National Laboratory Inventory Integral Part of Wild Poliovirus Eradication

Abstract

© The Global Commission for the Certification of the Eradication of Poliomyelitis will declare polio eradication when all regions have documented the absence of wild poliovirus transmission for at least 3 consecutive years, and when laboratories with wild poliovirus materials have implemented appropriate containment measures.1 In anticipation of global polio eradication within the next few years, the Department of Health and Human Services (HHS) has proposed a national survey of all biomedical laboratories that may be in possession of wild poliovirus infectious materials. The HHS has indicated that this survey is a necessary first step in laboratory containment of wild poliovirus. Once polio eradication is complete, the prevention of viral transmission to the growing non-immune community will be crucial in maintaining a polio-free society. The national laboratory survey is necessary because, following global eradication, laboratories will theoretically be the only remaining source of wild poliovirus. It is because of this anticipated need for extreme caution that the United States has joined 122 other polio-free countries in moving towards wild polio laboratory containment.2 In theory, poliovirus may be transmitted to persons outside the laboratory through contaminated materials released into sewage, solid wastes transported to landfills, spent air exhausted to surroundings, or through contaminated workers’ skin or clothing.3 However, while these transmission routes are possible, a much higher threat of inadvertent public infection exists via the accidental infection of laboratory personnel. From 1941 to 1976, 12 laboratory-associated poliomyelitis cases were recorded. Seven of the 12 were unpublished, and 2 of the cases resulted in deaths.4-7 While most of these cases occurred in the pre-vaccine era and before the dawn of cell culture, recent evidence indicates that the potential remains for transmission of the virus from the laboratory to the surrounding community. As recently as 1992, 2 cases of accidental polio transmission were documented. In the first case, a wild-type strain used for vaccine production was transmitted from an employee in a vaccine production facility to his young son.8 In the second incident, a child was infected with a prototype strain of National Laboratory Inventory Integral Part of Wild Poliovirus Eradication