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Poliovirus and Other Enteroviruses from Environmental Surveillance in Italy, 2009–2015

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Abstract

Within the initiatives for poliomyelitis eradication by WHO, Italy activated an environmental surveillance (ES) in 2005. ES complements clinical Acute Flaccid Paralysis (AFP) surveillance for possible polio cases, detects poliovirus circulation in environmental sewage, and is used to monitor transmission in communities. In addition to polioviruses, the analyses comprised: (i) the monitoring of the presence of non-polio enteroviruses in sewage samples and (ii) the temporal and geographical distribution of the detected viruses. From 2009 to 2015, 2880 sewage samples were collected from eight cities participating in the surveillance. Overall, 1479 samples resulted positive for enteroviruses. No wild-type polioviruses were found, although four Sabin-like polioviruses were detected. The low degree of mutation found in the genomes of these four isolates suggests that these viruses have had a limited circulation in the population. All non-polio enteroviruses belonged to species B and the most frequent serotype was CV-B5, followed by CV-B4, E-11, E-6, E-7, CV-B3, and CV-B2. Variations in the frequency of different serotypes were also observed in different seasons and/or Italian areas. Environmental surveillance in Italy, as part of the ‘WHO global polio eradication program’, is a powerful tool to augment the polio surveillance and to investigate the silent circulation or the re-emergence of enteroviruses in the population.

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Acknowledgements

The authors wish to thank the workers of the wastewater-treatment plants in charge of collecting samples for the environmental surveillance.

Funding

This work was partially supported by grants from the Italian Ministry of Health, CCM, “AFP surveillance in Italy. Research of Poliovirus and other enteroviruses in immunodeficient patients and in the environment”.

Author information

Author notes

  1. Roberto Delogu and Andrea Battistone contributed equally to this study.

Authors and Affiliations

  1. National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Rome, Italy

    Roberto Delogu, Andrea Battistone, Karen Cristiano, Lucia Fiore & Carlo Pini

  2. Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy

    Gabriele Buttinelli, Stefano Fiore, Stefano Fontana, Concetta Amato & Paola Stefanelli

  3. Comprensorio Sanitario di Bolzano, Servizio Igiene e Sanità Pubblica, Bolzano, Italy

    Sabine Gamper & Josef Simeoni

  4. ARPA - Veneto, Venice, Italy

    Rita Frate

  5. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy

    Laura Pellegrinelli & Sandro Binda

  6. Department of Medicine and Surgery, University of Parma, Parma, Italy

    Licia Veronesi & Roberta Zoni

  7. Department of Biomedical Sciences, University of Sassari, Sassari, Italy

    Paolo Castiglia & Andrea Cossu

  8. Department of Public Health, University of Naples Federico II, Naples, Italy

    Maria Triassi & Francesca Pennino

  9. Hygiene Unit, Department DIMO, University of Bari, Bari, Italy

    Cinzia Germinario & Viviana Balena

  10. AMAP S.p.A., Palermo, Italy

    Antonella Cicala & Pietro Mercurio

  11. National Centre for the Control and the Evaluation of Medicines, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy

    Roberto Delogu

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Correspondence to Roberto Delogu.

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Delogu, R., Battistone, A., Buttinelli, G. et al. Poliovirus and Other Enteroviruses from Environmental Surveillance in Italy, 2009–2015. Food Environ Virol 10, 333–342 (2018). https://doi.org/10.1007/s12560-018-9350-8

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  • DOI: https://doi.org/10.1007/s12560-018-9350-8

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