In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Among the three wild poliovirus (WPV) types (type 1, type 2, and type 3), WPV type 2 (WPV2) has been eliminated in the wild since 1999, and WPV type 3 (WPV3) has not been reported since 2012. In 2015, only Afghanistan and Pakistan have reported WPV transmission. On May 25, 2015, all WHO Member States endorsed World Health Assembly resolution 68.3 on full implementation of the Polio Eradication and Endgame Strategic Plan 2013-2018 (the Endgame Plan), and with it, the third Global Action Plan to minimize poliovirus facility-associated risk (GAPIII). All WHO Member States have committed to implementing appropriate containment of WPV2 in essential laboratory and vaccine production facilities* by the end of 2015 and of type 2 oral poliovirus vaccine (OPV2) within 3 months of global withdrawal of OPV2, which is planned for April 2016. This report summarizes critical steps for essential laboratory and vaccine production facilities that intend to retain materials confirmed to contain or potentially containing type-specific WPV, vaccine-derived poliovirus (VDPV), or OPV/Sabin viruses, and steps for nonessential facilities† that process specimens that contain or might contain polioviruses. National authorities will need to certify that the essential facilities they host meet the containment requirements described in GAPIII. After certification of WPV eradication, the use of all OPV will cease; final containment of all polioviruses after polio eradication and OPV cessation will minimize the risk for reintroduction of poliovirus into a polio-free world.

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I have been a strong advocate, for many years, for the merits of IPV for the control of poliomyelitis, and the ultimate eradication of the disease and of poliovirus from the environment (Beale AJ. Poliovaccines: time for a change in immunization policy? Lancet 1990; 335:839-842). I have also recognized how fortunate we are in the Public Health field to have such an excellent vaccine as Sabin\'s OPV. Dr. Foege has argued aloquently and cogently for an approach that uses both vaccines: OPV and IPV. The EPI programme has used 3 or 4 doses of OPV, but in a number of developing countries this has proved inadequate to provide satisfactory control. In South America the use of 10 or more doses has been required to bring the disease under control. A combined approach of using killed poliovaccine combined in DTP and three doses of OPV seems to be the preferred consensus solution. It would cause the minimum and, hopefully, no disruption of the existing programmes of the EPI. It would almost certainly bring forward the day when poliomyelitis will be controlled and the disease at least will be eradicated. It is clear that the sooner this is done the better. It is cheaper to do it now, although it requires more funds in the short term; and it is better for the children of the world--present and future. The extra cost of putting IPV into DTP is probably about one US$ per course, which is probably no more expensive than giving six more doses of OPV, when the total costs of administration are considered.(ABSTRACT TRUNCATED AT 250 WORDS)

This communication is the third in a four-part series on nosocomial viral infections from the Strong Memorial Hospital. This third article discusses guidelines for prevention and control of exanthematous viruses, gastroenteritis, viruses, adenoviruses and the picornaviruses other than rhinoviruses. Several uncommonly seen viruses, such as the virus of Creutzfeldt-Jakob disease and Marburg, Ebola, and Lassa fever viruses, also are reviewed briefly.

I have tried to summarize the spirit of the Centers for Disease Control Guideline for Infection Control in Hospital Personnel. By eliminating certain unnecessary practices and preventing one infectious disease, we could have saved the hospital in these examples more than $18,000 in just 1 year. We must continue to evaluate and eliminate unnecessary practices while maintaining a safe environment for our employees.