Published Date: 2013-06-04 16:19:54
Subject: PRO/EDR> Poliomyelitis update (09): Israel, positive environmental samples, RFI
Archive Number: 20130604.1754766
POLIOMYELITIS UPDATE (09): ISRAEL, POSITIVE ENVIRONMENTAL SAMPLES, REQUEST FOR INFORMATION
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Tue 4 Jun 2013
Source: The New York Times [edited]
[Poliovirus] has been found in a sewage sample from Israel for the 1st time since 2002, the World Health Organization announced on Monday [3 Jun 2013]. But no children or adults newly paralyzed by polio have been identified in Israel or in Gaza or the West Bank.
The sample was from Rahat, a city in the Negev Desert near the Egyptian border that has 53 000 residents, primarily Bedouins.
There has not been a case of polio in Israel since 1988. The virus was last found in sewage samples in 1991 and 2002.
Because most Israelis and Palestinians are routinely immunized against polio, it is unlikely the virus will spread further, said Dr Bruce Aylward, director of the WHO’s polio campaign. “Things usually dead-end there because immunity is so high,” he said.
Only preliminary sequencing of the virus, found on [9 Apr 2013], has been done, so it is not yet clear where it came from, but it is of the same strain as a virus found in January  in sewage samples from Cairo [Egypt], which itself was related to a strain circulating in Pakistan and Afghanistan, Dr Aylward said.
“This shows how it can jump from place to place,” Dr Aylward said. “If there’s any sense of complacency about the endgame plan, I hope the world has gotten over it.”
Polio is very close to eradication; only 223 cases of paralysis occurred in the world last year .
However, every year sees outbreaks in countries far from Pakistan, Afghanistan, and Nigeria, where polio is still endemic, and sometimes the virus is found in sewage even when no cases of paralysis are found. All those outbreaks have been contained by vaccinating millions of people nearby.
The discovery of the virus in Egypt earlier this year  was the 1st time it has been seen there since 2004; no cases of paralysis were found. Egypt vaccinated millions of residents after the virus was found in January , and sewage samples have been negative since then, Dr Aylward said. “But samples are only useful when they’re positive, not when they’re negative,” he said, “so we can’t rule out that it’s there.”
The Rahat strain is definitely not related to the one recently found circulating in Somalia and in a camp in Kenya housing thousands of Somali refugees. That strain comes from Nigeria.
[Byline: Donald G McNeil Jr]
[The newswire above contains the additional information that based on preliminary testing, the virus isolated in Israel is the “same strain as a virus found in January  in sewage samples from Cairo [Egypt], which itself was related to a strain circulating in Pakistan and Afghanistan.” According to a prior ProMED-mail report on the isolation of the WPV in Egypt, the isolates (there were 2) were reported to have been similar to a strain recently discovered in Sukkur (Sindh), Pakistan (see prior ProMED-mail post Poliomyelitis – worldwide (01): Egypt ex Pakistan, Niger 20130122.1509210).
As long as there is continued transmission of the wild poliovirus (WPV) in the endemic countries (Afghanistan, Nigeria, and Pakistan) the risk of importation into countries that have interrupted transmission of WPV exists. Hence the continued need to maintain high levels of polio vaccination, even if there is no known circulation of the WPV in a country.