The first part of polio eradication is to rid the world of polio through immunization. It is the largest public health effort ever
undertaken and is spearheaded by the World Health Organization, CDC, UNICEF and Rotary International with the help of many global funding
partners and millions of volunteers in developing countries. The second part of polio eradication is laboratory containment.
I thought polio had already been eradicated?
Successful eradication of polio is anticipated within the next few years. There are currently 10 countries where polio is endemic. In
the last year, less than 500 cases worldwide were reported.
When and where was the last outbreak of poliomyelitis in the US?
The last outbreak of poliomyelitis in the United States was in 1979 in Pennsylvania, Iowa, Wisconsin, and Missouri. The outbreak was
associated with unvaccinated persons in religious communities.
Why is laboratory containment of wild polioviruses important?
When global polio eradication is achieved within the next few years, containing the virus in the laboratory is essential to reduce the
risk of inadvertent re-introduction of polio to the community.
Why is the national wild poliovirus inventory being conducted separately from the Select Agents Registry?
The notification of possession or use of select agents or high consequence livestock pathogens and toxins is carried out under the
Public Health Security and Bioterrorism Preparedness Response Act of 2002. The wild poliovirus inventory is part of the worldwide effort
to eradicate polio.
A recent Science report described the creation of poliovirus in a test tube. What are the implications of this for the wild
poliovirus national inventory and future laboratory containment?
None. DNA copies of the poliovirus genome were shown as early as 1981 to produce infectious poliovirus when inserted into a cell. The
2002 Science report confirmed those findings using synthetic DNA.
I work with polioviruses. Can I continue to do so?
Yes. Laboratories that wish to keep their materials and continue to work with wild polioviruses should do so under Biosafety Level
2/polio. When wild poliovirus transmission is interrupted, you will be notified to implement biosafety measures appropriate for the
materials stored and procedures performed. Additional information on biosafety requirements can be accessed in Annex
3 and Annex 4 of the Global Action Plan.
The national inventory of all biomedical laboratories is the first step toward containment. Laboratories are alerted to the anticipated
successful global eradication of polio and encouraged to destroy all unneeded wild poliovirus materials. Laboratories that retain wild
poliovirus materials for ongoing work will be placed on the national inventory. When wild poliovirus transmission is interrupted
worldwide, laboratories will be notified to destroy all materials or implement appropriate biosafety measures to further reduce the risk
of transmitting wild poliovirus to the community.
Who is conducting the inventory?
The US Department of Health and Human Services (DHHS) is conducting the inventory pursuant to Section 301 of the Public Health Service
Act (42 U.S.C. § 241). The inventory is being compiled and maintained by the Centers for Disease Control and Prevention (CDC).
Who is included in the inventory process?
All biomedical laboratories located in academic, federal government, hospital, industry, private, and state and local government
facilities.
Are other countries involved in the inventory process?
Yes, in response to the World Health Assembly resolution, national inventories are already underway or completed in 122 countries in
the Western Pacific, European, Eastern Mediterranean and Southeast Asia regions.
The following institutions were sent inventory packets:
CLIA laboratories certified to perform microbiology. CLIA refers to the Clinical Laboratory Improvement Amendments of 1988, which
set forth standards for certification of laboratories performing tests on human beings.
Research oriented academic institutions listed on the database of the Integrated Postsecondary Education Data System.
Industries listed on pharmaceutical and biotechnology databases.
Federal, state, and local government facilities.
I don't work with poliovirus. Why is my laboratory included in the inventory?
Wild polioviruses may be present in many biomedical laboratories in clinical and environmental materials collected for any purpose from
areas of the world where polio was endemic. Many such laboratories are located in departments other than microbiology, and many may be
unaware they have stored potential wild poliovirus materials.
Our institution has several sites with many laboratories. Does each site submit a completed inventory form?
No. The responsible facility officer reports for the entire institution.
Please note: Institution branches or subsidiaries independently registered with CLIA were sent inventory packets with unique
User Ids and Passwords. The institutional RFO reporting on behalf of branches/subsidiaries should submit each inventory result separately
using the User ID and Password assigned to each branch/subsidiary.
My institution has several laboratories. How do I conduct the inventory?
A laboratory worksheet is available at www.cdc.gov/od/nvpo/polio to assist RFO's
inventory multiple laboratories. The worksheet may be modified to accommodate institutional needs and is circulated to all relevant
biomedical laboratories along with the informational brochure. Laboratory directors return the completed worksheet to the RFO, who will
use the information to complete the inventory form.
Does DHHS need to know the exact amount of wild poliovirus materials held in my laboratory?
Only the approximate number of samples is requested to determine the magnitude of poliovirus containment in terms of laboratory number
and relative size of holdings.
How should I destroy unneeded poliovirus materials?
Unneeded materials are to be disposed of in accord with individual State regulations governing biomedical waste, such as sharps. Such
materials are autoclaved or incinerated by the laboratory or medical waste contractor before disposal in a landfill.
Are vaccines included in the recommendation to destroy all unneeded wild poliovirus materials?
No. The Salk inactivated (killed) vaccine (IPV), which replaced the Sabin oral (live) polio vaccine (OPV) in 2000, continues to be an
essential component of routine childhood immunizations in the US.
Do I need to complete the inventory if I have disposed of wild poliovirus infectious or potential infectious materials?
Yes, an important component of the national inventory process is documentation that laboratories do not have such materials.
Will the national inventory be shared with other parties?
Access to the inventory will be limited to personnel with a need to know to perform their official job duties.
Most terms are defined in Appendix I of the inventory form. Other and more detailed definitions
may be found in the Global Action Plan. Definitions of common terms are below.
What are wild polioviruses?
Polioviruses from any source other than licensed attenuated live virus vaccines (referred to as the OPV or Sabin vaccine) or samples
from persons receiving such vaccines are considered wild. The live poliovirus vaccine is no longer used in the US. OPV was replaced by IPV
(containing inactivated or killed polioviruses) in 2000.
What are wild poliovirus infectious materials?
Clinical materials from confirmed wild poliovirus infections
Environmental sewage or water samples in which such viruses are present
Products of such viruses, including cell culture isolates and reference strains
Infected animals or samples from such animals
Research materials from laboratory derivatives that have wild poliovirus capsid sequences.
Circulating vaccine-derived poliovirus (cVDPV) is considered wild for containment purposes. Such viruses are rare and have been found
only in the non-endemic countries of Haiti and the Dominican Republic (2000-2001), the Philippines (2001), and Madagascar (2002). Detailed
definitions and examples can be accessed at Box 2 of the Global Action Plan.
What are potential wild poliovirus infectious materials?
Feces, respiratory secretions, and environmental sewage and water samples collected for any purpose at a time and in a geographic area
where wild polioviruses were suspected to be present. Appendix II of the inventory form lists the last documented polio case for
polio-free countries. The date for the US is 1979. For containment purposes, samples may be considered polio-free immediately after the
date of the last documented case. Blood and serum specimens are not considered potentially infectious.
What is meant by "stored" materials?
Stored materials refer to permanent or long-term collections of wild poliovirus or potential infectious materials held under conditions
in which polioviruses survive. Samples held in the refrigerator or freezer only for the period of time required for completion of
diagnostic tests are not considered stored materials and are not part of the national inventory.
