Belgasmi Hanen, Miles Stacey Jeffries, Sayyad Leanna, Wong Kimberly, Harrington Chelsea, Gerloff Nancy, Coulliette-Salmond Angela D, Guntapong Ratigorn, Tacharoenmuang Ratana, Ayutthaya Apiradee Isarangkul Na, Apostol Lea Necitas G, Valencia Ma Anne-Lesley D, Burns Cara C, Benito Gloria-Rey, Vega Everardo
Polio and Picornavirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Cherokee Nation Assurance, Tulsa, OK, United States.
Front Environ Sci. 2022 Jul 4;10. doi: 10.3389/fenvs.2022.914387.
Acute flaccid paralysis (AFP) surveillance has been used to identify polio cases and target vaccination campaigns since the inception of the Global Poliovirus Eradication Initiative (GPEI) in 1988. To date, only Afghanistan and Pakistan have failed to interrupt wild poliovirus transmission. Circulation of vaccine-derived polioviruses (VDPV) continues to be a problem in high-risk areas of the Eastern Mediterranean, African, and Southeast Asian regions. Environmental surveillance (ES) is an important adjunct to AFP surveillance, helping to identify circulating polioviruses in problematic areas. Stools from AFP cases and contacts (>200,000 specimens/year) and ES samples (>642 sites) are referred to 146 laboratories in the Global Polio Laboratory Network (GPLN) for testing. Although most World Health Organization supported laboratories use the two-phase separation method due to its simplicity and effectiveness, alternative simple, widely available, and cost-effective methods are needed. The CAFÉ (Concentration and Filtration Elution) method was developed from existing filtration methods to handle any type of sewage or residual waters. At $10-20 US per sample for consumable materials, CAFÉ is cost effective, and all equipment and reagents are readily available from markets and suppliers globally. The report describes the results from a parallel study of CAFÉ method with the standard two-phase separation method. The study was performed with samples collected from five countries (Guatemala, Haïti, Thailand, Papua New Guinea, and the Philippines), run in three laboratories-(United States, Thailand and in the Philippines) to account for regional and sample-to-sample variability. Samples from each site were divided into two 500 ml aliquots and processed by both methods, with no other additional concentration or manipulation. The results of 338 parallel-tested samples show that the CAFÉ method is more sensitive than the two-phase separation method for detection of non-polio enteroviruses (-value < 0.0001) and performed as well as the two-phase separation method for polioviruses detection with no significant difference (-value > 0.05). The CAFÉ method is a robust, sensitive, and cost-effective method for isolating enteroviruses from residual waters.
自1988年全球根除脊髓灰质炎行动（GPEI）启动以来，急性弛缓性麻痹（AFP）监测一直被用于识别脊髓灰质炎病例并确定疫苗接种活动的目标地区。迄今为止，只有阿富汗和巴基斯坦未能阻断野生脊髓灰质炎病毒的传播。疫苗衍生脊髓灰质炎病毒（VDPV）的传播在东地中海、非洲和东南亚地区的高风险地区仍然是一个问题。环境监测（ES）是AFP监测的重要辅助手段，有助于在问题地区识别正在传播的脊髓灰质炎病毒。AFP病例及其接触者的粪便（每年超过20万个样本）和ES样本（超过642个采样点）被送往全球脊髓灰质炎实验室网络（GPLN）的146个实验室进行检测。尽管世界卫生组织支持的大多数实验室由于其简单性和有效性而使用两阶段分离法，但仍需要替代的简单、广泛可用且具有成本效益的方法。CAFÉ（浓缩和过滤洗脱）方法是在现有过滤方法的基础上开发的，用于处理任何类型的污水或残留水。CAFÉ方法每个样本的耗材成本为10至20美元，具有成本效益，所有设备和试剂均可从全球市场和供应商处轻松获得。该报告描述了CAFÉ方法与标准两阶段分离法平行研究的结果。该研究使用从五个国家（危地马拉、海地、泰国、巴布亚新几内亚和菲律宾）收集的样本，在三个实验室（美国、泰国和菲律宾）进行，以考虑地区和样本间的变异性。每个采样点的样本被分成两个500毫升的等分试样，并采用两种方法进行处理，无需进行其他额外的浓缩或操作。338个平行测试样本的结果表明，CAFÉ方法在检测非脊髓灰质炎肠道病毒方面比两阶段分离法更敏感（P值<0.0001），在检测脊髓灰质炎病毒方面与两阶段分离法表现相当，无显著差异（P值>0.05）。CAFÉ方法是一种从残留水中分离肠道病毒的可靠、灵敏且具有成本效益的方法。
