Importance of detecting pathogens in water

A recent trial has highlighted the value of water testing for the early detection of infection outbreaks, to enable health and care providers to implement robust infection prevention measures. However, water testing can offer a valuable contribution to IP&C in a variety of ways – from epidemiology and environmental monitoring, to ensuring the safety of medical devices.

Early detection of pathogens through water testing strategies can offer valuable insights into potential threats. Wastewater-based epidemiology (WBE) has had an important role in monitoring risk from pathogens for many decades but there has been a renewed focus in recent years. Most recently, the UK Heath Security Agency (UKHSA) and Medicines and Healthcare products Regulatory Agency (MHRA) found poliovirus in sewage samples collected from treatment works in the London area, providing an early indication of person to person transmission in the UK. 

As part of routine surveillance, it is normal for 1 to 3 ‘vaccine-like’ polioviruses to be detected each year in UK sewage samples but these have always been one-off findings that were not detected again. These previous detections occurred when an individual vaccinated overseas with the live oral polio vaccine (OPV) returned or travelled to the UK and briefly ‘shed’ traces of the vaccine-like poliovirus in their faeces

Further investigations have been taking place after several closely-related viruses were found in sewage samples taken between February and May 2022. The virus has continued to evolve and is now classified as a ‘vaccine-derived’ poliovirus type 2 (VDPV2), which on rare occasions can cause serious illness, such as paralysis, in people who are not fully vaccinated. 

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