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The quantity and type of enteroviruses (EVs) in the influent of a local sewage treatment plant were compared to local clinical EV cases to determine if testing sewage was adequate for an EV surveillance system. Monthly influent specimens were processed by organic flocculation and aliquots of concentrate were inoculated onto BGM, RD and Caco-2 cell cultures. Sewage EV titers were calculated using software provided by the US Environmental Protection Agency for MPN determination. For clinical cases, laboratory testing was performed for virus isolation on specimens submitted by local hospitals and also typed EV isolates submitted by hospital virus labs. The comparison study was carried out from August 1994 through December 1998. All 537 sewage EV isolates were subgrouped by host range analysis and 33% of non-polio EVs were further identified by LBM microneutralization tests. All 470 clinical isolates were identified by the LBM procedure. EVs were detected in 48 of 52 monthly influent samples. Includes 8 references, tables, figures.