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首页> 外文期刊>Applied Microbiology >Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019–2023
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Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019–2023

机译：环境监测措施基于案例的脊髓灰质炎策略急性松弛瘫痪2019-2023

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The Polio Endgame Strategy 2019–2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance.IMPORTANCE Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillance, provides continued high-quality surveillance performance in achieving the GPEI and detecting the circulation of enterovirus. Given the ongoing cVDPV outbreaks in the world, we present the surveillance capacity of environmental surveillance in capturing enterovirus circulation. The final poliovirus (especially VDPV) elimination has become increasingly complex, and the case-based AFP surveillance alone will lead to difficulties in early detecting dynamics of poliovirus transmission and monitoring the extent of environmental circulation. This study goes beyond previous work to provide a detailed comprehensive evaluation of the enterovirus surveillance and can be used to formulate a set of implementation plan and performance indicators for environmental surveillance.
机译：已经开发了Polio Endame战略2019-2023。然而，应使用更有效和有效的监测活动进行疫苗衍生的脊髓灰质炎病毒（VDPV）或野生脊髓灰质炎病毒（WPV）的准备。我们审查了案例的急性急性松弛瘫痪（AFP）监测（1991年至2018年）和环境监测（2011年至2018年）在中国山东省脊髓灰质炎中的影响。评估AFP病例和肠病毒（EV）研究样品调查的临床特征。在此期间，研究了10,224例AFP病例，收集了352个污水样品。自1997年以来，非政治会议AFP率超过2.0 / 100,000。在10,224例，男性和幼儿的严重疾病的风险较高，68.5％遭受较低的肢体瘫痪。我们从AFP病例中收集了1,707名EV，包括763个脊髓灰质炎病毒和944个非球虫肠病（NPEV）。自1992年以来孤立无WPV。AFP监测在检测143例疫苗相关的麻痹性脊髓灰质炎（VAPP）病例和6个VDPV方面表现出高敏感性。对于环境监测，217（61.6％）样品对脊髓灰质炎病毒阳性，并且共同分离出838个脊髓灰质病毒和2,988个NPEV。虽然确定了一个VDPV2，但在环境监测中没有被隔离WPV。系统发育分析显示环境监测有能力检测大范围的NPEV。基于案例的AFP监测对于使用口服脊髓灰质炎疫苗的国家/地区检测VAPP病例和VDPV循环是必不可少的。环境监测有利于识别EV循环，并应对持续循环VDPV爆发，并应扩大以补充AFP监测。分别中断野生脊髓灰质炎毒蕈的透射和停止循环疫苗衍生的脊髓灰质病毒（CVDPV）爆发已被提出为两个全球目标全球脊髓灰质炎的世界卫生组织根除倡议（GPEI）。该分析根据28年的急性弛缓性瘫痪（AFP）监测和8年环境监测，在实现GPEI和检测肠道病毒的循环方面提供持续的高质量监测性能。鉴于世界上正在进行的CVDPV爆发，我们展示了捕获肠道病毒流通的环境监测的监测能力。最终的脊髓灰质病毒（特别是VDPV）消除变得越来越复杂，而仅案例的AFP监测将导致脊髓灰质炎病毒传播的早期检测动态和监测环境循环程度的困难。本研究超出了以前的工作，提供了对肠道病毒监测的详细综合评价，可用于制定一套实施计划和环境监测绩效指标。

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