Summary of the CDC Pilot Survey for Laboratories Containing Wild
Poliovirus

**[Initiation of Survey]{.underline}**

On January 29, 2001, a meeting was held at the Centers of Disease
Control and Prevention (CDC) with individuals from the National Centers
of Infectious Diseases (NCID) to discuss a CDC pilot survey for
laboratories containing wild polioviruses. Participants were:

Walter Dowdle Suzette Bartley Larry Anderson Bala Swaminathan

Alison Mawle Mark Rayfield Betty Robertson Mark Eberhard

Jonathan Richmond Brian Mahy Mark Pallansch Rich Knudson

Kim Koporc Dean Erdman Cheryl Bopp Dick Facklam

Sandra Browning Steve Monroe Joy Wells Roger Glass

Marty Cetron Jim LeDuc Jay Butler

Dr. Dowdle made a brief slide presentation discussing the concept and
rationale for effective containment of wild type polioviruses stored in
laboratories. He also discussed the importance and benefits of doing a
pilot survey at CDC. The participant response at this meeting was a high
degree of interest and willingness to participate. Issues raised at this
meeting concerned:

-   practicality of conducting a laboratory survey before all global
    eradication issues are resolved

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-   specific biosafety techniques to be used when working with
    poliovirus materials

-   possible use of neutralizing poliovirus antibodies when working with
    cultures

-   feasibility of conducting a study to determine if 10 of 100 fecal
    specimens collected in polio endemic countries from children under 5
    are positive for poliovirus

-   availability of enough BSL-3 containment centers to house OPV
    vaccine viruses once global eradication of polio is achieved

-   appropriateness of limiting search to only wild poliovirus

-   need to develop biosafety standards appropriate for procedure
    performed and material involved

Next steps developed from this initial polio containment meeting at CDC
included; development of a letter to be delivered to CDC's Director of
Science, in order to initiate the pilot survey at CDC, a proposed review
of polio collections identified by the survey to determine appropriate
biosafety recommendations for the operational risks of procedures being
performed, and proposed development of a process for inventory of
high-risk collections to ascertain poliovirus positivity.

**[Development of Survey Instruments]{.underline}**

At the next CDC meeting held on March 8, 2001 with a group of NCID
individuals most likely be involved in working with poliovirus, the
survey instruments and method for conducting the survey were discussed.
Individuals present at this meeting served as point individuals,
offering help when the pilot survey was conducted in NCID.

Participants:

Walter Dowdle Kim Koporc Olen Kew Mark Eberhard

Alison Mawle Sandra Browning Joy Wells Jon Gentsch

**[Presentation of Survey Packet]{.underline}**

On March 23^rd^, the survey packet was presented to Dr. David Fleming,
Deputy Director for Science and Public Health by:

Walter Dowdle Alison Mawle Kim Koporc

Dixie Snider Jonathan Richmond Sandra Browning

March 30^th^, Dr. Fleming sent a letter of introduction and the
Laboratory inventory to all CIO Directors, requesting their
participation in the pilot survey. The completed inventories were
returned to Jonathan Richmond, Director of the Office of Health and
Safety, who had been appointed as the CDC contact for the pilot survey.
Jonathan submitted the completed CDC Agency Inventory to the National
Program Office, NVPO on April 23rd.

**[Post-Survey Focus Group]{.underline}**

A final focus group meeting was held on May 15th with two NCID divisions
whose laboratories were both positive and negative for poliovirus
materials. Approximately 30 people attended this meeting. The purpose of
this meeting was to receive feedback on the use of the survey
instruments. The following comments received from individuals of the
focus group and from participants of the survey are being incorporated
to improve the new survey instruments.

-   The initial focus of the survey instrument addressed poliovirus and
    a majority of individuals automatically assumed that since they did
    not work with poliovirus, their laboratories were negative for
    poliovirus materials.

-   Communication of important information for people performing the
    inventory did not survive the trip through the organizational
    levels.

-   Clarification of infectious and potentially infectious materials is
    needed.

-   It is important to emphasize that blood and sera samples are not
    included in this survey unless collected from polio cases.

-   The list of disinfectants that destroy poliovirus should be
    complete.

-   Laboratories that stored no poliovirus materials were not inclined
    to complete and return a survey form.

-   The terms Supervisor and Head of Laboratory were used
    interchangeably to denote the person in charge of the laboratory.

-   In an agency with multiple CIO's containing numerous divisions,
    sections and branches, it is imperative to request a specific
    laboratory name, including the branch, section, division, and CIO.

-   It must be made clear that a laboratory "owning" specimens stored in
    a laboratory or facility not belonging to the agency, must still
    account for those specimens on their laboratory inventory.

-   Because of confusion concerning the request for a signature, the
    majority of participants chose to submit the forms by hardcopy
    rather than electronically.

-   The survey instruments do not FAX well and need to be made more user
    friendly.

-   The sign \> may be mistaken for a 7.

**[Conclusions:]{.underline}**

1.  Use of the word poliovirus will be avoided in initial wording of the
    survey instrument.

2.  All pertinent information must be included on survey instrument so
    that individuals performing the survey have adequate understanding
    of the process.

3.  Emphasizing the importance of participation of non-poliovirus
    laboratories will be addressed at the beginning of the survey
    instrument.

4.  The questions on the laboratory inventory will be more specific so
    that people utilizing the inventory forms will understand in intent
    of the survey.

5.  The laboratory survey will state that blood and sera specimens are
    not included in the survey unless these materials are from polio
    cases.

6.  Wording is needed to clarify that submission of the form
    electronically, with printed name rather than signature is
    preferred.

7.  Questions and answers are needed to address other issues concerning
    the survey.

8.  The website for the survey needs further development.

9.  Many people do not read directions, and those who do read; often
    choose not to follow the directions.