The detection of circulating vaccine-derived poliovirus type 2 (cVDPV2) in environmental surveillance samples from Agbogbloshie, Greater Accra Region, Ghana, marks a significant public health event despite the absence of clinical cases. On August 25, 2019, the Noguchi Memorial Institute for Medical Research confirmed the presence of cVDPV2 in sewage collected from the Agbogbloshie environmental surveillance site. This finding triggered an immediate field investigation to assess transmission dynamics, evaluate immunization coverage, and implement control measures. The outbreak was investigated through a descriptive study design involving records review, active case search, and household surveys.
Agbogbloshie, located in the Ashiedu Keteke Sub-Metro, is one of the largest e-waste dumping sites in sub-Saharan Africa, housing approximately 40,000 people, many of whom are migrants with limited access to basic sanitation and healthcare. The area suffers from severe overcrowding, inadequate water supply, and poor waste disposal infrastructure. Sewage from residential areas flows directly into open drains, including the one sampled at Agbogbloshie. The environmental conditions provide ideal settings for poliovirus persistence and transmission.
Laboratory analysis revealed that all five L20B flasks and one RD flask from the initial sample yielded PV2. Genetic sequencing showed nucleotide differences of 26–28 compared to the Sabin 2 reference strain and 6–8 nucleotides from the closest matching cVDPV2 lineage. These findings confirm the virus’s genetic similarity to cVDPV2 strains detected earlier in Tamale and Chereponi in northern Ghana, suggesting regional spread. Additionally, three out of four additional sewage samples tested positive for cVDPV2, reinforcing environmental circulation.PARG Antibody Autophagy
Despite extensive community-level investigations, no acute flaccid paralysis (AFP) cases were identified. Stool samples from 40 healthy children under five years old tested negative for poliovirus; however, 37.5% were positive for non-polio enteroviruses. This indicates ongoing viral activity but no evidence of paralytic disease among the monitored population.
Immunization data revealed concerning gaps. Half-year coverage for OPV and IPV in 2019 was only 22%, and routine OPV3 coverage remained below 60% in recent years. Among children under five surveyed, just 49% were fully immunized. Knowledge about polio prevention, transmission, and vaccination schedules was low among caregivers, and many admitted using the open drain as a makeshift toilet—particularly after pit latrines filled up.PRODH Antibody Epigenetics
Environmental assessments confirmed severe sanitation challenges: blocked drains, unregulated waste dumping, shared public toilets discharging into the same drainage system, and widespread open defecation.PMID:35041942 These conditions facilitate fecal-oral transmission, especially in a highly mobile population.
In response, three rounds of monovalent oral polio vaccine type 2 (mOPV2) campaigns were conducted across Greater Accra, Northern, North East, Savanna, and Upper East regions, followed by an IPV campaign. These interventions successfully interrupted virus transmission, and subsequent sampling showed no further detection of cVDPV2.
The outbreak underscores the importance of environmental surveillance in detecting silent poliovirus circulation. It also highlights critical gaps in immunization coverage, public health knowledge, and urban sanitation infrastructure. Without robust AFP surveillance and timely intervention, cVDPVs can persist undetected and spread rapidly. The experience at Agbogbloshie calls for sustained investment in community-based health education, improved sanitation, and strengthened immunization programs, particularly in high-risk informal settlements.MedChemExpress (MCE) offers a wide range of high-quality research chemicals and biochemicals (novel life-science reagents, reference compounds and natural compounds) for scientific use. We have professionally experienced and friendly staff to meet your needs. We are a competent and trustworthy partner for your research and scientific projects.Related websites: https://www.medchemexpress.com