Progress and Challenges of Polio Environmental Surveillance in Indonesia

As the gold standard to monitor poliovirus transmission in population, Acute Flaccid Paralysis (AFP) surveillance that we conducted found only about <1% poliovirus circulation appeared as paralysis cases. Therefore, we need Polio Environmental Surveillance as supplemental surveillance that can detect poliovirus in the environment to stop the poliovirus transmission. Polio Environmental Surveillance has been established in several countries and Indonesia started since 2016. This study aimed to analyze the Environmental Surveillance in monitoring poliovirus circulation in Indonesia. One Liter wastewater sample from wastewater treatment plant (WWTP), communal septic tank and open canal collected by grab method and send to the National Polio Laboratory Network. Samples were concentrated using the Two-Phase Separation Method and inoculated in both RD and L20B cell lines. Poliovirus identification using PCR and sequencing was carried out on positive isolates. Data analysis was performed on the 2016-2018 results. Two-point six percent (4) poliovirus and 39.5 % (60) Non-Polio Enterovirus (NPEV) were isolated from 152 samples were received at National Polio Laboratory Network. Three out of 152 samples were positive both poliovirus and NPEV. All Positive results were only found on the sample collected from wastewater treatment plants and communal septic tanks. Polio Environmental Surveillance in Indonesia has been giving information on the poliovirus circulation in the environment. A proper selection of the sampling site is needed to provide valuable information.