Poliovirus containment high on agenda of European Regional Polio Laboratory Network meeting

WHO/Alex Shpigunov

With only 11 cases of wild poliovirus reported so far this year, global poliomyelitis (polio) eradication has become imminent. As this milestone approaches, laboratories of the WHO European Regional Polio Laboratory Network (EPLN) play an increasingly critical role in ensuring safe containment of potentially infectious poliovirus materials and in maintaining high-quality laboratory surveillance to detect any polio cases.

The WHO European Region has the highest number of polio vaccine-manufacturing and research facilities in the world. The process of poliovirus containment was therefore a main topic of discussion at EPLN’s annual meeting on 29–31 August 2017 in Copenhagen, Denmark. Representatives from 36 countries met staff from WHO headquarters and international partner agencies to review and discuss:

  • progress in poliovirus containment;
  • recommendations from the 31st meeting of the European Regional Certification Commission for Poliomyelitis Eradication;
  • performance quality assurance and annual accreditation.

Containment progress

Countries choosing to retain polioviruses for research or vaccine production must fulfil requirements established in the WHO global action plan to minimize poliovirus facility-associated risk after type-specific eradication of wild polioviruses and sequential cessation of routine oral polio vaccine use (GAPIII). Progress is being made towards GAPIII requirements, but implementation needs to be accelerated to meet the established timeline. In the European Region 12 Member States have indicated they intend to establish a total of at least 37 poliovirus essential facilities (PEFs), 12 of which will be vaccine-manufacturing facilities.

Additional steps include establishment of the Containment Working Group and the Containment Advisory Group of the Global Certification Commission. Mechanisms for the certification of PEFs by national authorities for containment (NACs) have been established and detailed guidelines for establishing and certifying PEFs have been produced.

A spill of poliovirus-infectious materials and response measures taken at a vaccine-production facility in the Netherlands in early 2017 provided valuable lessons for all countries, particularly those hosting vaccine-production facilities.

The deliberations of the EPLN meeting will serve as the foundation for a dedicated plenary session on poliovirus containment at the upcoming European regional meeting of national immunization programme managers (24–26 October 2017) to promote countries’ continued efforts to ensure safe and secure work with polioviruses.

Further outcomes of the meeting

All laboratories in the Region passed the 2016 poliovirus isolation proficiency test and their WHO accreditation has been reaffirmed for 2017. The next accreditation round is scheduled to begin in March 2018. The revised laboratory testing algorithm for isolation of polioviruses has been successfully adopted by all laboratories in the Region and the new intratypic differentiation (ITD) 5.0 algorithm has been adopted by all laboratories conducting ITD.

All WHO laboratories were recommended to review and, if necessary, update their preparedness plans for a sudden increase of sample numbers in the event of importation/outbreak detection.

Progress continues

Significant progress has been made since the close of the meeting, including destruction of poliovirus type 2 materials in Lithuania, nomination of an NAC in Belgium and the decision by Croatia not to designate a PEF in the country. Several PEFs are preparing to submit their applications to NACs to initiate the certification process in accordance with the GAPIII Containment Certification Scheme.

All these developments contribute significantly to the reduction of poliovirus-associated biorisk in the Region and WHO/Europe commends the respective governments for their continued commitment to the containment process.