U.S. Poliovirus Containment Survey
Maintaining the National Inventory for Poliovirus Containment to Minimize Risk of Poliovirus Release from U.S. Laboratories
If you didn’t receive a request to take the survey but wish to participate or were directed by someone at your facility or institution to take the survey, click the link below.
If you received an email directly from the U.S. NAC inviting you to participate in the National Inventory for Poliovirus Containment, please access the survey by clicking on the link provided at the bottom of the email.
If you no longer have the email or if you have any questions about the survey, contact us at email@example.com and your survey link will be re-sent to you.
The U.S. National Authority for Containment of Poliovirus (NAC), located in the Centers for Disease Control and Prevention, Office of Readiness and Response appreciates your participation in U.S. Poliovirus Containment Survey. This survey is designed to collect relevant facility inventory data to ensure compliance with requirements established in the WHO Global Action Plan (GAP), as adapted for the WHO Region of the Americas. Per GAP, each country is required to maintain a national inventory of poliovirus-containing materials.
The survey should be completed by laboratories, storage sites, wastewater facilities, or other facilities that test, extract, handle, or store poliovirus or biological samples from humans, experimentally infected animals, sewage, or environmental waters.
Purpose: Identify Infectious Poliovirus and PIM
Unlike previous releases of the national survey that focused on identifying facilities with infectious poliovirus, this release puts greater emphasis on poliovirus potentially infectious materials (PIM) in addition to infectious poliovirus. PIM should be identified based on where and when the specimens were collected, not based on any test results. PIM includes human fecal samples and upper respiratory secretions collected for polio or non-polio related work in a time and place where one of the following apply:
- Wild poliovirus (WPV) was circulating
- Vaccine-derived poliovirus (VDPV) was circulating
- Oral polio vaccine (OPV) was in use
Historical domestic and international specimens are more likely to fall into the categories above. Also, PIM cultured in some common cell lines to isolate other viruses of interest may unintentionally amplify poliovirus. Respiratory or enteric viral isolates obtained from PIM specimens using poliovirus-permissive cell lines are also considered PIM. For more details, see Appendix C Common Cell Lines and Animals Susceptible to Poliovirus.
Extracted nucleic acid and specimens that may contain only OPV (i.e., OPV PIM) are not subject to GAP containment at this time; however, these materials are still considered part of the U.S. poliovirus inventory and should be reported in the survey.
Before starting the survey, please review the WHO Country and Territory-Specific Poliovirus Case Data and the Country Information on Last Use of Trivalent Oral Poliovirus to determine if a biological specimen or environmental sample in your inventory may contain poliovirus. If you need assistance with the using the tables, contact the NAC.
After Identifying Infectious Poliovirus or PIM
Facilities are encouraged to destroy all unneeded or nonessential poliovirus material. If your facility intends to destroy some or all the poliovirus PIM or infectious material it possesses, you will be asked to complete an attestation of destruction for the material. (Download and fill out form in Acrobat. Form cannot be filled out in browser view.)
The U.S. National Survey Guidance for Poliovirus Containment is intended to help you prepare your survey responses prior to completing the survey online. Note, the survey cannot be submitted in a paper-based format. This guidance includes instructions, appendices, definitions, and other references.
The survey is divided into six modules:
- Facility Information
- Material Types
- Inventory Information
- Disposition of Materials
- Key Facility Personnel
In the survey, you will be asked to state the scope of your responses (i.e., if you represent a single laboratory, department, or entire institution). This is important and helps us to determine if your facility is adequately represented. The amount of time needed to complete the survey will vary depending on the complexity of your laboratory or facility and the availability of needed information.
Please contact the NAC at firstname.lastname@example.org if you have any questions about the survey and someone will provide assistance.
The definitions given below apply to the terms as used in the Global Action Plan III (GAPIII) standard or the PIM guidance.
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.
Inactivation: Procedures that render PV non-infectious and unable to grow or replicate in the absence of transfection reagents (e.g., transfection) or cellular manipulation (e.g., electroporation). Procedures to inactivate PV may include, but are not limited to, nucleic acid or protein extractions, specimen fixations (e.g., formalin, acetone), irradiation, heat, or enzymes (e.g., lysozymes).
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.
Infectious Materials (IM): Wild Poliovirus/Vaccine-derived Poliovirus (WPV/VDPV)
- Clinical materials from confirmed wild poliovirus (including VDPV) 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;
- Cells persistently infected with poliovirus strains whose capsid sequences are derived from wild poliovirus.
Infectious Materials (IM): OPV/Sabin
- 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;
- Cells persistently infected with poliovirus strains whose capsid sequences are derived from OPV/Sabin strains.
Nucleic Acid, Poliovirus: Full-length 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.
Note: WHO has exempted full-length PV nucleic acids from GAPIII containment. However, WHO does require that full-length PV nucleic acids are included as part of the facility and national inventories
Oral Poliovirus Vaccine (OPV): Attenuated poliovirus strains (approved for use in oral polio vaccines by national regulatory authorities, principally Sabin strains). Also called ‘Sabin vaccine’, OPV contains live, attenuated (weakened) poliovirus strains. 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). Poliovirus types 2 and 3 have been eliminated in the wild. 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.
Potentially infectious materials:
- Fecal or respiratory secretion samples and their derivatives (e.g., stool suspensions, extracted nucleic acids, etc.) collected for any purpose in a geographic area where WPV/cVDPV is present or OPV is being used at the time of collection
- Products of such materials (above) from PV-permissive cells or experimentally infected polio-susceptible animals;
- Uncharacterized enterovirus-like cell culture isolates from human specimens from countries known or suspected to have circulating WPV/VDPV or use of OPV at the time of collection;
- Respiratory and enteric virus stocks derived from PV PIM and handled under conditions conducive to maintaining the viability or enabling the replication of incidental PV; and
- Environmental samples (i.e., concentrated sewage, wastewater) collected from areas known or suspected to have circulating WPV/VDPV or use of OPV at the time of collection.
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 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 six WHO regions: Africa, Americas, South-East Asia, Europe, Eastern Mediterranean, and Western Pacific.
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 Member State||Last Year of tOPV|
|United States of America||2000|
|Antigua and Barbuda||2016|
|Bosnia and Herzegovina||2016|
|Central Africa Republic (CAR)||2016|
|China (People’s Republic of)||2016|
|Democratic Republic Congo (DRC)||2016|
|Federated States of Micronesia||2016|
|Iran (Islamic Republic of)||2016|
|Lao People’s Democratic Republic (LPDR)/Laos||2016|
|Palau (Republic of)||2012|
|Papua New Guinea||2016|
|Republic of Korea||2004|
|Republic of Moldova||2016|
|Saint Kitts & Nevis||2016|
|Saint Vincent and the Grenadines||2016|
|Sao-Tome et Principe||2016|
|Syrian Arab Republic||2016|
|TFY Republic of Macedonia||2016|
|Trinidad and Tobago||2016|
|Turks and Caicos Islands||2016|
|UK of Great Britain and Northern Ireland||2004|
|United Arab Emirates||2016|
|Virgin Islands (UK)||2016|
|Wallis and Futuna||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.
|Various neuroblastoma (e.g. IMR-32, SK-N-MC)||Human|
|BGMK (sometimes referred to as BGM or GMK)||African green monkey|
|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|
|Old World Monkeys and higher primates|
|Human poliovirus receptor (PVR; CD155) transgenic mice|
|Autoclave||The use of moist steam under pressure is the most effective method for sterilizing laboratory materials.
|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:
*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 (email@example.com) 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 to Minimize Risks for Facilities Collecting, Handling or Storing Materials Potentially Infectious For Polioviruses
- Guidance for poliovirus potentially infectious materials (PIM)