Expanded programme on immunization

Fifth Meeting on Vaccine-Preventable Diseases Laboratory Networks and Poliovirus Biorisk Management Training in the Western Pacific Region

25-30 May 2015, Manila, Philippines

The Fifth Meeting on Vaccine-Preventable Diseases Laboratory Networks and Poliovirus Biorisk Management Training in the Western Pacific Region was held in Manila, the Philippines from 25 to 30 May 2015 to review the performance and identify the challenges of the polio and measles/rubella network laboratories in the Region and to hold a four-day training to implement biorisk management for laboratories holding wild and oral polio vaccine (OPV)/Sabin poliovirus materials.

The Laboratory Networks meeting reviewed ways to strengthen the performance of network laboratories and also to monitor implementation of recommendations from the fourth vaccine-preventable diseases laboratory networks meeting in 2013. The meeting also provided an opportunity to discuss ways to improve the quality and timeliness of laboratory testing among network laboratories including the subnational laboratories in China.

A two-day session for the polio laboratory network in the Western Pacific Region was organized to discuss global progress towards polio eradication, to identify challenges in maintaining polio-free status in the Western Pacific Region, to share updates on global and regional polio laboratory networks, to review the performance of the polio network laboratories and to discuss the implementation of new requirements. The session included presentations on the polio endgame strategy and updates on the polio eradication initiative, detection of vaccine-derived polio viruses (VDPVs), experiences with real-time reverse transcription polymerase chain reaction (rRT-PCR) and sequencing among ITD laboratories, laboratory quality assurance, enhanced ITD techniques providing greater sensitivity, detection of polioviruses from non-acute flaccid paralysis (AFP) cases, experiences of the polio laboratory network for the laboratory diagnosis of hand, foot and mouth disease (HFMD), biorisk management, data management and country reports.

The meeting concluded that the performance of the regional polio laboratory network has been sustained at polio-free-certification standard and that AFP surveillance activities have been efficiently supported. The network laboratories provided critical evidence in support of the continued polio-free status of the Region. As of March 2015, all 43 network laboratories are fully accredited including all 33 polio laboratories with ITD function. All ITD laboratories passed the ITD proficiency test (PT), and 22 ITD laboratories scored 100%. Six ITD laboratories also participated in polio sequencing PT, and four ITD laboratories scored 100%. It is planned that seven laboratories will participate in polio sequencing (PT) in 2015.

Since the Western Pacific Region has been polio-free for more than 10 years, network laboratories have been actively involved in supplementary enterovirus or environmental surveillance. In particular, China established a very extensive HFMD laboratory network based on existing polio laboratories. The polio laboratories in Australia, Japan and Malaysia were involved in testing samples from environmental surveillance and China’s polio network laboratories are performing environmental surveillance in nine provinces with a further two to start shortly. In the Region in 2014, China detected four VDPVs in AFP cases and the Philippines one VDPV2, none of which were considered to be circulating. The continued use of environmental and enterovirus surveillance in a number of countries and areas in the Region has provided valuable data to support evidence of the continued polio-free status of the Region.

Tremendous efforts have been made towards polio eradication with support from the polio laboratory network. Continuous strong quality assurance procedures and training activities are being implemented in the Region ensuring high performance, high-quality laboratory support.

The Global action plan (GAP III) was endorsed by Sixty-eighth World Health Assembly in May 2015. GAP III establishes the long-term goal to minimize poliovirus facility-associated risk after type-specific eradication of wild polioviruses and sequential cessation of OPV use by reducing the number of facilities holding poliovirus to a minimum. The implementation of GAP III will be done in phases and WHO Regional Office for the Western Pacific is organizing a series of trainings for stakeholders to assist with implementation.