Research says Polio Detection Times could be reduced

A new study, “Sensitive poliovirus detection using nested PCR and nanopore sequencing: a prospective validation study,” published on August 17, 2023 in Nature Microbiology, demonstrates that adopting DDNS to detect polio epidemics can save public health officials valuable time and money. Researchers from the Institut National de Recherche Biomédicale in Kinshasa collaborated with the MHRA, Imperial College London, the University of Edinburgh, and various laboratories from the World Health Organization (WHO) Global Polio Laboratory Network (GPLN) to conduct this study.

This is the first time that a scientific technique of this type has been utilized to identify polio. Previously, similar approaches were employed to detect COVID-19, Ebola, measles, and monkeypox.

The expenses and delays of transit and testing can be reduced from an average of 42 days to an average of 19 days by allowing samples to be examined in the country where the outbreak occurred rather than being transported to specialist laboratories abroad.

To confirm a polio case, stool samples from countries with active polio epidemics, such as the Democratic Republic of the Congo, must currently be sent around the world for lengthy, complex laboratory tests. Faster detection of polio in areas where outbreaks still occur helps authorities to respond more quickly through focused, localized vaccination campaigns, reducing the virus’s ability to spread.

“We are standing at a delicate and pivotal moment for the eradication of polio. While vaccination programs have seen polio disappear in many countries, the delayed detection of outbreaks poses a major threat to those efforts.” said Javier Martin, lead scientist in virology at the MHRA.

He also added “By implementing detection methods such as DDNS, we can identify where outbreaks are and which polio strain is present much more quickly, allowing us to act at the earliest opportunity. This is the result of years of work, collaborating with our partners. Together, we will continue to build on this research and support countries at risk of outbreaks to implement DDNS testing to help make polio a disease of the past.”

This study found that DDNS tests performed locally in the DRC over a six-month period were 23 days faster than the usual approach, with greater than 99% accuracy.

Researchers tried this technology in the United Kingdom and discovered poliovirus in London in 2022, prompting the recent push to guarantee that children under the age of 12 be immunized through the London polio catch-up campaign 2023.

Professor Placide Mbala-Kingebeni, Medical Doctor and Virologist at the Institut National de Recherche Biomédicale, stated, “This is the perfect example of collaboration, where combining and sharing knowledge together with all our partners has supported the vital work of the INRB in the DRC where poliomyelitis remains a serious public health problem.

“Collaboration and training with our partners has empowered the local team not only to master and confidently carry out this new technique but also to transfer the knowledge and skills to other African countries where poliovirus outbreaks are reported regularly.”

“This method allows the rapid confirmation of polio strains, facilitating swifter vaccine responses that can reduce the number of polio cases stemming from an outbreak. Development and validation of the method has been the result of fruitful collaboration between a consortium of many partners” says Dr. Alex Shaw, research fellow in the School of Public Health at Imperial College London.

“As a consortium we look forward to the training of additional national laboratories in this method, with prior trainees, including members of INRB, now taking on the role of trainers. The sequencing technology used in this method is easily adapted for the detection and typing of other organisms. This rollout will therefore provide a foundation of skills and experience that can be redirected to the genomic surveillance of other pathogens as needed.”

Polio is an infectious disease caused by the poliovirus, which is most usually spread by contact with infected feces in contaminated food and water. While many people never display symptoms, polio can cause permanent paralysis or death in extreme cases, particularly in babies and children under the age of five.

Delays in detection have been noted by the WHO as one of the primary issues facing their Polio eradication strategy 2022-2026.
While speedier detection systems like DDNS cannot eliminate polio on their own, they are critical in managing outbreaks.

The MHRA’s scientists will continue to support the testing and validation of DDNS as a polio detection tool, as well as teaching WHO laboratories around the world in its use.

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