a1 National Institute for Health and Welfare (THL), Helsinki, Finland
a2 Central Virology Laboratory (CVL), Ministry of Health, Sheba Medical Center, Tel-Hashomer, Israel
a3 National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
a4 Enterovirus Research Centre (ERC), Mumbai, India
a5 Global Poliomyelitis Eradication Initiative, WHO, Geneva, Switzerland
Environmental poliovirus surveillance (ENV) means monitoring of poliovirus (PV) transmission in human populations by examining environmental specimens supposedly contaminated by human faeces. The rationale is based on the fact that PV-infected individuals, whether presenting with disease symptoms or not, shed large amounts of PV in the faeces for several weeks. As the morbidity:infection ratio of PV infection is very low, this fact contributes to the sensitivity of ENV which under optimal conditions can be better than that of the standard acute flaccid paralysis (AFP) surveillance. The World Health Organization has included ENV in the new Strategic Plan of the Global Polio Eradication Initiative for years 2010–2012 to be increasingly used in PV surveillance, supplementing AFP surveillance. In this paper we review the feasibility of using ENV to monitor wild PV and vaccine-derived PV circulation in human populations, based on global experiences in defined epidemiological situations.
(Accepted December 21 2010)
(Online publication August 18 2011)