DIRECT-DETECTION OF WILD POLIOVIRUS CIRCULATION BY STOOL SURVEYS OF HEALTHY-CHILDREN AND ANALYSIS OF COMMUNITY WASTE-WATER

Cartagena, Colombia, was one of the last cities in the Americas known to have endemic poliomyelitis. After 3 cases were identified in 1991, two approaches for detecting continued silent transmission of wild pol ioviruses within a high-risk community were used: stool surveys of hea lthy children and virologic analysis of community sewage. Wild type 1 polioviruses were isolated from 8% of the children studied and from 21 % of sewage samples. The proportions of wild polioviruses, vaccine-rel ated polioviruses, and nonpolio enteric viruses were similar for both approaches. Wild poliovirus sequences were also amplified directly fro m processed sewage samples by the polymerase chain reaction using prim er pairs specific for the indigenous type 1 genotype. The last reporte d cases associated with wild polioviruses in the Americas occurred in Colombia (8 April 1991) and Peru (23 August 199 1). Direct sampling fo r wild polioviruses in high-risk communities can provide further evide nce that eradication of the indigenous wild polioviruses has been achi eved in the Americas.