Moran-Gilad Jacob, Mendelson Ella, Burns Cara C, Bassal Ravit, Gdalevich Michael, Sofer Danit, Oberste M Steven, Shulman Lester M, Kaliner Ehud, Hindiyeh Musa, Mor Orna, Shahar Liora, Iber Jane, Yishay Ruth, Manor Joseph, Lev Boaz, Gamzu Ronni, Grotto Itamar
Public Health Services, Ministry of Health, Jerusalem, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel; School of Public Health, Tel-Aviv University, Tel-Aviv, Israel.
J Clin Virol. 2015 May;66:51-5. doi: 10.1016/j.jcv.2015.03.005. Epub 2015 Mar 10.
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.
To estimate the rate of WPV1 excretion by age and residence and inform decision-making regarding supplemental immunization with OPV.
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.
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.
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.
自2005年以来，以色列一直采用仅接种灭活脊髓灰质炎疫苗（IPV）的免疫程序（接种率达95%）。2013年初，以色列南部通过常规环境监测在无临床病例的情况下检测到野生型脊髓灰质炎病毒1型（WPV1）悄然重新传入。
评估不同年龄和居住地的WPV1排泄率，并为关于口服脊髓灰质炎疫苗（OPV）补充免疫的决策提供依据。
在事件中心的贝都因人和犹太人居住区选取便利样本，重点关注8岁以下未接种过OPV的儿童。使用新型定量逆转录聚合酶链反应（qRT-PCR）检测法直接检测粪便样本中的WPV1 RNA。阳性样本通过金标准细胞培养进行确认并进行基因分型。
总体而言，共收集并分析了2196份无重复的粪便样本。在61份样本（2.8%）中检测到WPV1，其中55份（90.2%）来自贝都因人。贝都因人的WPV1排泄率为5.4%，犹太人的排泄率为0.6%。贝都因儿童和犹太儿童中，0至2岁年龄组的排泄率分别为4.9%和0.2%，2至8岁年龄组分别为7.2%和1.7%。分子检测的灵敏度为89.5%（高于细胞培养），特异性为100%。
一项评估WPV1排泄情况的现场研究迅速开展，明确显示以色列南部8岁以下儿童中WPV1感染率很高，从而为对该年龄组接种bOPV的决策以及向医护人员和公众进行风险沟通提供了依据。因此，快速开发和实施分子筛查可为复杂流行病学情况下的风险评估和管理提供支持。
