Progress Toward Poliovirus Containment Implementation - Worldwide, 2017-2018.

Jacqueline Fournier-Caruana,Harpal Singh,Roland W Sutter,Liliane Boualam,Anna Llewellyn,Michel Zaffran,Nicoletta Previsani,Joseph Swan

doi:10.15585/mmwr.mm6735a5

Abstract

Substantial progress has been made since the World Health Assembly (WHA) resolved to eradicate poliomyelitis in 1988 (1). Among the three wild poliovirus (WPV) types, type 2 (WPV2) was declared eradicated in 2015, and type 3 (WPV3) has not been reported since 2012 (1). In 2017 and 2018, only Afghanistan and Pakistan have reported WPV type 1 (WPV1) transmission (1). When global eradication of poliomyelitis is achieved, facilities retaining poliovirus materials need to minimize the risk for reintroduction of poliovirus into communities and reestablishment of transmission. Poliovirus containment includes biorisk management requirements for laboratories, vaccine production sites, and other facilities that retain polioviruses after eradication; the initial milestones are for containment of type 2 polioviruses (PV2s). At the 71st WHA in 2018, World Health Organization (WHO) Member States adopted a resolution urging acceleration of poliovirus containment activities globally, including establishment by the end of 2018 of national authorities for containment (NACs) to oversee poliovirus containment (2). This report summarizes containment progress since the previous report (3) and outlines remaining challenges. As of August 2018, 29 countries had designated 81 facilities to retain PV2 materials; 22 of these countries had established NACs. Although there has been substantial progress, intensification of containment measures is needed.

Highlights

The Global Polio Eradication Initiative continues to make progress toward polio eradication
Countries need to carefully weigh the risks and benefits of designating facilities for the retention of poliovirus materials and the need to comply with the primary, secondary, and tertiary safeguards
Further intensification of measures will be needed to ensure that effective containment will be in place by the time the world is certified polio-free

Summary

Background

The Global Polio Eradication Initiative continues to make progress toward polio eradication. The WHO Global Action Plan to minimize poliovirus facility–associated risk after type-specific eradication of wild polioviruses and sequential cessation of oral poliovirus vaccine use (GAPIII) [7] defines the biorisk management standards to be followed by facilities retaining poliovirus materials. To prevent reintroduction of poliovirus and reestablishment governance were established to support national and global containment implementation and certification processes.† At of transmission, the number of facilities designated to retain PV2 materials will need to be reduced to the minimum necesthe 71st WHA in May 2018, WHO Member States unani- sary to perform critical national and international functions mously adopted Resolution WHA71.16 [2], which urged (e.g., vaccine production, diagnosis, and research).

Discussion

Summary