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R. Soc. Interface."],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>Environmental pathogen surveillance is a sensitive tool that can detect early-stage outbreaks, and it is being used to track poliovirus and other pathogens. However, interpretation of longitudinal environmental surveillance signals is difficult because the relationship between infection incidence and viral load in wastewater depends on time-varying shedding intensity. We developed a mathematical model of time-varying poliovirus shedding intensity consistent with expert opinion across a range of immunization states. Incorporating this shedding model into an infectious disease transmission model, we analysed quantitative, polymerase chain reaction data from seven sites during the 2013 Israeli poliovirus outbreak. Compared to a constant shedding model, our time-varying shedding model estimated a slower peak (four weeks later), with more of the population reached by a vaccination campaign before infection and a lower cumulative incidence. We also estimated the population shed virus for an average of 29 days (95% CI 28\u201331), longer than expert opinion had suggested for a population that was purported to have received three or more inactivated polio vaccine (IPV) doses. One explanation is that IPV may not substantially affect shedding duration. Using realistic models of time-varying shedding coupled with longitudinal environmental surveillance may improve our understanding of outbreak dynamics of poliovirus, SARS-CoV-2, or other pathogens.<\/jats:p>","DOI":"10.1098\/rsif.2022.0006","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T07:05:53Z","timestamp":1652857553000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["The role of time-varying viral shedding in modelling environmental surveillance for public health: revisiting the 2013 poliovirus outbreak in Israel"],"prefix":"10.1098","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3779-5287","authenticated-orcid":true,"given":"Andrew F.","family":"Brouwer","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa C.","family":"Eisenberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lester M.","family":"Shulman","sequence":"additional","affiliation":[{"name":"Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel"},{"name":"School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Famulare","sequence":"additional","affiliation":[{"name":"Institute for Disease Modeling, Bellevue, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Koopman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve J.","family":"Kroiss","sequence":"additional","affiliation":[{"name":"Institute for Disease Modeling, Bellevue, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Hindiyeh","sequence":"additional","affiliation":[{"name":"Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yossi","family":"Manor","sequence":"additional","affiliation":[{"name":"Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itamar","family":"Grotto","sequence":"additional","affiliation":[{"name":"Ministry of Health, Jerusalem, Israel"},{"name":"Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph N. 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