Will the three steps for containment of poliovirus be enough to convince policy-makers?
Year: 2004
Type: article
Abstract: Permanent eradication of poliomyelitis requires the cessation of (wild) poliovirus circulation in the human population and effective containment of wild polioviruses in laboratories and inactivated poliovirus vaccine (IPV) production sites. Dowdle et al. (1) discuss the principles underlying effective containment and conclude that, although absolute containment can never be guaranteed, it is technically and operationally possible on a global scale. However, although it is now generally accepted that the strategy and tools for the interruption of wild poliovirus transmission will be effective, if applied correctly, the need for and feasibility of laboratory containment of wild polioviruses are still being debated (2-4). Probably the greatest challenge for containment is the search for and destruction or adequate containment of all wild poliovirus infectious or potentially infectious materials. The WHO global action plan for laboratory containment of wild poliovirus (Global Action Plan) (5) provides a clear and logical framework and process for this formidable task and requires that a variety of laboratories--and not only the virological laboratories--search their freezers thoroughly for the presence of wild poliovirus (potentially) infectious materials. Recent studies have shown that collections of potentially infectious materials may indeed contain wild polioviruses, and stressed the need for such a search (6). The greatest risk will probably come from laboratories engaged in virological diagnosis or research. Searching their freezers is a formidable job, particularly when adequate archiving systems for freezers are lacking. Also, the mislabelling or contamination of stocks of rhinoviruses or enteroviruses with (wild) polioviruses (7, 8) will present considerable risks. In recognition of these issues WHO has developed guidelines and a checklist for assessing the quality of the laboratory survey. These checks, however, cannot assess the thoroughness of the search carried out in laboratories, which is the weakest part of the laboratory survey and can hardly be remedied by independent onsite inspections. This is one of the reasons that Dowdle et al. conclude that ultimately, the responsibility for effective containment of wild poliovirus materials rests on the individual laboratory. This is not a very reassuring thought as complacency and accidents do happen, and even intentional release cannot be excluded. The recent cases of poliomyelitis due to a prototype type 2 poliovirus (9) emphasize this issue. Because accidents do happen, the other principles mentioned by Dowdle et al.--minimal risks from handling wild poliovirus (potentially) infectious materials, and minimal risk of workers and the population subsequently being infected--are also important. The consequences of wild poliovirus transmission from the laboratory to the community will be minimal if laboratory workers and the general population are maximally protected against poliovirus infection by adequate vaccination. This, however, will be difficult to achieve because even oral poliovirus vaccine (OPV) does not fully protect against (re)infection and because some countries will probably stop polio vaccination once eradication has been certified. Once wild poliovirus transmission has been stopped, effective containment will depend on biosafety level (BSL-3)/ polio containment for storing and handling wild poliovirus stocks. BSL-3/polio facilities, procedures, and training will be needed for laboratories that wish to continue working with wild polioviruses. …
Source: Europe PMC (PubMed Central)
Author: Barry D. Schoub
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W338805963