%ABrouwer, Andrew [Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109,]%ABrouwer, Andrew%AEisenberg, Joseph [Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109,]%AEisenberg, Joseph%APomeroy, Connor [Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109,]%APomeroy, Connor%AShulman, Lester [Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel ,, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel,]%AShulman, Lester%AHindiyeh, Musa [Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel ,]%AHindiyeh, Musa%AManor, Yossi%AManor, Yossi [Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel ,]%AGrotto, Itamar%AGrotto, Itamar [Division of Public Health Services, Ministry of Health, Jerusalem 9101002, Israel,, Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel]%AKoopman, James [Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109,]%AKoopman, James%AEisenberg, Marisa [Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109,]%AEisenberg, Marisa%BJournal Name: Proceedings of the National Academy of Sciences; Journal Volume: 115; Journal Issue: 45; Related Information: CHORUS Timestamp: 2022-04-13 04:09:14 %D2018%IProceedings of the National Academy of Sciences %JJournal Name: Proceedings of the National Academy of Sciences; Journal Volume: 115; Journal Issue: 45; Related Information: CHORUS Timestamp: 2022-04-13 04:09:14 %K %MOSTI ID: 10077582 %PMedium: X %TEpidemiology of the silent polio outbreak in Rahat, Israel, based on modeling of environmental surveillance data %XSignificance

The 2013–2014 silent polio epidemic in Israel was a setback to global eradication efforts because Israel had previously been certified as polio-free by the World Health Organization. Fortunately, Israel has a robust environmental surveillance program that detected the epidemic and allowed rapid mobilization of a vaccine campaign before any cases of acute flaccid paralysis. This kind of silent (caseless) epidemic will be increasingly common as we approach global eradication, demonstrating the need for both enhanced environmental surveillance and an accompanying inference framework to translate environmental data into public health metrics. We incorporate environmental data into a population-level disease transmission model, generating insights into the epidemiology of the outbreak. This framework can be used to guide future interventions.

%0Journal Article