PLANS FOR CONTAINMENT OF POLIOVIRUS FOLLOWING TYPE-SPECIFIC POLIO ERADICATION WORLDWIDE, 2015

Friday, 7th of August 2015 Print

PLANS FOR CONTAINMENT OF POLIOVIRUS FOLLOWING TYPE-SPECIFIC POLIO

ERADICATION WORLDWIDE, 2015

Nicoletta Previsani,a Rudi Tangermann,a Graham Tallis, Hamid Jafari a

Excerpt below; full text is at http://www.who.int/wer/2015/wer9032.pdf?ua=1 

Discussion

Although available data estimate the number of facilities currently holding type 2 wild polioviruses to be around 500 worldwide, one of the goals of poliovirus containment will be to reduce this number substantially,10 dissuading candidate facilities not meeting the GAPIII containment criteria from holding any polioviruses. Only designated essential facilities that

meet GAPIII containment criteria will store and handle polioviruses.

 

Polio diagnostic and research laboratories that hold type 2 poliovirus containing infectious or potentially infectious materials should begin preparations to comply with GAPIII in accordance with the timelines above. Considering the substantial investments and technical capacity that are required by facilities to become compliant with GAPIII it is expected that most diagnostic and research laboratories holding poliovirus materials will either destroy or transfer such materials to a laboratory that is GAPIII compliant.

 

Similarly, significant number of facilities maintain faecal or respiratory samples collected in areas where tOPV was in use at the time of collection. Successful management of poliovirus-associated risk requires such facilities to apply bio-safety and containment measures that reduce the risk of human exposure to live polioviruses from manipulation of such samples.

 

National authorities in countries that host designated essential facilities that store and handle polioviruses for the purpose of diagnosis, research or vaccine production, will be assisted by WHO to implement the international scheme to certify containment in compliance with GAPIII.

Manufacturing of IPV involves amplification of wild polioviruses at an industrial scale, thus requiring extraordinary measures to mitigate the risk of facility associated risk of poliovirus spread. WHO has kept IPV manufacturers informed about the phased approach to containment of all polioviruses, starting with the type2 poliovirus. WHO is working with national authorities and vaccine manufacturers to assure appropriate risk management and ultimately full GAPIII compliance.

 

WHO has planned the provision of technical assistance and training to national authorities, managers of essential laboratories and vaccine manufacturers to facilitate compliance with GAPIII, and implementation of the international containment certification

scheme.

 

The timeline cited in GAPIII for the type-specific containment of polioviruses is short for candidate essential poliovirus facilities to be assessed and certified in accordance with GAPIII and for the national authorities responsible for containment to deliver containment certificates. However, continuation of polio vaccine production, surveillance and essential research activities are considered critical and must continue. Thus, in order to help manage practical challenges associated with the implementation of containment for essential facilities, an additional status of interim certification of containment is introduced. This allows the containment certification scheme to proceed in the endgame phases of eradication in a controlled and structured manner,

while managing potential delays that may be associated with meeting the requirements for full containment within pressing timelines. The proposed mechanisms will provide some degree of flexibility while facilities make the required changes, and countries and other bodies develop the required capability and capacity to implement the certification scheme.

 

The final containment of all infectious materials and WPV/VDPVs, including types 1 and type

3 polioviruses is also approaching. The initial process to contain PVS2 is also an opportunity to learn how containment of all polioviruses can best be achieved.

 

After WPV transmission has been stopped, final containment will minimize the risk of reintroduction into a polio-free world once all OPV use has been phased-out. As for variola virus, containment requirements will have to be regularly assessed and maintained, until a global decision is made to destroy all remaining poliovirus materials and prohibit any de

novo synthesis.

 

Author affiliations

a

Polio Operations and Research Department, World

Health Organization, Geneva, Switzerland States

(Corresponding author: Nicoletta Previsani,

previsanin@who.int).

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