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Since the 1988 World Health Assembly resolution to eradicate poliomyelitis, (1) three WHO regions (Americas, Europe and Western Pacific) have been certified polio-free, and the number of countries where polio is endemic has decreased from 125 in 1988 to 6 in 2003 (Afghanistan, Egypt, India, Niger, Nigeria and Pakistan). In anticipation of a polio-free world, the Fifty-second World Health Assembly passed a resolution recommending that all Member States "begin the process leading to the laboratory containment of wild poliovirus in maximum containment laboratories". (2)
As at 31 December 2003, 194 of 214 countries and areas had formally appointed a national task force for laboratory containment activities. Of these, 157 are conducting a survey of laboratories and 81 have completed the survey and compiled national inventories of laboratories found to be holding materials containing infectious or potentially infectious wild poliovirus. This report describes the survey and inventory and results obtained in in the United States--one of the most challenging countries for poliovirus containment because of its large and highly developed laboratory infrastructure. In October 2002, the United States Department of Health and Human Services (USDHHS) sent letters and surveys to 32 429 biomedical institutions/laboratories (3) listed in multiple databases. The purpose of the mailing was to alert laboratories to the impending global eradication of polio, to encourage disposal of unneeded wild poliovirus materials and to establish a national inventory of institutions/laboratories retaining such materials. The purpose of the national inventory is to maintain a current list of institutions/laboratories that would be kept informed of eradication progress and the need to implement appropriate poliovirus containment procedures.
In the survey, the institutions/laboratories were categorized as (a) those most likely to possess wild poliovirus materials (academic, government, industrial and state/local public health institutions), (b) those that may possess such materials (clinical laboratories certified for complex testing in microbiology) and (c) those least likely to possess (clinical laboratories certified for non-complex testing in microbiology). The purpose of including the least likely to possess category in the survey was to quantify the risk of stored wild poliovirus materials in small clinical laboratories licensed to perform non-complex tests (e.g. private physicians' offices). Institutions/laboratories were asked to review records, to search storage areas and to provide electronically, by mail or by fax the numbers of laboratories included in the search and the names of laboratories storing wild poliovirus materials, together with the types of materials and the amounts. Institutions/laboratories not responding by the specified date were reminded by follow-up letters and telephone calls.
Total responses in the three categories represented 105 356 individual laboratories. All (100%) of the 5585 institutions/ laboratories in the categories of most likely to possess and may possess wild poliovirus materials responded to the survey; 90% (24 206 of 26 844) of the institutions/ laboratories categorized as least likely to possess such materials also responded (Table 1). Because none of the 24 206 responders reported storing wild poliovirus materials, follow-up of the remaining 2638 (many of which were no longer in business) was discontinued.
The quality and completeness of the survey and inventory were validated by a search of …