Jacob Moran-Gilad1, Ella Mendelson2, Cara C Burns3, Ravit Bassal4, Michael Gdalevich5, Danit Sofer6, M Steven Oberste3, Lester M Shulman2, Ehud Kaliner7, Musa Hindiyeh, Musa Hindiye6, Orna Mor6, Liora Shahar5, Jane Iber3, Ruth Yishay8, Joseph Manor6, Boaz Lev9, Ronni Gamzu10, Itamar Grotto11. 1. Public Health Services, Ministry of Health, Jerusalem, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: giladko@post.bgu.ac.il. 2. Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel; School of Public Health, Tel-Aviv University, Tel-Aviv, Israel. 3. Viruses Branch, Centers for Disease Control and Prevention, Atlanta, USA. 4. Israel Center for Disease Control, Ministry of Health, Tel-Hashomer, Israel. 5. Southern District Health Office, Ministry of Health, Beer-Sheva, Israel. 6. Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel. 7. Public Health Services, Ministry of Health, Jerusalem, Israel. 8. Department of Laboratories, Public Health Services, Ministry of Health, Jerusalem, Israel. 9. Directorate, Ministry of Health, Jerusalem, Israel. 10. School of Public Health, Tel-Aviv University, Tel-Aviv, Israel; Directorate, Ministry of Health, Jerusalem, Israel. 11. Public Health Services, Ministry of Health, Jerusalem, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Abstract
BACKGROUND: Israel has used an inactivated polio vaccine (IPV)-only schedule since 2005 (95% coverage). Silent reintroduction of wild type poliovirus 1 (WPV1) into Israel in early 2013 was detected in Southern Israel via routine environmental surveillance without clinical cases. OBJECTIVES: To estimate the rate of WPV1 excretion by age and residence and inform decision-making regarding supplemental immunization with OPV. STUDY DESIGN: A convenience sample of Bedouin and Jewish residential areas in the epicenter of the incident, focusing on under 8 year-olds who not previously given OPV. Fecal samples were directly tested for WPV1 RNA using a novel qRT-PCR assay. Positive samples were confirmed by gold standard cell culture and subject to genotyping. RESULTS: Overall, 2196 non-duplicate fecal samples were collected and analyzed. WPV1 was detected in 61 samples (2.8%), 55 of which (90.2%) were from Bedouins. WPV1 excretion rates were 5.4% among Bedouins and 0.6% among Jewish individuals. Respective age-specific rates among Bedouin and Jewish children were 4.9% and 0.2% for 0-2 years and 7.2% and 1.7% for 2-8 years. Molecular testing had 89.5% sensitivity (higher than culture) and 100% specificity. CONCLUSION: The rapid performance of a field study to evaluate WPV1 excretion unequivocally demonstrated substantial WPV1 infection rates among children under 8 years in Southern Israel, thus informing the decision to vaccinate this age group with bOPV and risk communication to both healthcare personnel and the public. Rapid development and implementation of molecular screening can thus underpin risk assessment and management in complex epidemiological situations.
BACKGROUND: Israel has used an inactivated polio vaccine (IPV)-only schedule since 2005 (95% coverage). Silent reintroduction of wild type poliovirus 1 (WPV1) into Israel in early 2013 was detected in Southern Israel via routine environmental surveillance without clinical cases. OBJECTIVES: To estimate the rate of WPV1 excretion by age and residence and inform decision-making regarding supplemental immunization with OPV. STUDY DESIGN: A convenience sample of Bedouin and Jewish residential areas in the epicenter of the incident, focusing on under 8 year-olds who not previously given OPV. Fecal samples were directly tested for WPV1 RNA using a novel qRT-PCR assay. Positive samples were confirmed by gold standard cell culture and subject to genotyping. RESULTS: Overall, 2196 non-duplicate fecal samples were collected and analyzed. WPV1 was detected in 61 samples (2.8%), 55 of which (90.2%) were from Bedouins. WPV1 excretion rates were 5.4% among Bedouins and 0.6% among Jewish individuals. Respective age-specific rates among Bedouin and Jewish children were 4.9% and 0.2% for 0-2 years and 7.2% and 1.7% for 2-8 years. Molecular testing had 89.5% sensitivity (higher than culture) and 100% specificity. CONCLUSION: The rapid performance of a field study to evaluate WPV1 excretion unequivocally demonstrated substantial WPV1 infection rates among children under 8 years in Southern Israel, thus informing the decision to vaccinate this age group with bOPV and risk communication to both healthcare personnel and the public. Rapid development and implementation of molecular screening can thus underpin risk assessment and management in complex epidemiological situations.
Authors: Andrew F Brouwer; Marisa C Eisenberg; Lester M Shulman; Michael Famulare; James S Koopman; Steve J Kroiss; Musa Hindiyeh; Yossi Manor; Itamar Grotto; Joseph N S Eisenberg Journal: J R Soc Interface Date: 2022-05-18 Impact factor: 4.293
Authors: Andrew F Brouwer; Joseph N S Eisenberg; Connor D Pomeroy; Lester M Shulman; Musa Hindiyeh; Yossi Manor; Itamar Grotto; James S Koopman; Marisa C Eisenberg Journal: Proc Natl Acad Sci U S A Date: 2018-10-18 Impact factor: 11.205
Authors: Michael Famulare; Christian Selinger; Kevin A McCarthy; Philip A Eckhoff; Guillaume Chabot-Couture Journal: PLoS Biol Date: 2018-04-27 Impact factor: 8.029
Authors: Alexander G Shaw; Laura V Cooper; Nicksy Gumede; Ananda S Bandyopadhyay; Nicholas C Grassly; Isobel M Blake Journal: J Infect Dis Date: 2022-08-26 Impact factor: 7.759
Authors: Rami Yaari; Ehud Kaliner; Itamar Grotto; Guy Katriel; Jacob Moran-Gilad; Danit Sofer; Ella Mendelson; Elizabeth Miller; Amit Huppert; E Anis; E Kopel; Y Manor; O Mor; L Shulman; R Singer; M Weil Journal: BMC Med Date: 2016-06-23 Impact factor: 8.775
Authors: Elizabeth B Brickley; Ruth I Connor; Wendy F Wieland-Alter; Marc S Collett; Marianne Hartford; Harrie Van Der Avoort; Austin W Boesch; Joshua A Weiner; Margaret E Ackerman; Mark A McKinlay; Minetaro Arita; Ananda S Bandyopadhyay; John F Modlin; Peter F Wright Journal: BMJ Glob Health Date: 2019-08-28