Emerging Infectious Diseases (Aug 2023)

Response to Vaccine-Derived Polioviruses Detected through Environmental Surveillance, Guatemala, 2019

  • Rodrigo Rodríguez,
  • Elisa Juárez,
  • Concepción F. Estívariz,
  • Coralia Cajas,
  • Gloria Rey-Benito,
  • María Olga Bautista Amézquita,
  • Stacey Jeffries Miles,
  • Oscar Orantes,
  • María Cecilia Freire,
  • Ana-Elena Chévez,
  • Leticia Castillo Signor,
  • Leanna Sayyad,
  • Claudia Jarquin,
  • Emilia Cain,
  • Andrea Patricia Villalobos Rodríguez,
  • Linda Mendoza,
  • Carlos A. Ovando,
  • Haroldo de Jesús Barillas Mayorga,
  • Ericka Gaitán,
  • Antonio Paredes,
  • Hanen Belgasmi-Allen,
  • Lorena Gobern,
  • Marc Rondy

DOI
https://doi.org/10.3201/eid2908.230236
Journal volume & issue
Vol. 29, no. 8
pp. 1524 – 1530

Abstract

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Guatemala implemented wastewater-based poliovirus surveillance in 2018, and three genetically unrelated vaccine-derived polioviruses (VDPVs) were detected in 2019. The Ministry of Health (MoH) response included event investigation through institutional and community retrospective case searches for acute flaccid paralysis (AFP) during 2018–2020 and a bivalent oral polio/measles, mumps, and rubella vaccination campaign in September 2019. This response was reviewed by an international expert team in July 2021. During the campaign, 93% of children 6 months <7 years of age received a polio-containing vaccine dose. No AFP cases were detected in the community search; institutional retrospective searches found 37% of unreported AFP cases in 2018‒2020. No additional VDPV was isolated from wastewater. No evidence of circulating VDPV was found; the 3 isolated VDPVs were classified as ambiguous VDPVs by the international team of experts. These detections highlight risk for poliomyelitis reemergence in countries with low polio vaccine coverage.

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