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Volume 25, Number 7—July 2019
Historical Review

Facility-Associated Release of Polioviruses into Communities—Risks for the Posteradication Era

Ananda S. BandyopadhyayComments to Author , Harpal Singh, Jacqueline Fournier-Caruana, John F. Modlin, Jay Wenger, Jeffrey Partridge, Roland W. Sutter, and Michel J. Zaffran
Author affiliations: Bill & Melinda Gates Foundation, Seattle, Washington, USA (A.S. Bandyopadhyay, J.F. Modlin, J. Wenger, J. Partridge); World Health Organization, Geneva, Switzerland (H. Singh, J. Fournier-Caruana, R.W. Sutter, M.J. Zaffran); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (R.W. Sutter)

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Table 1

Reported incidents of poliovirus release from laboratories and vaccine production facilities in the pre–polio vaccine era*

Year Location (reference) Source Poliovirus type No. cases* Exposure
Description
Primary Secondary Tertiary
1933
United States (20,21)
Lab
Not indicated
1
Physician
NA
NA
Bitten (cutaneous disruption) by a normal macaque while doing work on poliomyelitis (paralysis); filterable virus capable of reproducing the disease in rabbits was isolated from the case; case was fatal
1935
United States (22)
Vaccine production facility
Not indicated
12
Vaccine trial patients, age 5 mo to 20 y
NA
NA
12 cases of paralytic poliomyelitis in patients receiving trial vaccination against poliomyelitis; natural infections ruled out as cause; 6 deaths
1941
United States (19,20,23)
Lab
Not indicated
1
Lab staff
NA
NA
Lab staff member experienced paralysis after preparation of infected tissues for inoculation into monkeys; cutaneous inoculation; no polio outbreaks reported in place of residence or areas of travel
1945
United States (20,23)
Lab
Not indicated
1
Lab staff
NA
NA
Lab staff member scratched on hand by noninoculated monkey during transport; subsequent virus contamination of hands might have occurred while feeding or inoculating monkeys; patient experienced paralysis and later died
1946
Zimbabwe (formerly Rhodesia) (20,25)
Lab
Not indicated
1
Lab staff
NA
NA
Infection acquired during inoculation of monkeys with polio virus; paralysis occurred, case was fatal
1949
United States (20,24)
Lab
WPV2 (mouse- adapted Lansing strain)
2
Lab staff
NA
NA
Two lab technicians were infected in the eyes and nose with Lansing (Armstrong) strain while inoculating mice during polio experiments; both experienced paralysis
1950
Canada (20,25)
Lab
Not indicated
1
Physician
Na
NA
Doctor acquired poliomyelitis while performing autopsy on poliomyelitis patient; intracutaneous inoculation; residual weakness; case was not fatal
1954 United Kingdom (20,26) Lab WPV2 (MEF-1) strain 1 Lab staff NA NA Lab technicians infected by cutaneous inoculation while performing necropsy on animals infected with wild type-2 (MEF-1) strain; subsequent paralysis; cases were not fatal

*Cases defined as laboratory positive (with or without paralysis) for poliovirus by standard methods of virus isolation or known exposure to poliovirus. Lab, laboratory; MEF-1, wild poliovirus type 2 laboratory reference strain; NA, not applicable; WPV2, wild poliovirus type 2.

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References
  1. World Health Organization. World Health Assembly resolution WHA41.28. Global eradication of poliomyelitis by the year 2000 [cited 2018 Oct 10]. http://www.who.int/ihr/polioresolution4128en.pdf
  2. Global Polio Eradication Initiative. Global wild poliovirus 2012–2018 [cited 2018 Oct 10]. http://polioeradication.org/wp-content/uploads/2018/08/global-wild-poliovirus-2013-2018-20180807.pdf
  3. Martín  J. Vaccine-derived poliovirus from long term excretors and the end game of polio eradication. Biologicals. 2006;34:11722. PubMedGoogle Scholar
  4. de Silva  R, Gunasena  S, Ratnayake  D, Wickremesinghe  GD, Kumarasiri  CD, Pushpakumara  BA, et al. Prevalence of prolonged and chronic poliovirus excretion among persons with primary immune deficiency disorders in Sri Lanka. Vaccine. 2012;30:75615. DOIPubMedGoogle Scholar
  5. Global Polio Eradication Initiative. Polio eradication and endgame strategic plan 2013–2018 [cited 2018 Nov 2]. http://polioeradication.org/wp-content/uploads/2016/07/PEESP_EN_A4.pdf
  6. World Health Organization. WHO global action plan to minimize poliovirus facility-associated risk after type-specific eradication of wild polioviruses and sequential cessation of oral polio vaccine use (GAPIII) [cited 2018 Nov 2]. http://www.polioeradication.org/wp-content/uploads/2016/12/GAPIII_2014.pdf
  7. Global Polio Eradication Initiative. Global eradication of wild poliovirus type 2 declared [cited 2018 Nov 2]. http://polioeradication.org/news-post/global-eradication-of-wild-poliovirus-type-2-declared
  8. Global Certification Commission for the Eradication of Poliomyelitis. Report from the sixteenth GCC meeting, Paris, France, 4–5 July 2017 [cited 2018 Nov 2]. http://polioeradication.org/wp-content/uploads/2017/09/GCC-16th-meeting-report-0405072017.pdf
  9. Global Certification Commission for the Eradication of Poliomyelitis. Report from the special meeting of the GCC on poliovirus containment, Geneva, Switzerland, 23–25 October 2017 [cited 2018 Nov 2]. http://polioeradication.org/wp-content/uploads/2018/01/polio-global-certification-commission-report-2017-10-final-en.pdf
  10. Rijksinstituut voor Volksgezondheid en Milieu (National Institute for Public Health and the Environment, the Netherlands). Employee vaccine manufacturer infected with polio virus [cited 2018 Nov 2]. https://www.rivm.nl/en/Documents_and_publications/Common_and_Present/Newsmessages/2017/Employee_vaccine_manufacturer_infected_with_polio_virus
  11. Bilthoven Biologicals. Employee infected with polio virus [cited 2018 Nov 2]. https://www.bbio.nl/nieuws/2017/april/medewerker-besmet-met-poliovirus
  12. Duizer  E, Ruijs  WL, van der Weijden  CP, Timen  A. Response to a wild poliovirus type 2 (WPV2)-shedding event following accidental exposure to WPV2, the Netherlands, April 2017. Euro Surveill. 2017;22:30542. DOIPubMedGoogle Scholar
  13. World Health Organization. Guidance to minimize risks for facilities collecting, handling, or storing materials potentially infectious for polioviruses. WHO/POLIO/18.03 [cited 2019 Jan 27]. http://polioeradication.org/wp-content/uploads/2018/06/polio-containment-guidance-for-non-poliovirus-facilities-20180614-en.pdf
  14. Dowdle  WR, Birmingham  ME. The biologic principles of poliovirus eradication. J Infect Dis. 1997;175(Suppl 1):S28692. DOIPubMedGoogle Scholar
  15. Van Rooyen  CE, Rhodes  A. Virus diseases of man. New York: Thomas Nelson & Sons; 1948.
  16. Byers  K, Harding  A. Viral agents of human diseases: biosafety concerns. In: Wooley D, Byers K, editors. Biological safety: principles and practices. 5th edition. Washington: ASM Press; 2017. p. 187–220.
  17. Pike  RM. Laboratory-associated infections: summary and analysis of 3921 cases. Health Lab Sci. 1976;13:10514.PubMedGoogle Scholar
  18. Pike  RM. Laboratory-associated infections: incidence, fatalities, causes, and prevention. Annu Rev Microbiol. 1979;33:4166. DOIPubMedGoogle Scholar
  19. Sulkin  SE, Pike  RM. Viral infections contracted in the laboratory. N Engl J Med. 1949;241:20513. DOIPubMedGoogle Scholar
  20. Pike  RM, Sulkin  SE, Schulze  ML. Continuing importance of laboratory acquired infections. Am J Public Health Nations Health. 1965;55:1909. DOIPubMedGoogle Scholar
  21. Sabin  AB, Wright  AM. Acute ascending myelitis following a monkey bite, with the isolation of a virus capable of reproducing the disease. J Exp Med. 1934;59:11536. DOIPubMedGoogle Scholar
  22. Leake  JP. Poliomyelitis following vaccination against this disease. Cal West Med. 1936;44:1412.PubMedGoogle Scholar
  23. Sabin  AB, Ward  R. Poliomyelitis in a laboratory worker exposed to the virus. Science. 1941;94:1134. DOIPubMedGoogle Scholar
  24. Beller  K. Laboratory infection with the Lansing virus [in German]. Zentralblatt für Bakteriologie, Parasitenkunde. Infektionskrankheiten und Hygiene. 1949;153:26973.
  25. Burns  JS. Poliomyelitis: a case possibly due to intracutaneous inoculation. Can Med Assoc J. 1950;63:4989.PubMedGoogle Scholar
  26. McMATH  WFT. Accidental inoculation with poliomyelitis virus. Lancet. 1955;268:7023. DOIPubMedGoogle Scholar
  27. Nathanson  N, Langmuir  AD. The Cutter incident: poliomyelitis following formaldehyde-inactivated poliovirus vaccination in the United States during the spring of 1955. II. Relationship of poliomyelitis to Cutter vaccine. Am J Hyg. 1963;78:2960.PubMedGoogle Scholar
  28. Offit  PA. The Cutter incident, 50 years later. N Engl J Med. 2005;352:14112. DOIPubMedGoogle Scholar
  29. Dowdle  WR, Wolff  C, Sanders  R, Lambert  S, Best  M. Will containment of wild poliovirus in laboratories and inactivated poliovirus vaccine production sites be effective for global certification? Bull World Health Organ. 2004;82:5962.PubMedGoogle Scholar
  30. Mulders  MN, Reimerink  JHJ, Koopmans  MPG, van Loon  AM, van der Avoort  HG. Genetic analysis of wild-type poliovirus importation into The Netherlands (1979-1995). J Infect Dis. 1997;176:61724. DOIPubMedGoogle Scholar
  31. Deshpande  JM, Nadkarni  SS, Siddiqui  ZA. Detection of MEF-1 laboratory reference strain of poliovirus type 2 in children with poliomyelitis in India in 2002 & 2003. Indian J Med Res. 2003;118:21723.PubMedGoogle Scholar
  32. World Health Organization. Wild poliovirus type 2—reference strains isolated in India. Wkly Epidemiol Rec. 2003;78:88 [cited 2018 Oct 10]. https://apps.who.int/iris/bitstream/handle/10665/232120/WER7812_88-88.PDF
  33. World Health Organization. Update on actions taken following the isolation of MEF-1 reference poliovirus associated with acute flaccid paralysis cases in India in late 2002 and early 2003. Wkly Epidemiol Rec. 2003;78:277–84 [cited 2018 Oct 10]. https://www.who.int/wer/2003/wer7832
  34. Duizer  E, Rutjes  S, de Roda Husman  AM, Schijven  J. Risk assessment, risk management and risk-based monitoring following a reported accidental release of poliovirus in Belgium, September to November 2014. Euro Surveill. 2016;21:30169. DOIPubMedGoogle Scholar
  35. Duizer  E. Laboratory analysis of environmental samples taken following the reported release of live poliovirus. RIVM letter report 2015–0032 [cited 2018 Oct 10]. http://www.rivm.nl/bibliotheek/rapporten/2015-0032.pdf
  36. Wenner  HA, Paul  JR. Fatal infection with poliomyelitis virus in a laboratory technician; isolation of virus from lymph nodes. Am J Med Sci. 1947;213:918. DOIPubMedGoogle Scholar
  37. Gear  JH, Rodger  LM. Studies in poliomyelitis; poliomyelitis in Northern Rhodesia, with special reference to an outbreak occurring on the Roan Antelope Copper Mine, Luanshya, in 1946. S Afr Med J. 1946;20:6703.PubMedGoogle Scholar
  38. Sushmi Dey. Contaminated vaccines put India’s “polio free” status at risk. The Times of India. October 1, 2018 [cited 2018 Nov 2]. http://timesofindia.indiatimes.com/articleshow/66021197.cms
  39. Upfill-Brown  A, Taniuchi  M, Platts-Mills  JA, Kirkpatrick  B, Burgess  SL, Oberste  MS, et al. Nonspecific effects of oral polio vaccine on diarrheal burden and etiology among Bangladeshi infants. Clin Infect Dis. 2017;65:4149. DOIPubMedGoogle Scholar
  40. Her Majesty’s Stationery Office. Report on an investigation into the cause of the 1978 Birmingham smallpox occurrence. London: Her Majesty’s Stationery Office; 1980 [cited 2018 Nov 2]. https://biotech.law.lsu.edu/blaw/bt/smallpox/refs/report_1978_london.pdf
  41. Bandyopadhyay  AS, Garon  J, Seib  K, Orenstein  WA. Polio vaccination: past, present and future. Future Microbiol. 2015;10:791808. DOIPubMedGoogle Scholar
  42. Sutter  RW. Unraveling the mucosal Immunity of inactivated poliovirus vaccine. J Infect Dis. 2018;217:3446. DOIPubMedGoogle Scholar
  43. McKinlay  MA, Collett  MS, Hincks  JR, Oberste  MS, Pallansch  MA, Okayasu  H, et al. Progress in the development of poliovirus antiviral agents and their essential role in reducing risks that threaten eradication. J Infect Dis. 2014;210(Suppl 1):S44753. DOIPubMedGoogle Scholar
  44. World Health Organization. World Health Assembly resolution WHA71.16. Poliomyelitis—containment of polioviruses. In: Seventy-first World Health Assembly, Geneva, Switzerland; May 20–26, 2018 [cited 2018 Nov 2]. http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_R16-en.pdf

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