National Inventory for Poliovirus Containment:

Minimizing Risk of Poliovirus Release from Laboratories in the United States

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The US Poliovirus National Authority for Containment of Poliovirus (NAC), located in the Centers for Disease Control and Prevention, Center for Preparedness and Response, appreciates your participation in this survey. This survey is designed to collect relevant laboratory inventory data to ensure compliance with requirements established in the WHO Global Action Plan (GAPIII)External, as adapted for the WHO Region of the Americas. PerGAPIII, each country is required to complete a national inventory of poliovirus-containing materials. Unlike previous surveys, the 2018 survey focuses on institutions that may have poliovirus potentially infectious materials (PIM). PIM includes human respiratory secretion and fecal specimens collected for non-polio related work in a time and place where wild poliovirus (WPV) or vaccine-derived poliovirus (cVDPV) was circulating or where oral polio vaccine (OPV) was in use. Historical domestic and international specimens are more likely to fall into these categories. Additionally, PIM cultured in some common cell lines (see Appendix C: Common Cell Lines and Animals Susceptible to Poliovirus) in order to isolate other viruses of interest may have unintentionally amplified poliovirus, so respiratory or enteric viral isolates obtained from PIM specimens using any of these cell lines are also considered PIM.

The survey should be completed by laboratories, storage sites, or other facility types that test, extract, handle, or store biological samples from humans, experimentally infected animals, sewage, or environmental waters. The survey questions are intended to identify facilities that possess any materials that may contain poliovirus. The questions seek to distinguish between PIM containing wild poliovirus (WPV), circulating vaccine derived poliovirus (cVDPV), and oral poliovirus vaccine (OPV). With the release of the WHO PIM guidanceExternal in April 2018, extracted nucleic acid and specimens that may contain only OPV are no longer subject to containment under WHO GAP III. However, they are still considered to be part of the US inventory and should be reported.

For the purpose of this survey, PIM should be identified on the basis of where and when the specimens were collected, not on the basis of any test results see WHO’s Annex 2: Country or Territory-Specific Poliovirus DataCdc-pdfExternal. If your facility intends to destroy all of the potentially infectious poliovirus material or infectious material it possesses, you will then be asked to complete an attestation of destruction of the material. This attestation form will be sent to you once the completed survey is received.

Survey Overview

For an overview of the survey, please click hereCdc-pdf. This document has been provided to help you prepare your survey responses and is not intended to be completed as a paper-based format. Appendices and other references can be found below. The survey must be completed online.

Survey Instructions

This survey is divided into six modules:

  1. Facility Information
  2. Material Types
  3. Inventory Information
  4. Disposition of Materials
  5. Key Facility Personnel
  6. Attestation

Throughout the survey, questions requiring a single answer are indicated by a circle (○) and check boxes (□) are used if multiple answers are permitted. Instructions are provided with certain questions. Definitions of key words used in the survey can be found in Appendix A. Please pay close attention to the instructions at the end of Modules A and B, as these will determine whether modules C and D need to be completed. Modules E and F will be completed by all survey recipients. The time needed to complete the online survey will vary depending on the complexity of your facility and the availability of needed information. If you begin the survey and then terminate it early, you will be provided with a return code via email. Click the survey link and enter the code when prompted by the system. Please contact poliocontainment@cdc.gov immediately if you have any questions about the survey or the questions it contains and someone will provide assistance.

National Inventory for Poliovirus Containment Survey

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Appendices

The definitions given below apply to the terms as used in the Global Action Plan III (GAPIII) standard, and may have different meanings in other contexts.

Circulating VDPV (cVDPV): VDPV isolates for which there is evidence of person-to-person transmission in the community.

Global Action Plan III (GAPIII): The WHO global action plan to minimize poliovirus facility-associated risk after type-specific eradication of wild polioviruses and sequential cessation of OPV use (GAPIII). The 3rd edition of the Global Action Plan (GAPIII) aligns the safe handling and containment of poliovirus infectious and potentially infectious materials with the WHO Endgame Strategy and replaces both the 2009 draft version of the 3rd edition and the 2nd edition of the WHO global action plan for laboratory containment of wild polioviruses

Inactivated Poliovirus Vaccine (IPV): The inactivated poliovirus vaccine was developed in 1955 by Salk and Youngner. IPV is a killed-virus vaccine and is administered by injection.

Inactivation: Rendering an organism inert by the application of heat or other means.

Nucleic Acid, Poliovirus: Poliovirus RNA, cDNA, and total nucleic acid extracted from poliovirus infectious materials (e.g., a virus isolate) or potentially infectious materials (e.g., stool, respiratory specimen, sewage) using methods demonstrated to inactivate poliovirus, or synthesized RNA or cDNA (e.g., cDNA clone, synthetic transcript). Poliovirus nucleic acid can be handled outside of poliovirus containment under the condition that these materials will not be introduced into poliovirus-permissive cells or animals (as defined in GAPIII and in the “Guidance for non-poliovirus facilities to minimize risk of sample collections potentially infectious for polioviruses”) with or without a transfection reagent, except under appropriate containment conditions as described in GAPIII Annex 2 or Annex 3.

Oral Poliovirus Vaccine (OPV): The oral polio vaccine (OPV) was developed in 1961 by Albert Sabin. Also called “Sabin vaccine”, OPV contains live, attenuated (weakened) poliovirus strains. A Sabin OPV strain has been developed for each of the three poliovirus types. OPV formulations include:

  • Trivalent OPV (tOPV), contains all three serotypes of Sabin strains (1 + 2 + 3); use of tOPV ended in April 2016
  • Bivalent OPV (bOPV), contains Sabin strains 1 + 3; as of April 2016, only bOPV is used routinely
  • Monovalent OPV (mOPV) contains only one serotype of Sabin strain

Poliovirus: A picornavirus consisting of three serotypes: 1, 2 and 3; protective immunity is type-specific. Poliovirus serotypes are further subdivided into wild (circulating in nature) and Sabin strains (attenuated strains used for oral polio vaccines). Polioviruses use CD155 as the primary cellular receptor. Type 2 poliovirus has been eliminated in the wild; the last wild type 2 poliovirus was detected in India in 1999. In this current stage of polio eradication, only type 1 wild poliovirus continues to circulate in endemic areas. It is highly infectious and causes paralytic polio.

Poliovirus, Wild:

  • Wild polioviruses are naturally occurring isolates known or believed to have circulated persistently in the community.
  • Vaccine-derived polioviruses (VDPV) are classified with wild polioviruses and usually demonstrate 1–15% sequence differences from the parental oral polio vaccine (OPV) strain; they may have circulated in the community (cVDPV) or have replicated for prolonged periods in immunodeficient subjects (iVDPV) or be ambiguous and of unknown origin (aVDPV).
  • Attenuated strains not licensed for use as live vaccines (Cox/Lederle and Koprowski/Wistar series) are classified with wild polioviruses as their clinical properties are unproven.

Wild poliovirus materials may be (a) infectious or (b) potentially infectious.

  • (a) Poliovirus infectious materials, wild: These include:
    • Clinical materials from confirmed wild poliovirus (including cVDPV) infections;
    • Environmental sewage or water samples that have tested positive for the presence of wild polioviruses;
    • Cell culture isolates and reference strains of wild poliovirus;
    • Seed stocks and infectious materials from IPV production;
    • Infected animals or samples from such animals, including human poliovirus receptor transgenic mice;
    • Derivatives produced in the laboratory that have capsid sequences from wild polioviruses, unless demonstrably proven to be safer than Sabin strains. The safety of new derivatives containing wild poliovirus capsid sequences will be assessed by an expert panel, on the basis of comparison to reference Sabin strains for (i) degree and stability of attenuation; (ii) potential for person-to-person transmission; and (iii) neurovirulence in animal models;
    • Full-length RNA or cDNA of viruses proven to be safer than Sabin strains, but that includes wild poliovirus capsid sequences. The safety of these full-length RNA or cDNA and their containment requirements will be assessed by an expert panel convened by WHO, on the basis of comparison to reference Sabin strains for (i) degree and stability of attenuation; (ii) potential for person-to-person transmission; and (iii) neurovirulence in animal models;
    • Cells persistently infected with poliovirus strains whose capsid sequences are derived from wild poliovirus.
  • (b) Poliovirus potentially infectious materials, wild: These include:
    • Fecal or respiratory secretion samples collected for any purpose in a time and geographic area of wild poliovirus (including cVDPV) circulation;
    • Products of such materials from poliovirus permissive cells or animals;
    • Uncharacterized enterovirus-like cell culture isolates from countries known or suspected to have circulating wild poliovirus or cVDPV at the time of collection;
    • Respiratory and enteric virus stocks handled under conditions where poliovirus contamination or replication is possible;
    • Environmental samples (i.e. concentrated sewage, waste water) collected from areas known or suspected to have circulating WPV/VDPV or use of OPV at the time of collection.

Poliovirus, Sabin (OPV/Sabin strains): Attenuated poliovirus strains (approved for use in oral polio vaccines by national regulatory authorities, principally Sabin strains).

Poliovirus, OPV-like: For the laboratory network not involved in manufacture, isolates consistent with a limited period of virus excretion or person-to-person transmission, demonstrating less than 1% difference from parent OPV strains for poliovirus types 1 and 3, and less than 0.6% difference from the type 2 parent OPV strain by full Viral Protein 1 sequence homology. The phenotype of clinical and environmental OPV-like isolates need not be determined as the great majority are assumed to be of low virulence.

Sabin materials may be (a) infectious or (b) potentially infectious. The attenuated phenotype of viruses resulting from manufacture based on the OPV/Sabin seeds must be assured and cannot rely on the lack of sequence drift alone.

  • (a) Poliovirus infectious materials, OPV/Sabin: These include:
    • Cell culture isolates and reference OPV/Sabin strains
    • Seed stocks and live virus materials from OPV production
    • Environmental sewage or water samples that have tested positive for the presence of OPV/Sabin strains
    • Fecal or respiratory secretion samples from recent OPV recipients
    • Infected animals or samples from such animals, including poliovirus receptor transgenic mice
    • Derivatives produced in the laboratory that have capsid sequences from OPV/Sabin strains
    • Full-length RNA or cDNA that includes capsid sequences of viruses proven to be safer than Sabin strains, but that includes OPV/Sabin poliovirus capsid sequences. The safety of these full-length RNA or cDNA and their containment requirements will be assessed by an expert panel convened by WHO, on the basis of comparison to reference Sabin strains for (i) degree and stability of attenuation; (ii) potential for person-to-person transmission; and (iii) neurovirulence in animal models;
    • Cells persistently infected with poliovirus strains whose capsid sequences are derived from OPV/Sabin strains.
  • (b) Poliovirus potentially infectious materials, OPV/Sabin: These include:
    • Fecal or respiratory secretion samples collected for any purpose in a time and geographic area of OPV use
    • Products of such materials from poliovirus permissive cells or animals
    • Respiratory and enteric virus stocks handled under conditions where OPV/Sabin strain contamination or replication is possible

Sample: 1) any material–biological, clinical or environmental sample — taken as a representation of a whole, used for analysis or medical diagnosis. 2) an unknown for which an assay is testing for an outcome.

Specimen: See definition for ‘Sample’

Vaccine derived poliovirus (VDPV): Classified with wild polioviruses and usually demonstrate 1–15% sequence differences from the parental oral polio vaccine (OPV) strain; they may have circulated in the community (cVDPV) or have replicated for prolonged periods in immunodeficient subjects (iVDPV) or be ambiguous and of unknown origin (aVDPV).

WHO Regions: WHO Member States are grouped into 6 WHO regions: African Region, Region of the Americas, South-East Asia Region, European Region, Eastern Mediterranean Region, and Western Pacific Region. See WHO’s websiteExternal for more information.

The table below provides the information about last year that trivalent oral poliovirus vaccine (tOPV) was used in each respective country. The purpose of the table is to provide you with information that will help you determine whether oral poliovirus (OPV) was circulating at a time and geographic location which your specimens/samples were collected.

In accordance with the WHO Polio Endgame Plan, the last routine doses of trivalent oral poliovirus vaccine (tOPV) were given in April 2016. If samples were collected during a time when vaccine derived poliovirus (cVDPV) was circulating or at or last date that tOPV was administered, the material is considered potentially infectious.

WHO Members
WHO Member State Last Year of tOPV
United States of America 2000
Afghanistan (endemic) 2016
Albania 2016
Algeria 2016
American Samoa 2016
Andorra 2004
Angola 2016
Anguilla 2016
Antigua and Barbuda 2016
Argentina 2016
Armenia 2016
Aruba 2016
Australia 2005
Austria 2002
Azerbaijan 2016
Bahamas, The 2016
Bahrain 2016
Bangladesh 2016
Barbados 2016
Belarus 2016
Belgium 2001
Belize 2016
Benin 2016
Bermuda 2016
Bhutan 2016
Bolivia 2016
Bosnia and Herzegovina 2016
Botswana 2016
Brazil 2016
Brunei Darussalam 2012
Bulgaria 2007
Burkina Faso 2016
Burundi 2016
Cambodia  2016
 Cameroon  2016
 Canada  1996
 Cape Verde  2016
 Cayman Islands  2016
 Central Africa Republic (CAR)  2016
 Chad  2016
 Chile  2016
 China (People’s Republic of)  2016
 Colombia  2016
 Comoros  2016
 Congo  2016
 Cook Islands  2016
 Costa Rica  2011
 Cote d’Ivoire  2016
 Croatia  2008
Cuba 2016
Curaçao 2016
Cyprus 2002
Czech Republic 2007
Denmark 1968
Djibouti 1963
Dominica 2016
Dominican Republic 2016
DPR Korea 2016
Democratic Republic Congo (DRC) 2016
Ecuador 2016
Egypt 2016
El Salvador 2016
Equatorial Guinea 2016
Eritrea 2016
Estonia 2008
Ethiopia 2016
Federated States of Micronesia 2016
Fiji 2016
Finland 1960
France 1983
French Guyana 2016
French Polynesia 2016
Gabon 2016
Gambia 2016
Georgia 2015
Germany 1999
Ghana 2016
Greece 2003
Grenada 2016
Guam 2016
Guatemala 2016
Guinea 2016
Guinee Bissau 2016
Guyana 2016
Haiti 2016
Honduras 2016
Hong Kong 2016
Hungary 2006
Iceland Never Used
India 2016
Indonesia 2016
Iran (Islamic Republic of) 2016
Iraq 2016
Ireland 2001
Israel 1998
Italy 2002
Jamaica 2016
Japan 2012
Jordan 2016
Kazakhstan 2016
Kenya 2016
Kiribati 2016
Kuwait 2016
Kyrgyzstan 2016
Lao People’s Democratic Republic (LPDR)/Laos 2016
Latvia 2001
Lebanon 2016
Lesotho 2016
Liberia 2016
Libya 2016
Lithuania 2004
Luxembourg 2003
Macao 2016
Madagascar 2016
Malawi 2016
Malaysia 2016
Maldives 2016
Mali 2016
Malta 2016
Marshall Islands 2016
Mauritania 2016
Mauritius 2016
Mexico 2016
Monaco Unknown
Mongolia 2016
Montenegro 2011
Montserrat 2016
Morocco 2016
Mozambique 2016
Myanmar 2016
Namibia 2016
Nauru 2016
Nepal 2016
Netherlands Never Used
New Caledonia 2016
New Zealand 2002
Nicaragua 2016
Niger 2016
Nigeria 2016
Niue 2016
Northern Mariana 2016
Norway 1979
Oman 2016
Pakistan (endemic) 2016
Palau (Republic of) 2012
Palestine 2016
Panama 2016
Papua New Guinea 2016
Paraguay 2016
Peru 2016
Philippines 2016
Poland 2016
Portugal 2016
Puerto Rico 2016
Qatar 2016
Republic of Korea 2004
Republic of Moldova 2016
Romania 2008
Russian Federation 2016
Rwanda 2016
Saint Kitts & Nevis 2016
Saint Lucia 2016
Saint Vincent and the Grenadines 2016
Samoa 2016
San Marino 2002
Sao-Tome et Principe 2016
Saudi Arabia 2016
Senegal 2016
Serbia 2016
Seycheles 2016
Sierra Leone 2016
Singapore 2016
Slovakia 2005
Slovenia 2003
Solomon Islands 2016
Somalia 2016
South Africa 2006
South Sudan 2016
Spain 2004
Sri Lanka 2016
St Maarten 2016
Sudan 2016
Suriname 2016
Swaziland 2016
Sweden Never Used
Switzerland 2004
Syrian Arab Republic 2016
Taiwan 2016
Tajikistan 2016
Tanzania 2016
TFY Republic of Macedonia 2016
Thailand 2016
Timor-Leste 2016
Togo 2016
Tokelau 2016
Tonga 2016
Trinidad and Tobago 2016
Tunisia 2016
Turkey 2016
Turkmenistan 2016
Turks and Caicos Islands 2016
Tuvalu 2016
Uganda 2016
UK of Great Britain and Northern Ireland 2004
Ukraine 2016
United Arab Emirates 2016
Uruguay 2012
Uzbekistan 2016
Vanuatu 2016
Venezuela 2016
Viet Nam 2016
Virgin Islands (UK) 2016
Wallis and Futuna 2016
Yemen 2016
Zambia 2016
Zimbabwe 2016

*The information in this table was modified from the 2015 U.S. National Poliovirus Containment Survey: Appendix B: Summary of Country Information on Last Known Polio Cases.

Poliovirus grows in nearly all human and monkey cell lines, in addition to mouse L cells (L20B, Lα) that express the human poliovirus receptor (CD155). The below lists highlights some, but not all, cell lines susceptible to poliovirus.

Poliovirus Sensitive Cell Lines
Cell Line Origin
A-549 Human
CaCo-2 Human
HEK Human
HeLA Human
HEp-2 Human
MRC-5 Human
PERC-6 Human
RD Human
WI-38 Human
Various neuroblastoma (e.g. IMR-32, SK-N-MC) Human
BGMK (sometimes referred to as BGM or GMK) African green monkey
LLC-MK2 Rhesus macaque
MA-104 (Vero derivative) African green monkey
Primary monkey kidney cells Old world monkeys
Vero African green monkey
L20B Transgenic mouse cell line
la Transgenic mouse cell line
E-MX Hybrid; mixture of cell lines
R-MX Hybrid; mixture of cell lines

 

Animals Susceptible to Poliovirus
Old World Monkeys and higher primates
Human poliovirus receptor (PVR; CD155) transgenic mice
Autoclave and Incineration
Autoclave The use of moist steam under pressure is the most effective method for sterilizing laboratory materials.
  • All cultures and contaminated materials should be autoclaved in leak-proof containers (e.g., autoclave bags placed in a leak-proof tray) before disposal.
  • Packaging should allow the penetration of steam.
  • After being autoclaved the materials may be placed in transfer containers for transportation to the disposal point.
  • Autoclaves should be validated in order to ensure that sterilizing conditions are fulfilled under all loading patterns.
Incineration Incineration is the method of choice for final disposal of contaminated waste, including carcasses of laboratory animals, preferably after autoclaving.

Incineration of materials is an alternative to autoclaving only if:

  • the incinerator and transport to the incinerator is under laboratory control;
  • the incinerator is provided with an efficient means of temperature control and a secondary burning chamber.

*Source: World Health Organization. WHO/CDS/CSR/LYO/LAB/2003. Geneva, 2003.

If other means of destruction are to be used, contact the National Authority for Poliovirus Containment (poliocontainment@cdc.gov) prior to destruction.

Please note that the disposal of laboratory and medical waste is subject to various national regulations. In general, ash from incinerators may be treated in the same way as normal domestic waste and removed by local authorities. Autoclaved waste may be disposed of by off-site incineration or in licensed landfill sites.

Guidance for potentially infectious poliovirus materials (PIM)
National Inventory for Poliovirus Containment Survey

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Page last reviewed: December 12, 2018, 02:35 PM