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Containment of Polioviruses After Eradication and OPV Cessation: Characterizing Risks to Improve Management

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  • Walter Dowdle
  • Harrie Van Der Avoort
  • Esther De Gourville
  • Francis Delpeyroux
  • Jagadish Desphande
  • Tapani Hovi
  • Javier Martin
  • Mark Pallansch
  • Olen Kew
  • Chris Wolff

Abstract

The goal of the World Health Organization is to stop routine use of oral poliovirus vaccine shortly after interruption of wild poliovirus transmission. A key component of this goal is to minimize the risk of reintroduction by destruction of polioviruses except in an absolute minimum number of facilities that serve essential functions and implement effective containment. Effective containment begins with a complete facility risk assessment. This article focuses on characterizing the risks of exposure to polioviruses from the essential vaccine production, quality control, and international reference and research facilities that remain. We consider the potential exposure pathways that might lead to a poliovirus reintroduction, including para‐occupational exposures and releases to the environment, and review the literature to provide available estimates and a qualitative assessment of containment risks. Minimizing the risk of poliovirus transmission from a poliovirus facility to increasingly susceptible communities is a crucial and ongoing effort requiring understanding and actively managing the potential exposure pathways.

Suggested Citation

  • Walter Dowdle & Harrie Van Der Avoort & Esther De Gourville & Francis Delpeyroux & Jagadish Desphande & Tapani Hovi & Javier Martin & Mark Pallansch & Olen Kew & Chris Wolff, 2006. "Containment of Polioviruses After Eradication and OPV Cessation: Characterizing Risks to Improve Management," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1449-1469, December.
    • Handle: RePEc:wly:riskan:v:26:y:2006:i:6:p:1449-1469
    DOI: 10.1111/j.1539-6924.2006.00844.x
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    References listed on IDEAS

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    1. Joseph N. Eisenberg & Edmund Y. W. Seto & Adam W. Olivieri & Robert C. Spear, 1996. "Quantifying Water Pathogen Risk in an Epidemiological Framework," Risk Analysis, John Wiley & Sons, vol. 16(4), pages 549-563, August.
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    Cited by:

    1. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Dominika A. Kalkowska & Steven G. F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Characterizing Poliovirus Transmission and Evolution: Insights from Modeling Experiences with Wild and Vaccine‐Related Polioviruses," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 703-749, April.
    2. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Review and Assessment of Poliovirus Immunity and Transmission: Synthesis of Knowledge Gaps and Identification of Research Needs," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 606-646, April.
    3. Kimberly M. Thompson, 2006. "Poliomyelitis and the Role of Risk Analysis in Global Infectious Disease Policy and Management," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1419-1421, December.
    4. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Konstantin M. Chumakov & Neal A. Halsey & Tapani Hovi & Philip D. Minor & John F. Modlin & Peter A. Patriarca & Roland W. Sutter & Peter F. Wright & S, 2013. "Expert Review on Poliovirus Immunity and Transmission," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 544-605, April.
    5. Thomas R Hird & Nicholas C Grassly, 2012. "Systematic Review of Mucosal Immunity Induced by Oral and Inactivated Poliovirus Vaccines against Virus Shedding following Oral Poliovirus Challenge," PLOS Pathogens, Public Library of Science, vol. 8(4), pages 1-9, April.
    6. Kimberly M. Thompson, 2013. "Modeling Poliovirus Risks and the Legacy of Polio Eradication," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 505-515, April.

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