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Volume 25, Number 7—July 2019
Historical Review

Facility-Associated Release of Polioviruses into Communities—Risks for the Posteradication Era

Ananda S. BandyopadhyayComments to Author , Harpal Singh, Jacqueline Fournier-Caruana, John F. Modlin, Jay Wenger, Jeffrey Partridge, Roland W. Sutter, and Michel J. Zaffran
Author affiliations: Bill & Melinda Gates Foundation, Seattle, Washington, USA (A.S. Bandyopadhyay, J.F. Modlin, J. Wenger, J. Partridge); World Health Organization, Geneva, Switzerland (H. Singh, J. Fournier-Caruana, R.W. Sutter, M.J. Zaffran); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (R.W. Sutter)

Main Article

Table 2

Reported incidents of poliovirus release from laboratories and vaccine production facilities in the post–polio vaccine era*

Year Location (reference) Source Poliovirus type No. cases Exposure
 Description
Primary Secondary Tertiary
1955
 United States (27,28)
 Vaccine production facility
 Not indicated
 164
 Vaccine recipients(≈40,000 children)
 113 contacts of the children
 NA
 “Cutter incident”; inadequate formaldehyde virus inactivation during poliovirus vaccine production (≈120,000 doses); ≈40,000 children experienced muscle weakness, of whom 51 experienced paralysis; 5 deaths; 113 contacts of the children were also paralyzed, of whom 5 died
1991
 France (29)
 Lab and
vaccine production facility
 WPV3 (Saukett) strain
 1
 No definitive information on exposure of case
 Saukett strain isolated in France from a woman from Algeria; source of this lab strain could not be confirmed
1992
 Netherlands (30)
 Vaccine production facility
 WPV1 (Mahoney) strain
 1
 Father (worker at facility)
 Son
 NA
 Boy (age 19 mo) with respiratory symptoms (no paralysis); father with history of accidental exposure to Mahoney strains while working in a poliovirus vaccine production facility
1993
 Netherlands (30)
 Vaccine production facility
 WPV3 (Saukett) strain
 1
 No definitive information on exposure of case
 Child with gastroenteritis (no paralysis); had travel history to France; no epidemiology established to trace lab exposure; Saukett strains typical for IPV production in France isolated from the stool samples
2000
 India (31–33)
 Lab and
vaccine production facility
 WPV2 (MEF-1) strain
 3
 No definitive information on exposure of case
 WPV2 isolates found in Sep 2000 and Nov 2002–Feb 2003 from 10 children with AFP, 1 healthy contact, and 1 environmental sample; isolates unrelated to all previous WPV2 strains found in India; because this was a lab reference strain and not a community-derived wild strain, lab source was suspected
2002–2003
 India (31–33)
 Lab and
vaccine production facility
 WPV2 (MEF-1) strain
 8
 No definitive information on exposure of case
2014
 Belgium (34,35)
 Vaccine production facility
 WPV3 (Saukett) strain
 0
 NA
 NA
 NA
 ≈1013 infectious WPV3 particles accidentally released into sewage system from production plant in Belgium; no poliovirus detected in environmental or human samples
2017 Netherlands (12) Vaccine production facility WPV2 (MEF-1) strain 1 Worker None None Accidental leakage in vaccine production room; 1 of 2 exposed staff members tested positive by RT-PCR

*Cases are defined as laboratory positive (with or without paralysis) for poliovirus by standard methods of virus isolation or known exposure to poliovirus. AFP, acute flaccid paralysis; IPV, inactivated poliovirus vaccine; lab, laboratory; MEF-1, wild poliovirus type 2 laboratory reference strain; NA, not applicable; RT-PCR, reverse transcription PCR; WPV, wild poliovirus; WPV1, wild poliovirus type 1; WPV2, wild poliovirus type 2; WPV3, wild poliovirus type 3.

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Page updated: June 17, 2019
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