Combating a resurgence of poliomyelitis through public health surveillance and vaccination

Poliomyelitis, or polio, is a highly infectious disease and can result in permanent flaccid paralysis of the limbs. Singapore was certified polio-free by the World Health Organization (WHO) on 29 October 2000, together with 36 other countries in the Western Pacific Region. The last imported case of polio in Singapore was in 2006. Fortunately, polio is vaccine-preventable-the world saw the global eradication of wild poliovirus types 2 and 3 achieved in 2015 and 2019, respectively. However, in late 2022, a resurgence of paralytic polio cases from vaccine-derived poliovirus (VDPV) was detected in countries like Israel and the US (specifically, New York); VDPV was also detected during routine sewage water surveillance with no paralysis cases in London, UK. Without global eradication, there is a risk of re-infection from importation and spread of wild poliovirus or VDPV, or new emergence and circulation of VDPV. During the COVID-19 pandemic, worldwide routine childhood vaccination coverage fell by 5% to 81% in 2020-2021. Fortunately, Singapore has maintained a constantly high vaccination coverage of 96% among 1-year-old children as recorded in 2021. All countries must ensure high poliovirus vaccination coverage in their population to eradicate poliovirus globally, and appropriate interventions must be taken to rectify this if the coverage falters. In 2020, WHO approved the emergency use listing of a novel oral polio vaccine type 2 for countries experiencing circulating VDPV type 2 outbreaks. Environmental and wastewater surveillance should be implemented to allow early detection of "silent" poliovirus transmission in the population, instead of relying on clinical surveillance of acute flaccid paralysis based on case definition alone.

Estimation of the consumption level of four drugs in Beijing using wastewater-based epidemiology / 中华预防医学杂志

Objective: To estimate the consumption level of four drugs in Beijing using wastewater-based epidemiology (WBE). Methods: The primary sludge from one large wastewater treatment plants (WWTPs) was collected in Beijing from July 2020 to February 2021. The concentrations of codeine, methadone, ketamine and morphine in the sludge were detected through solid-phase extraction-liquid chromatography-tandem mass spectrometry. The consumption, prevalence and number of users of four drugs were estimated by using the WBE approach. Results: Among 416 sludge samples, codeine had the highest detection rate (82.93%, n=345) with a concentration [M (Q1, Q3)] of 0.40 (0.22-0.8) ng·g-1, and morphine had the lowest detection rate (28.37%,n=118) with a concentration [M (Q1, Q3)] of 0.13 (0.09, 0.17) ng·g-1. There was no significant difference in the consumption of the four drugs on working days and weekends (all P values>0.05). Drug consumption was significantly higher in winter than that in summer and autumn (all P values <0.05). The consumption [M (Q1, Q3)] of codeine, methadone, ketamine and morphine in winter was 24.9 (15.58, 38.6), 9.39 (4.57, 26.72), 9.84 (5.18, 19.45) and 5.67 (3.57, 13.77) μg·inhabitant-1·day-1, respectively. For these drugs, there was an upward trend in the average drug consumption during summer, autumn and winter (the Z values of the trend test were 3.23, 3.16, 2.19, and 3.32, respectively and all P values<0.05). The prevalence [M (Q1, Q3)] of codeine, methadone, ketamine and morphine were 0.0056% (0.003 4%, 0.009 2%), 0.0148% (0.009 6%, 0.026 7%),0.0333% (0.0210%, 0.0710%) and 0.0072% (0.003 8%, 0.011 7%), respectively. The estimated number of drug users [M (Q1, Q3)] was 918 (549, 1 511), 2 429 (1 578, 4 383), 5 451 (3 444, 11 642) and 1 173 (626, 1 925),respectively. Conclusion: Codeine, methadone, ketamine and morphine have been detected in the sludge of WWTPs in Beijing, and the consumption level of these drugs varies in different seasons.

SARS-CoV-2 en aguas residuales y superficiales: ¿cómo lidiar con el problema? / Sars-cov-2 in wastewater and surface water: how to deal with the problem?

Introducción: hoy la humanidad sufre uno de los peores episodios debido a la pandemia causada por el SARS-CoV-2. Su alta infectividad, rápida propagación y persistencia en ciertas superficies dificultan el combate de este virus. Su presencia en aguas residuales y posible transmisión fecal-oral podría ser una nueva amenaza para la salud pública. Objetivo: alertar a la comunidad científica internacional y a los gobiernos sobre la presencia de SARS-CoV-2 en las aguas residuales y sobre qué hacer para evitar su propagación por este medio. Métodos: se realizó una revisión de artículos referenciados en SCOPUS y Web of Science desde el año 2019 relacionados con la presencia del virus en aguas residuales y superficiales. Resultados y discusión: es necesario establecer sistemas de monitoreo, utilizar métodos analíticos sensibles y rápidos para la detección del virus en las aguas residuales y superficiales. Asimismo, implantar protocolos de inactivación del virus en las unidades de salud y en las plantas de tratamiento de aguas. Se recomiendan procesos con oxidantes químicos, radiación ultravioleta, fotocatálisis, foto-Fenton, ozono o filtración por membrana. Además, se debe alertar a la población sobre la importancia del lavado y de la desinfección de productos agrícolas, así como del cuidado en su manejo por parte de los trabajadores agrícolas

Introduction: Today, humanity suffers one of the worst episodes due to a pandemic caused by the SARS-CoV-2. Its high infectivity and rapid spread combined with its persistence on certain surfaces difficult to fight this virus. Its presence in wastewater and possible fecal-oral transmission could be a new public health threat. Objective: To alert the international scientific community and governments about the presence of SARS-CoV-2 in wastewater, and what to do to prevent its spread by this means. Methods: A review of articles referenced in SCOPUS and Web of Science since 2019 related to the presence of the virus in wastewater and surface water was performed. Results and discussion: It is necessary to establish monitoring systems with the use of sensitive and rapid analytical methods for the on-site detection of viruses in wastewaters and surface waters. It should be established virus inactivation protocols at the health units, and water treatment plants, where are recommended processes with chemical oxidants, ultraviolet radiation, photocatalysis, photo-Fenton, ozone, or membrane filtration. It is necessary to alert the population about the importance of washing and disinfecting agricultural products, mainly vegetables and fruits, as well as the care in its handling by agricultural workers