh E, Schnabel Ruppert P, Backenson PB, St. George K, Rosenberg ES, Anderson BJ, Fuschino M, Popowich M, Punjabi C, Souto M, McKay K, Rulli S, Insaf T, Hill D, Kumar J, Gelman I, Jorba J, Ng TFF, Gerloff N, Masters NB, Lopez A, Dooling K, Stokley S, Kidd S, Oberste MS, Routh J. Public Health Response to a Case of Paralytic Poliomyelitis in an Unvaccinated Person and Detection of Poliovirus in Wastewater - New York, June-August 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1065-1068. [PMID: 35980868 PMCID: PMC9400530 DOI: 10.15585/mmwr.mm7133e2] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Belgasmi H, Miles SJ, Sayyad L, Wong K, Harrington C, Gerloff N, Coulliette-Salmond AD, Guntapong R, Tacharoenmuang R, Ayutthaya AIN, Apostol LNG, Valencia MLD, Burns CC, Benito GR, Vega E. CaFÉ: A Sensitive, Low-Cost Filtration Method for Detecting Polioviruses and Other Enteroviruses in Residual Waters. Front Environ Sci 2022; 10:10.3389/fenvs.2022.914387. [PMID: 35928599 PMCID: PMC9344547 DOI: 10.3389/fenvs.2022.914387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Acute flaccid paralysis (AFP) surveillance has been used to identify polio cases and target vaccination campaigns since the inception of the Global Poliovirus Eradication Initiative (GPEI) in 1988. To date, only Afghanistan and Pakistan have failed to interrupt wild poliovirus transmission. Circulation of vaccine-derived polioviruses (VDPV) continues to be a problem in high-risk areas of the Eastern Mediterranean, African, and Southeast Asian regions. Environmental surveillance (ES) is an important adjunct to AFP surveillance, helping to identify circulating polioviruses in problematic areas. Stools from AFP cases and contacts (>200,000 specimens/year) and ES samples (>642 sites) are referred to 146 laboratories in the Global Polio Laboratory Network (GPLN) for testing. Although most World Health Organization supported laboratories use the two-phase separation method due to its simplicity and effectiveness, alternative simple, widely available, and cost-effective methods are needed. The CAFÉ (Concentration and Filtration Elution) method was developed from existing filtration methods to handle any type of sewage or residual waters. At $10-20 US per sample for consumable materials, CAFÉ is cost effective, and all equipment and reagents are readily available from markets and suppliers globally. The report describes the results from a parallel study of CAFÉ method with the standard two-phase separation method. The study was performed with samples collected from five countries (Guatemala, Haïti, Thailand, Papua New Guinea, and the Philippines), run in three laboratories-(United States, Thailand and in the Philippines) to account for regional and sample-to-sample variability. Samples from each site were divided into two 500 ml aliquots and processed by both methods, with no other additional concentration or manipulation. The results of 338 parallel-tested samples show that the CAFÉ method is more sensitive than the two-phase separation method for detection of non-polio enteroviruses (p-value < 0.0001) and performed as well as the two-phase separation method for polioviruses detection with no significant difference (p-value > 0.05). The CAFÉ method is a robust, sensitive, and cost-effective method for isolating enteroviruses from residual waters.
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Affiliation(s)
- Hanen Belgasmi
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Stacey Jeffries Miles
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - Chelsea Harrington
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nancy Gerloff
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Angela D Coulliette-Salmond
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
- U.S Public Health Service, Rockville, MD, United States
| | - Ratigorn Guntapong
- Department of Medical Science, Enteric Viruses Section, National Institute of Health, Nonthaburi, Thailand
| | - Ratana Tacharoenmuang
- Department of Medical Science, Enteric Viruses Section, National Institute of Health, Nonthaburi, Thailand
| | | | | | | | - Cara C. Burns
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gloria-Rey Benito
- Pan American Health Organization, World Health Organization, Washington, DC, United States
| | - Everardo Vega
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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5
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Fontana S, Buttinelli G, Fiore S, Amato C, Pataracchia M, Kota M, Aćimović J, Blažević M, Mulaomerović M, Nikolaeva-Glomb L, Mentis A, Voulgari-Kokota A, Gashi L, Kaçaniku-Gunga P, Barbara C, Melillo J, Protic J, Filipović-Vignjevic S, O’Connor PM, D’Alberto A, Orioli R, Siddu A, Saxentoff E, Stefanelli P. Retrospective Analysis of Six Years of Acute Flaccid Paralysis Surveillance and Polio Vaccine Coverage Reported by Italy, Serbia, Bosnia and Herzegovina, Montenegro, Bulgaria, Kosovo, Albania, North Macedonia, Malta, and Greece. Vaccines (Basel) 2021; 10:vaccines10010044. [PMID: 35062705 PMCID: PMC8779529 DOI: 10.3390/vaccines10010044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Here we analyzed six years of acute flaccid paralysis (AFP) surveillance, from 2015 to 2020, of 10 countries linked to the WHO Regional Reference Laboratory, at the Istituto Superiore di Sanità, Italy. The analysis also comprises the polio vaccine coverage available (2015–2019) and enterovirus (EV) identification and typing data. Centralized Information System for Infectious Diseases and Laboratory Data Management System databases were used to obtain data on AFP indicators and laboratory performance and countries’ vaccine coverage from 2015 to 2019. EV isolation, identification, and typing were performed by each country according to WHO protocols. Overall, a general AFP underreporting was observed. Non-Polio Enterovirus (NPEV) typing showed a high heterogeneity: over the years, several genotypes of coxsackievirus and echovirus have been identified. The polio vaccine coverage, for the data available, differs among countries. This evaluation allows for the collection, for the first time, of data from the countries of the Balkan area regarding AFP surveillance and polio vaccine coverage. The need, for some countries, to enhance the surveillance systems and to promote the polio vaccine uptake, in order to maintain the polio-free status, is evident.
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Affiliation(s)
- Stefano Fontana
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Gabriele Buttinelli
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Stefano Fiore
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Concetta Amato
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Marco Pataracchia
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
| | - Majlinda Kota
- Laboratory of Virology, Department of Control of Infectious Diseases, Institute of Public Health, 1001 Tirana, Albania;
| | - Jela Aćimović
- Department of Epidemiology, Public Health Institute of the Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Mia Blažević
- Institute for Public Health of Federation Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina; (M.B.); (M.M.)
| | - Mirsada Mulaomerović
- Institute for Public Health of Federation Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina; (M.B.); (M.M.)
| | - Lubomira Nikolaeva-Glomb
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria;
| | - Andreas Mentis
- National Poliovirus/Enterovirus Reference Laboratory, Diagnostic Department, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.M.); (A.V.-K.)
| | - Androniki Voulgari-Kokota
- National Poliovirus/Enterovirus Reference Laboratory, Diagnostic Department, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.M.); (A.V.-K.)
| | - Luljeta Gashi
- Department of Epidemiology, National Institute of Public Health, 10000 Pristina, Kosovo; (L.G.); (P.K.-G.)
| | - Pranvera Kaçaniku-Gunga
- Department of Epidemiology, National Institute of Public Health, 10000 Pristina, Kosovo; (L.G.); (P.K.-G.)
| | | | - Jackie Melillo
- Department for Health Regulation, Health Promotion and Disease Prevention, MSD2090 Msida, Malta;
| | - Jelena Protic
- National Reference Laboratory for ARBO Viruses and Hemorrhagic Fever, Institute of Virology, Vaccines and Sera “Torlak”, 11152 Belgrade, Serbia;
| | - Svetlana Filipović-Vignjevic
- Diagnostics and Research and Development, Institute of Virology, Vaccines and Sera “Torlak”, 11152 Belgrade, Serbia;
| | - Patrick M. O’Connor
- Global Immunization Division US Centers for Disease Control and Prevention, Atlanta, GA 30333, USA;
| | - Alessandra D’Alberto
- Prevention of Communicable Diseases and International Prophylaxis, Directorate General of Health Prevention, Ministry of Health, 00144 Rome, Italy; (A.D.); (R.O.); (A.S.)
| | - Riccardo Orioli
- Prevention of Communicable Diseases and International Prophylaxis, Directorate General of Health Prevention, Ministry of Health, 00144 Rome, Italy; (A.D.); (R.O.); (A.S.)
| | - Andrea Siddu
- Prevention of Communicable Diseases and International Prophylaxis, Directorate General of Health Prevention, Ministry of Health, 00144 Rome, Italy; (A.D.); (R.O.); (A.S.)
| | - Eugene Saxentoff
- Division of Health Emergencies and Communicable Diseases (DEC), Regional Office for Europe World Health Organization, DK-2100 Copenhagen, Denmark;
| | - Paola Stefanelli
- Department of Infectious Disease, Istituto Superiore di Sanità, 00161 Rome, Italy; (S.F.); (G.B.); (S.F.); (C.A.); (M.P.)
- Correspondence: ; Tel.: +39-06-4990-2126
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Coulliette-Salmond AD, Alleman MM, Wilnique P, Rey-Benito G, Wright HB, Hecker JW, Miles S, Peñaranda S, Lafontant D, Corvil S, Francois J, Rossignol E, Stanislas M, Gue E, Faye PC, Castro CJ, Schmidt A, Ng TFF, Burns CC, Vega E. Haiti Poliovirus Environmental Surveillance. Am J Trop Med Hyg 2020; 101:1240-1248. [PMID: 31701857 DOI: 10.4269/ajtmh.19-0469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Poliovirus (PV) environmental surveillance was established in Haiti in three sites each in Port-au-Prince and Gonaïves, where sewage and fecal-influenced environmental open water channel samples were collected monthly from March 2016 to February 2017. The primary objective was to monitor for the emergence of vaccine-derived polioviruses (VDPVs) and the importation and transmission of wild polioviruses (WPVs). A secondary objective was to compare two environmental sample processing methods, the gold standard two-phase separation method and a filter method (bag-mediated filtration system [BMFS]). In addition, non-polio enteroviruses (NPEVs) were characterized by next-generation sequencing using Illumina MiSeq to provide insight on surrogates for PVs. No WPVs or VDPVs were detected at any site with either concentration method. Sabin (vaccine) strain PV type 2 and Sabin strain PV type 1 were found in Port-au-Prince, in March and April samples, respectively. Non-polio enteroviruses were isolated in 75-100% and 0-58% of samples, by either processing method during the reporting period in Port-au-Prince and Gonaïves, respectively. Further analysis of 24 paired Port-au-Prince samples confirmed the detection of a human NPEV and echovirus types E-3, E-6, E-7, E-11, E-19, E-20, and E-29. The comparison of the BMFS filtration method to the two-phase separation method found no significant difference in sensitivity between the two methods (mid-P-value = 0.55). The experience of one calendar year of sampling has informed the appropriateness of the initially chosen sampling sites, importance of an adequate PV surrogate, and robustness of two processing methods.
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Affiliation(s)
- Angela D Coulliette-Salmond
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary M Alleman
- Polio Eradication Branch, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pierre Wilnique
- Division of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Gloria Rey-Benito
- Pan American Health Organization, World Health Organization, Washington, District of Columbia
| | | | | | | | - Silvia Peñaranda
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Donald Lafontant
- Division of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Salomon Corvil
- Division of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Jeannot Francois
- Expanded Programme on Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Emmanuel Rossignol
- National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Magalie Stanislas
- National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Edmond Gue
- Pan American Health Organization, World Health Organization Region of the Americas, Port-au-Prince, Haiti
| | - Papa C Faye
- Pan American Health Organization, World Health Organization Region of the Americas, Port-au-Prince, Haiti
| | - Christina J Castro
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee.,Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Terry Fei Fan Ng
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cara C Burns
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Everardo Vega
- Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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7
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Estívariz CF, Pérez-Sánchez EE, Bahena A, Burns CC, Gary HE, García-Lozano H, Rey-Benito G, Peñaranda S, Castillo-Montufar KV, Nava-Acosta RS, Meschke JS, Oberste MS, Lopez-Martínez I, Díaz-Quiñonez JA. Field Performance of Two Methods for Detection of Poliovirus in Wastewater Samples, Mexico 2016-2017. Food Environ Virol 2019; 11:364-373. [PMID: 31571037 PMCID: PMC10389298 DOI: 10.1007/s12560-019-09399-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/29/2019] [Indexed: 06/10/2023]
Abstract
To enhance our ability to monitor poliovirus circulation and certify eradication, we evaluated the performance of the bag-mediated filtration system (BMFS) against the two-phase separation (TPS) method for concentrating wastewater samples for poliovirus detection. Sequential samples were collected at two sites in Mexico; one L was collected by grab and ~ 5 L were collected and filtered in situ with the BMFS. In the laboratory, 500 mL collected by grab were concentrated using TPS and the sample contained in the filter of the BMFS was eluted without secondary concentration. Concentrates were tested for the presence of poliovirus and non-poliovirus enterovirus (NPEV) using Global Poliovirus Laboratory Network standard procedures. Between February 16, 2016, and April 18, 2017, 125 pairs of samples were obtained. Collectors spent an average (± standard deviation) of 4.3 ± 2.2 min collecting the TPS sample versus 73.5 ± 30.5 min collecting and filtering the BMFS sample. Laboratory processing required an estimated 5 h for concentration by TPS and 3.5 h for elution. Sabin 1 poliovirus was detected in 37 [30%] samples with the TPS versus 24 [19%] samples with the BMFS (McNemar's mid p value = 0.004). Sabin 3 poliovirus was detected in 59 [47%] versus 49 (39%) samples (p = 0.043), and NPEV was detected in 67 [54%] versus 40 [32%] samples (p < 0.001). The BMFS method without secondary concentration did not perform as well as the TPS method for detecting Sabin poliovirus and NPEV. Further studies are needed to guide the selection of cost-effective environmental surveillance methods for the polio endgame.
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Affiliation(s)
- Concepción F Estívariz
- Global Immunization Division, Global Health Center, Centers for Control Disease and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
| | - Elda E Pérez-Sánchez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - Anita Bahena
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - Cara C Burns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Howard E Gary
- Global Immunization Division, Global Health Center, Centers for Control Disease and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Herlinda García-Lozano
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - Gloria Rey-Benito
- Immunization Unit, Pan American Health Organization, 525 23rd Street NW, Washington, DC, 20037, USA
| | - Silvia Peñaranda
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Katy V Castillo-Montufar
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - Raúl S Nava-Acosta
- Organización Panamericana de la Salud, Ciudad de México, Montes Urales 440, 2nd floor, Col. Lomas de Chapultepec, 11000, Ciudad De Mexico, Mexico
| | - John Scott Meschke
- Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98195, USA
| | - M Steven Oberste
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Irma Lopez-Martínez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
| | - José A Díaz-Quiñonez
- Instituto de Diagnóstico y Referencia Epidemiológico, Francisco de P. Miranda 177, Lomas de Plateros-Alvaro Obregon, Ciudad De México, 01480, Mexico
- División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad De México, Mexico
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Majumdar M, Klapsa D, Wilton T, Akello J, Anscombe C, Allen D, Mee ET, Minor PD, Martin J. Isolation of Vaccine-Like Poliovirus Strains in Sewage Samples From the United Kingdom. J Infect Dis 2019; 217:1222-1230. [PMID: 29309594 DOI: 10.1093/infdis/jix667] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/20/2017] [Indexed: 12/25/2022] Open
Abstract
Background Environmental surveillance (ES) is a sensitive method for detecting human enterovirus (HEV) circulation, and it is used worldwide to support global polio eradication. We describe a novel ES approach using next-generation sequencing (NGS) to identify HEVs in sewage samples collected in London, United Kingdom, from June 2016 to May 2017. Methods Two different methods were used to process raw sewage specimens: a 2-phase aqueous separation system and size exclusion by filtration and centrifugation. HEVs were isolated using cell cultures and analyzed using NGS. Results Type 1 and 3 vaccine-like poliovirus (PV) strains were detected in samples collected from September 2016 through January 2017. NGS analysis allowed us to rapidly obtain whole-genome sequences of PV and non-PV HEV strains. As many as 6 virus strains from different HEV serotypes were identified in a single cell culture flask. PV isolates contained only a small number of mutations from vaccine strains commonly seen in early isolates from vaccinees. Conclusions Our ES setup has high sensitivity for polio and non-PV HEV detection, generating nearly whole-genome sequence information. Such ES systems provide critical information to assist the polio eradication endgame and contribute to the improvement of our understanding of HEV circulation patterns in humans.
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Affiliation(s)
- Manasi Majumdar
- Division of Virology, National Institute for Biological Standards and Control, South Mimms
| | - Dimitra Klapsa
- Division of Virology, National Institute for Biological Standards and Control, South Mimms
| | - Thomas Wilton
- Division of Virology, National Institute for Biological Standards and Control, South Mimms
| | - Joyce Akello
- Enterovirus Unit, Public Health England, London, United Kingdom
| | | | - David Allen
- Enterovirus Unit, Public Health England, London, United Kingdom
| | - Edward T Mee
- Division of Virology, National Institute for Biological Standards and Control, South Mimms
| | - Philip D Minor
- Division of Virology, National Institute for Biological Standards and Control, South Mimms
| | - Javier Martin
- Division of Virology, National Institute for Biological Standards and Control, South Mimms
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Gerloff N, Sun H, Mandelbaum M, Maher C, Nix WA, Zaidi S, Shaukat S, Seakamela L, Nalavade UP, Sharma DK, Oberste MS, Vega E. Diagnostic Assay Development for Poliovirus Eradication. J Clin Microbiol 2018; 56:e01624-17. [PMID: 29212703 DOI: 10.1128/JCM.01624-17] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/01/2017] [Indexed: 02/07/2023] Open
Abstract
With poliovirus eradication nearing, few pockets of active wild poliovirus (WPV) transmission remain in the world. Intratypic differentiation (ITD) plays a crucial part in laboratory surveillance as the molecular detection method that can identify and distinguish wild and vaccine-like polioviruses isolated from acute flaccid paralysis cases or environmental sources. The need to detect new variants of WPV serotype 1 (WPV1) and the containment of all serotype 2 polioviruses (PV2) in 2015 required changes to the previous version of the method. The ITD version 5.0 is a set of six real-time reverse transcription-PCR (rRT-PCR) assays that serve as accurate diagnostic tools to easily detect and differentiate PV serotypes and genotypes. We describe the creation and properties of quantitation standards, including 16 control RNA transcripts and nine plaque-isolated viruses. All ITD rRT-PCR assays were validated using these standards, and the limits of detection were determined for each assay. We designed and pilot tested two new assays targeting recently circulating WPV1 genotypes and all PV2 viruses. The WPV1 assay had 99.1% specificity and 100% sensitivity, and the PV2 assay had 97.7% specificity and 92% sensitivity. Before proceeding to the next step in the global poliovirus eradication program, we needed to gain a better understanding of the performance of the ITD 5.0 suite of molecular assays and their limits of detection and specificities. The findings and conclusions in this evaluation serve as building blocks for future development work.
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Jorba J, Diop OM, Iber J, Henderson E, Sutter RW, Wassilak SGF, Burns CC. Update on Vaccine-Derived Polioviruses - Worldwide, January 2016-June 2017. MMWR Morb Mortal Wkly Rep 2017; 66:1185-1191. [PMID: 29095803 PMCID: PMC5689216 DOI: 10.15585/mmwr.mm6643a6] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In 1988, the World Health Assembly launched the Global Polio Eradication Initiative (GPEI) (1). Among the three wild poliovirus (WPV) serotypes, only type 1 (WPV1) has been detected since 2012. Since 2014, detection of WPV1 has been limited to three countries, with 37 cases in 2016 and 11 cases in 2017 as of September 27. The >99.99% decline worldwide in polio cases since the launch of the GPEI is attributable to the extensive use of the live, attenuated oral poliovirus vaccine (OPV) in mass vaccination campaigns and comprehensive national routine immunization programs. Despite its well-established safety record, OPV use can be associated with rare emergence of genetically divergent vaccine-derived polioviruses (VDPVs) whose genetic drift from the parental OPV strains indicates prolonged replication or circulation (2). VDPVs can also emerge among persons with primary immunodeficiencies (PIDs). Immunodeficiency-associated VDPVs (iVDPVs) can replicate for years in some persons with PIDs. In addition, circulating vaccine-derived polioviruses (cVDPVs) can emerge very rarely among immunologically normal vaccine recipients and their contacts in areas with inadequate OPV coverage and can cause outbreaks of paralytic polio. This report updates previous summaries regarding VDPVs (3). During January 2016-June 2017, new cVDPV outbreaks were identified, including two in the Democratic Republic of the Congo (DRC) (eight cases), and another in Syria (35 cases), whereas the circulation of cVDPV type 2 (cVDPV2) in Nigeria resulted in cVDPV2 detection linked to a previous emergence. The last confirmed case from the 2015-2016 cVDPV type 1 (cVDPV1) outbreak in Laos occurred in January 2016. Fourteen newly identified persons in 10 countries were found to excrete iVDPVs, and three previously reported patients in the United Kingdom and Iran (3) were still excreting type 2 iVDPV (iVDPV2) during the reporting period. Ambiguous VDPVs (aVDPVs), isolates that cannot be classified definitively, were found among immunocompetent persons and environmental samples in 10 countries. Cessation of all OPV use after certification of polio eradication will eliminate the risk for new VDPV infections.
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11
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Cowger TL, Burns CC, Sharif S, Gary HE, Iber J, Henderson E, Malik F, Zahoor Zaidi SS, Shaukat S, Rehman L, Pallansch MA, Orenstein WA. The role of supplementary environmental surveillance to complement acute flaccid paralysis surveillance for wild poliovirus in Pakistan - 2011-2013. PLoS One 2017; 12:e0180608. [PMID: 28742803 PMCID: PMC5526532 DOI: 10.1371/journal.pone.0180608] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 06/19/2017] [Indexed: 02/04/2023] Open
Abstract
Background More than 99% of poliovirus infections are non-paralytic and therefore, not detected by acute flaccid paralysis (AFP) surveillance. Environmental surveillance (ES) can detect circulating polioviruses from sewage without relying on clinical presentation. With extensive ES and continued circulation of polioviruses, Pakistan presents a unique opportunity to quantify the impact of ES as a supplement to AFP surveillance on overall completeness and timeliness of poliovirus detection. Methods Genetic, geographic and temporal data were obtained for all wild poliovirus (WPV) isolates detected in Pakistan from January 2011 through December 2013. We used viral genetics to assess gaps in AFP surveillance and ES as measured by detection of ‘orphan viruses’ (≥1.5% different in VP1 capsid nucleotide sequence). We compared preceding detection of closely related circulating isolates (≥99% identity) detected by AFP surveillance or ES to determine which surveillance system first detected circulation before the presentation of each polio case. Findings A total of 1,127 WPV isolates were detected by AFP surveillance and ES in Pakistan from 2011–2013. AFP surveillance and ES combined exhibited fewer gaps (i.e., % orphan viruses) in detection than AFP surveillance alone (3.3% vs. 7.7%, respectively). ES detected circulation before AFP surveillance in nearly 60% of polio cases (200 of 346). For polio cases reported from provinces conducting ES, ES detected circulation nearly four months sooner on average (117.6 days) than did AFP surveillance. Interpretation Our findings suggest ES in Pakistan is providing earlier, more sensitive detection of wild polioviruses than AFP surveillance alone. Overall, targeted ES through strategic selection of sites has important implications in the eradication endgame strategy.
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Affiliation(s)
- Tori L. Cowger
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Cara C. Burns
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
- * E-mail:
| | - Salmaan Sharif
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health (NIH), Islamabad, Pakistan
| | - Howard E. Gary
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Jane Iber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Elizabeth Henderson
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Farzana Malik
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health (NIH), Islamabad, Pakistan
| | | | - Shahzad Shaukat
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health (NIH), Islamabad, Pakistan
| | - Lubna Rehman
- WHO Regional Reference Laboratory for Polio Eradication Initiative, Department of Virology, National Institute of Health (NIH), Islamabad, Pakistan
| | - Mark A. Pallansch
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Walter A. Orenstein
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
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Fontana S, Buttinelli G, Fiore S, Mulaomerovic M, Aćimović J, Amato C, Delogu R, Rezza G, Stefanelli P. Acute flaccid paralysis surveillance in bosnia and herzegovina: Recent isolation of two sabin like type 2 poliovirus. J Med Virol 2017; 89:1678-1681. [PMID: 28390186 DOI: 10.1002/jmv.24827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 03/19/2017] [Indexed: 11/06/2022]
Abstract
The WHO Regional Commission for the Certification of Poliomyelitis Eradication has recently indicated Bosnia and Herzegovina (B&H) as a high risk country for transmission, following importation, of wild poliovirus (WPV) or circulating vaccine-derived poliovirus (cVDPV). We analyzed data on Acute Flaccid Paralysis (AFP) surveillance between 2007 to 2016, and the trend of polio immunization coverage in B&H. The majority of AFP cases was recorded in 2016 suggesting an enhancement of the AFP surveillance activities. However, the decline in the immunization coverage, around 74%, and the isolation of two Sabin-like poliovirus type 2 strains, one of them close to a VDPV, require a particular attention in the area. Although B&H has successfully maintained its polio-free status since 2002 several challenges need to be addressed.
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Affiliation(s)
- Stefano Fontana
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Gabriele Buttinelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fiore
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Mirsada Mulaomerovic
- Department of Epidemiology, Institute for Public Health of Federation Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Jela Aćimović
- Department of Epidemiology, Public Health Institute of the Republic of Srpska
| | - Concetta Amato
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Roberto Delogu
- National Center for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanni Rezza
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.,WHO Polio Regional Reference Laboratory, c/o Istituto Superiore di Sanità, Rome, Italy
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