英国国家生物标准与控制研究所Javier Martin团队于2022年2月至7月，通过加强环境监测，在伦敦污水中持续检测到2型脊髓灰质炎病毒。相关论文于2022年10月12日发表在《柳叶刀》杂志上。

脊髓灰质炎病毒的国际传播使所有国家都面临爆发的风险，并被世界卫生组织指定为国际关注的公共卫生紧急事件。在使用灭活脊髓灰质炎疫苗的国家中，这种风险可能会加剧，这种疫苗可以提供很好的预防瘫痪的保护，但应对脊髓灰质炎病毒传播的效果不如口服疫苗，有可能在很长一段时间内未发现瘫痪病例的的情况下进行传播。该研究调查了污水中发现的2型脊髓灰质炎病毒分离物的分子特性，旨在检测病毒在社区中的传播。

研究组在英国伦敦进行了环境监测，使用世界卫生组织推荐的方法测试污水样本，包括浓度、细胞培养中的病毒分离和分子表征。此外还实现了直接分子检测，并使用新的纳米孔协议确定了每个分离物的全基因组序列。

2022年2月8日至7月4日，在伦敦收集的52份连续污水样本中的21份中，研究组检测到118株与血清型2 Sabin疫苗株相关的基因关联脊髓灰质炎病毒分离株。伦敦环境监测点的扩大有助于将传播定位到伦敦北部和东部的几个行政区。所有分离株都失去了两个关键的衰减突变（一种C型肠病毒的重组子），并且越来越多的分离株（118株中有20株）符合疫苗衍生脊髓灰质炎病毒的标准，VP1衣壳蛋白基因编码6到10个核苷酸变化。

研究结果表明，通过环境监测，可以及早检测到脊髓灰质炎病毒在伦敦的输入和传播，从而可以快速作出公共卫生反应，包括加强监测和在1-9岁儿童中开展脊髓灰质灭活疫苗运动。通过纳米孔测序产生的全基因组序列建立了分离株之间的联系，并证实了一种独特的重组脊髓灰质炎病毒谱系的传播，目前已在以色列和美国检测到。

附：英文原文

Title: Sustained detection of type 2 poliovirus in London sewage between February and July, 2022, by enhanced environmental surveillance

Author: Dimitra Klapsa, Thomas Wilton, Andrew Zealand, Erika Bujaki, Eugene Saxentoff, Catherine Troman, Alexander G Shaw, Alison Tedcastle, Manasi Majumdar, Ryan Mate, Joyce O Akello, Shahin Huseynov, Ali Zeb, Maria Zambon, Anita Bell, José Hagan, Matthew J Wade, Mary Ramsay, Nicholas C Grassly, Vanessa Saliba, Javier Martin

Issue&Volume: 2022-10-12

Abstract:

Background

The international spread of poliovirus exposes all countries to the risk of outbreaks and is designated a Public Health Emergency of International Concern by WHO. This risk can be exacerbated in countries using inactivated polio vaccine, which offers excellent protection against paralysis but is less effective than oral vaccine against poliovirus shedding, potentially allowing circulation without detection of paralytic cases for long periods of time. Our study investigated the molecular properties of type 2 poliovirus isolates found in sewage with an aim to detect virus transmission in the community.

Methods

We performed environmental surveillance in London, UK, testing sewage samples using WHO recommended methods that include concentration, virus isolation in cell culture, and molecular characterisation. We additionally implemented direct molecular detection and determined whole-genome sequences of every isolate using novel nanopore protocols.

Findings

118 genetically linked poliovirus isolates related to the serotype 2 Sabin vaccine strain were detected in 21 of 52 sequential sewage samples collected in London between Feb 8 and July 4, 2022. Expansion of environmental surveillance sites in London helped localise transmission to several boroughs in north and east London. All isolates have lost two key attenuating mutations, are recombinants with a species C enterovirus, and an increasing proportion (20 of 118) meet the criterion for a vaccine-derived poliovirus, having six to ten nucleotide changes in the gene coding for VP1 capsid protein.

Interpretation

Environmental surveillance allowed early detection of poliovirus importation and circulation in London, permitting a rapid public health response, including enhanced surveillance and an inactivated polio vaccine campaign among children aged 1–9 years. Whole-genome sequences generated through nanopore sequencing established linkage of isolates and confirmed transmission of a unique recombinant poliovirus lineage that has now been detected in Israel and the USA.

DOI: 10.1016/S0140-6736(22)01804-9

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01804-9/fulltext