Sustained detection of type 2 poliovirus in London sewage between February and July, 2022, by enhanced environmental surveillance
Sustained detection of type 2 poliovirus in London sewage between February and July, 2022, by enhanced environmental surveillance
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DOI：
10.1016/s0140-6736(22)01804-9
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发表时间：
2022-10-27
期刊：
影响因子：
168.9
通讯作者：
Martin, Javier
中科院分区：
文献类型：
--
作者：
Klapsa, Dimitra;Wilton, Thomas;Martin, Javier
背景脊髓灰质炎病毒的国际传播使所有国家都面临暴发的风险，并被世卫组织指定为国际关注的突发公共卫生事件。在使用灭活脊髓灰质炎疫苗的国家，这一风险可能会加剧，灭活脊髓灰质炎疫苗提供了极好的预防瘫痪的保护，但在预防脊髓灰质炎病毒脱落方面不如口服疫苗有效，可能会在很长一段时间内在没有发现麻痹病例的情况下传播。我们的研究调查了2型脊髓灰质炎病毒分离株在污水中发现的分子特性，目的是检测病毒在community.Methods传播，我们进行了环境监测，在伦敦，英国，测试污水样本使用WHO推荐的方法，包括浓度，病毒分离细胞培养，和分子特征。我们还实施了直接分子检测，并使用新的纳米孔protocols.Findings确定每个分离株的全基因组序列118与血清型2萨宾疫苗株相关的遗传连锁脊髓灰质炎病毒分离株在2022年2月8日至7月4日期间在伦敦收集的52个连续污水样本中的21个中检测到。伦敦环境监测点的扩大有助于将传播局限于伦敦北部和东部的几个行政区。所有分离株都丢失了两个关键的减毒突变，是一种C型肠道病毒的重组体，并且比例越来越大。（118个中的20个）符合疫苗衍生脊髓灰质炎病毒的标准，在编码VP 1衣壳蛋白的基因中有6至10个核苷酸变化。解释环境监测使伦敦能够及早发现脊髓灰质炎病毒的输入和传播，从而能够迅速采取公共卫生对策，包括加强监测和在1-9岁儿童中开展灭活脊髓灰质炎疫苗运动。通过纳米孔测序产生的全基因组序列建立了分离株的联系，并证实了一种独特的重组脊髓灰质炎病毒谱系的传播，这种病毒现已在以色列和美国被检测到。Copyright（c）2022 Crown Copyright由英国、加拿大或澳大利亚政府雇员主张。
Background The international spread of poliovirus exposes all countries to the risk of outbreaks and is designated a Public Health Emergency of International Concern by WHO. This risk can be exacerbated in countries using inactivated polio vaccine, which offers excellent protection against paralysis but is less effective than oral vaccine against poliovirus shedding, potentially allowing circulation without detection of paralytic cases for long periods of time. Our study investigated the molecular properties of type 2 poliovirus isolates found in sewage with an aim to detect virus transmission in the community.Methods We performed environmental surveillance in London, UK, testing sewage samples using WHO recommended methods that include concentration, virus isolation in cell culture, and molecular characterisation. We additionally implemented direct molecular detection and determined whole-genome sequences of every isolate using novel nanopore protocols.Findings 118 genetically linked poliovirus isolates related to the serotype 2 Sabin vaccine strain were detected in 21 of 52 sequential sewage samples collected in London between Feb 8 and July 4, 2022. Expansion of environmental surveillance sites in London helped localise transmission to several boroughs in north and east London. All isolates have lost two key attenuating mutations, are recombinants with a species C enterovirus, and an increasing proportion (20 of 118) meet the criterion for a vaccine-derived poliovirus, having six to ten nucleotide changes in the gene coding for VP1 capsid protein.Interpretation Environmental surveillance allowed early detection of poliovirus importation and circulation in London, permitting a rapid public health response, including enhanced surveillance and an inactivated polio vaccine campaign among children aged 1-9 years. Whole-genome sequences generated through nanopore sequencing established linkage of isolates and confirmed transmission of a unique recombinant poliovirus lineage that has now been detected in Israel and the USA. Copyright (c) 2022 Crown Copyright claimed by UK, Canadian or Australian Government employee.