title: Risk assessment, risk management and risk-based monitoring following a reported accidental release of poliovirus in Belgium, September to November 2014.
abstract: On 6 September 2014, the accidental release of 10(13) infectious wild poliovirus type 3 (WPV3) particles by a vaccine production plant in Belgium was reported. WPV3 was released into the sewage system and discharged directly to a wastewater treatment plant (WWTP) and subsequently into rivers that flowed to the Western Scheldt and the North Sea. No poliovirus was detected in samples from the WWTP, surface waters, mussels or sewage from the Netherlands. Quantitative microbial risk assessment (QMRA) showed that the infection risks resulting from swimming in Belgium waters were above 50% for several days and that the infection risk by consuming shellfish harvested in the eastern part of the Western Scheldt warranted a shellfish cooking advice. We conclude that the reported release of WPV3 has neither resulted in detectable levels of poliovirus in any of the samples nor in poliovirus circulation in the Netherlands. This QMRA showed that relevant data on water flows were not readily available and that prior assumptions on dilution factors were overestimated. A QMRA should have been performed by all vaccine production facilities before starting up large-scale culture of WPV to be able to implement effective interventions when an accident happens.
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Center for Infectious Diseases Control (CIb), Bilthoven, the Netherlands.
authors.forename: Erwin
authors.initials: E
authors.lastname: Duizer
authors.forename: Saskia
authors.initials: S
authors.lastname: Rutjes
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: de Roda Husman
authors.forename: Jack
authors.initials: J
authors.lastname: Schijven
mesh_terms: D001530:Belgium; D003264:Containment of Biohazards; D004784:Environmental Monitoring / Q000379:methods; D006801:Humans; D011051:Poliomyelitis / Q000517:prevention & control* / Q000635:transmission; D017955:Poliovirus / Q000472:pathogenicity*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage*; D018570:Risk Assessment / Q000379:methods*; D012308:Risk Management / Q000379:methods*; D012722:Sewage; D014871:Water Microbiology
chemical_list: D011055:Poliovirus Vaccine, Oral; D012722:Sewage
keywords: Poliovirus; QMRA; risk based monitoring