Detection of vaccine-derived poliovirus circulation by environmental surveillance in the absence of clinical cases
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis Group
Abstract
Background: On August 25, 2019, the Noguchi Memorial Institute for Medical Research notified the
confirmation of a circulating-vaccine-derived poliovirus type-2 (cVDPV2) from the Agbogbloshie environ mental surveillance (AES) site, in the Greater Accra Region. A field investigation of the outbreak was
conducted to describe the results of epidemiological and laboratory investigations, and control efforts.
Methods: We conducted a descriptive investigation, records review, and active-case-search. Caregivers
were interviewed on the vaccination status of their children; knowledge, attitude, and practices on polio
prevention; water, sanitation and hygiene practices, and health-seeking behaviors. Stool from healthy
children <5 y and sewage samples were taken for laboratory diagnosis.
Results: cVDPV2 genetically similar to the cVDPV2 diagnosed recently in the Northern Region of Ghana
and Nigeria was identified. 2019 half-year coverage of OPV and IPV was 22%. Fully immunized children
were 49% (29/59). Most health workers (70%) had a fair knowledge of polio and acute flaccid paralysis
(AFP). Forty-six percent of care-givers admitted to using the large drain linked to the site where the
cVDPV2 was isolated as their place of convenience and disposing of the fecal matter of their children. No
AFP case was identified. Stool samples from 40 healthy children yielded non-polio enteroviruses while
75% (3/4) of the additional sewage samples yielded cVDPV2.
Conclusion: cVDPV2 was isolated from the AES site. No AFP or poliovirus was identified from healthy
children. There is a need to improve health workers’ knowledge on AFP and to address the dire sanitation
conditions in the Agbogbloshie market and its environs.
Description
Research Article
Keywords
Polio, circulating vaccine-derived poliovirus, mOPV, Agbobloshie – Accra, Ghana