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Chen M, Zhang Y, Zhang W, Huang S, Zhu S, Li C, Guo X, Zeng H, Fang L, Ke B, Li H, Yoshida H, Xu W, Ke C, Deng X, Zheng H. Dynamic changes in polioviruses identified by environmental surveillance in Guangzhou, 2009-2021. J Med Virol 2023; 95:e28668. [PMID: 36905116 DOI: 10.1002/jmv.28668] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/16/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023]
Abstract
Polio cases can be missed by acute flaccid paralysis AFP case surveillance alone, emphasizing the importance of environmental surveillance. In this study, to investigate the serotype distribution and epidemiological trends of poliovirus (PV), we characterized PV isolated from domestic sewage in Guangzhou city, Guangdong province, China from 2009 to 2021. A total of 624 sewage samples were collected from the Liede Sewage Treatment Plant, and the positive rates of PV and non-polio enteroviruses were 66.67% (416/624) and 78.37% (489/624), respectively. After sewage sample treatment, each sewage sample was inoculated in six replicate tubes of three cell lines, and 3,370 viruses were isolated during the 13-year surveillance period. Among these, 1086 isolates were identified as PV, including type 1 PV (21.36%), type 2 PV (29.19%), and type 3 PV (49.48%). Based on VP1 sequences, 1057 strains were identified as Sabin-like, 21 strains were high-mutant vaccine, and eight strains were vaccine-derived poliovirus (VDPV). The numbers and serotypes of PV isolates in sewage were influenced by the vaccine switch strategy. After type 2 OPV was removed from the trivalent oral poliovirus vaccine and a bivalent OPV was adopted in May 2016, the last type 2 PV strain was isolated from sewage, with no detection thereafter. Type 3 PV isolates increased significantly and became the dominant serotype. Before and after the second vaccine switch in January 2020, that is, from the first dose of IPV and second-fourth doses of bOPV to the first two doses of IPV and third-fourth doses of bOPV, there was also a statistical difference in PV positivity rates in sewage samples. Seven type 2 VDPVs and one type 3 VDPV were identified in sewage samples in 2009-2021, and a phylogenetic analysis indicated that all VDPVs isolated from ES in Guangdong are newly discovered VDPVs, different from VDPV previously discovered in China, and were classified as ambiguous VDPV. It is noteworthy that no VDPV cases were reported in AFP case surveillance in the same period. In conclusion, continued PV environmental surveillance in Guangzhou since April 2008 has been a useful supplement to AFP case surveillance, providing an important basis for evaluating the effectiveness of vaccine immunization strategies. Environmental surveillance improves early detection, prevention, and control; accordingly, this strategy can curb the circulation of VDPVs and provide a strong laboratory basis for maintaining a polio-free status. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Meizhong Chen
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China.,School of Public Health, Southern Medical University. No. 1838, Shatai South Road, Baiyun District, Guangzhou, China
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory and Ministry of Health Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, China
| | - Wei Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Shufen Huang
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China.,School of Public Health, Southern Medical University. No. 1838, Shatai South Road, Baiyun District, Guangzhou, China
| | - Shuangli Zhu
- WHO WPRO Regional Polio Reference Laboratory and Ministry of Health Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, China
| | - Caixia Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Xue Guo
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Hanri Zeng
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Ling Fang
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Bixia Ke
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Hui Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Hiromu Yoshida
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, 208-0011, Japan
| | - Wenbo Xu
- WHO WPRO Regional Polio Reference Laboratory and Ministry of Health Key Laboratory for Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 155, Changbai Road, Changping District, Beijing, China
| | - Changwen Ke
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Xiaoling Deng
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
| | - Huanying Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Workstation for Emerging Infectious Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, China
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