Sporadic detection of vaccine-derived poliovirus type 2 using next-generation sequencing in Canadian wastewater in...

In July 2022, an unvaccinated young adult living in Rockland County, New York became paralyzed due to a vaccine-derived poliovirus type 2 (VDPV2) infection that was internationally transmitted. Wastewater surveillance in New York State uncovered VDPV2 in neighboring counties, showing silent community spread. These communities have strong epidemiological links to some vaccine-hesitant communities in Canada, spurring the need to monitor these populations for potential poliovirus importation. At the time, Canada did not have an established poliovirus wastewater method. We initiated this study to apply molecular methods to detect poliovirus in these communities and establish poliovirus wastewater surveillance capabilities in Canada. We sequence confirmed one poliovirus detection on August 30th, 2022 using both viral isolation and direct detection methods. Subsequent retrospective and prospective sampling was initiated, resulting in another sequence confirmed detection of VDPV2 in an overlapping catchment area collected on August 27th, 2022. Both VDPV2 detections were genetically linked to the New York clinical case. No clinical cases of poliomyelitis were detected in Canada during this study. The sporadic detection of VDPV2 in Canadian wastewater supports a travel-related shedding event without community transmission. Furthermore, we show that a direct detection method is sensitive to sequence confirm poliovirus in wastewater samples.