title: Containment of polioviruses after eradication and OPV cessation: characterizing risks to improve management.
abstract: The goal of the World Health Organization is to stop routine use of oral poliovirus vaccine shortly after interruption of wild poliovirus transmission. A key component of this goal is to minimize the risk of reintroduction by destruction of polioviruses except in an absolute minimum number of facilities that serve essential functions and implement effective containment. Effective containment begins with a complete facility risk assessment. This article focuses on characterizing the risks of exposure to polioviruses from the essential vaccine production, quality control, and international reference and research facilities that remain. We consider the potential exposure pathways that might lead to a poliovirus reintroduction, including para-occupational exposures and releases to the environment, and review the literature to provide available estimates and a qualitative assessment of containment risks. Minimizing the risk of poliovirus transmission from a poliovirus facility to increasingly susceptible communities is a crucial and ongoing effort requiring understanding and actively managing the potential exposure pathways.
authors.affiliation: Polio Eradication Program, The Task Force for Child Survival and Development, 750 Commerce Dr., Suite 400, Decatur, GA 30030, USA. wdowdle@taskforce.org
authors.forename: Walter
authors.initials: W
authors.lastname: Dowdle
authors.forename: Harrie
authors.initials: H
authors.lastname: van der Avoort
authors.forename: Esther
authors.initials: E
authors.lastname: de Gourville
authors.forename: Francis
authors.initials: F
authors.lastname: Delpeyroux
authors.forename: Jagadish
authors.initials: J
authors.lastname: Desphande
authors.forename: Tapani
authors.initials: T
authors.lastname: Hovi
authors.forename: Javier
authors.initials: J
authors.lastname: Martin
authors.forename: Mark
authors.initials: M
authors.lastname: Pallansch
authors.forename: Olen
authors.initials: O
authors.lastname: Kew
authors.forename: Chris
authors.initials: C
authors.lastname: Wolff
mesh_terms: D003264:Containment of Biohazards; D004196:Disease Outbreaks / Q000517:prevention & control; D004781:Environmental Exposure; D006801:Humans; D007107:Immune System; D017589:Immunization Programs; D016273:Occupational Exposure; D011051:Poliomyelitis / Q000517:prevention & control* / Q000635:transmission; D017955:Poliovirus / Q000378:metabolism*; D011055:Poliovirus Vaccine, Oral / Q000627:therapeutic use*; D011786:Quality Control; D012306:Risk; D018570:Risk Assessment; D014944:World Health Organization
chemical_list: D011055:Poliovirus Vaccine, Oral