{"id":1731,"date":"2016-07-15T16:55:43","date_gmt":"2016-07-15T20:55:43","guid":{"rendered":"https:\/\/www.bu.edu\/research\/?page_id=1731"},"modified":"2024-06-13T11:47:47","modified_gmt":"2024-06-13T15:47:47","slug":"polio-agent-information-sheet","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/research\/ethics-compliance\/safety\/rohp\/agent-information-sheets\/polio-agent-information-sheet\/","title":{"rendered":"Polio Agent Information Sheet"},"content":{"rendered":"<p><span>Boston University<br \/>\nResearch Occupational Health Program (ROHP)<br \/>\n617-358-7647<\/span><\/p>\n<h2>Agent<\/h2>\n<p>Polio virus is the type species of the <em>Enterovirus<\/em> genus in the family <em>Picornaviridae. Enteroviruses <\/em>are transient inhabitants of the gastrointestinal tract, and are stable at an acidic pH. Picornaviruses are small with an RNA genome. There are three poliovirus serotypes (P1, P2, and P3). Immunity to one serotype does not produce immunity to the other serotypes.<\/p>\n<h3>Disease\/Infection<\/h3>\n<p>Poliomyelitis, polioencephalitis<\/p>\n<h3>Pathogenicity<\/h3>\n<p>Almost 95 percent of infections are asymptomatic. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralyzed, 5% to 10% die when their breathing muscles become immobilized.<\/p>\n<p>Polio virus principally affects motor neurons and autonomic neurons. Neuronal destruction is accompanied by an inflammatory infiltrate of polymorphonuclear leukocytes, lymphocytes, and macrophages. The lesions are characteristically distributed throughout the gray matter of the anterior horn of the spinal column and the motor nuclei of the pons and medulla. Clinical symptoms depend on the severity of lesions rather than on their distribution.<\/p>\n<ol><\/ol>\n<ul>\n<li><strong>Special Populations at Risk<br \/>\n<\/strong>Immune deficiency, malnutrition, pregnancy, children<\/li>\n<\/ul>\n<h3><strong> <\/strong>Biosafety Information<\/h3>\n<p><strong> <\/strong><strong>Risk Group\/BSL<br \/>\n<\/strong>Risk Group 2<br \/>\nBiosafety Level 2 Practices<\/p>\n<p><strong>Modes of Transmission<\/strong><\/p>\n<div class=\"responsive-table\"><table>\n<tbody>\n<tr>\n<td><\/td>\n<td>Transmission<\/td>\n<\/tr>\n<tr>\n<td>Skin Exposure (Needlestick, bite, or scratch):<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td>Mucous Membrane Splash to Eye(s), Nose or Mouth:<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td>Inhalation:<\/td>\n<td>Unlikely<\/td>\n<\/tr>\n<tr>\n<td>Ingestion:<\/td>\n<td>Yes<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n<p><strong> <\/strong><strong>Host Range\/Reservoir<br \/>\n<\/strong>No endogenous reservoir exist in the United States<\/p>\n<p><strong style=\"line-height: 1.5;\">Symptoms<br \/>\n<\/strong>Polio invades the nervous system, and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent.<\/p>\n<p>Polioencephalitis is rare and generally occurs in infants. Between 25-50% of survivors may develop postpolio syndrome experienced over their remaining life as muscle weakness and extreme fatigue.<\/p>\n<p><strong style=\"line-height: 1.5;\">Incubation period<br \/>\n<\/strong>9-12 days<\/p>\n<p><strong style=\"line-height: 1.5;\">Viability<br \/>\n<\/strong>Polio virus is resistant to inactivation by common laboratory disinfectants such as alcohol. The virus is rapidly destroyed by exposure to temperatures of 50\u00b0C or more, autoclaving or incineration. It is readily inactivated by dilute solutions of formaldehyde bleach and UV light. 0.5% bleach solution is recommended disinfectant.<\/p>\n<p><strong style=\"line-height: 1.5;\">Survival Outside Host<br \/>\n<\/strong>Polio virus is very stable at an acidic pH and can remain infectious for long periods of time in food and water.<\/p>\n<h2>Information for Lab Workers<\/h2>\n<h3>Laboratory PPE<\/h3>\n<p>Personal protective equipment includes but is not limited to laboratory coats or gowns, disposable gloves, and safety glasses. Face shields may be recommended based on risk assessment.<\/p>\n<h3>Containment<\/h3>\n<p>BSL-2 practices, containment equipment, and facilities are recommended for all activities utilizing wild polio virus infectious culture fluids, environmental samples, clinical materials, and potentially infectious materials collected for any purpose. Laboratory personnel working with such materials must have documented polio immunization. ABSL-2 practices, containment equipment, and facilities are recommended for studies of virulent viruses in animals.<\/p>\n<h3><strong> <\/strong>In Case of Exposure\/Disease<\/h3>\n<ul>\n<li><span style=\"font-size: 16px; line-height: 1.5;\">For injuries in the lab which are major medical emergencies (heart attacks, seizures, etc\u2026):<\/span><\/li>\n<li><strong style=\"line-height: 1.5;\">Medical Campus: call or have a coworker call the Control Center at 617-414\u20134144.<\/strong><\/li>\n<li><strong style=\"line-height: 1.5;\">Charles River Campus: call or have a coworker call campus security at 617-353-2121.<br \/>\n<\/strong>You will be referred to or transported to the appropriate health care location by the emergency response team.<\/li>\n<li><span style=\"line-height: 1.5;\">For lab exposures (needle sticks, bite, cut, scratch, splash, etc\u2026) involving animals or infectious agents, or for unexplained symptoms or illness <\/span><strong style=\"line-height: 1.5;\">call the ROHP 24\/7 hour number (1-617-358-ROHP (7647); or, 8-ROHP (7647) if calling from an on-campus location)<\/strong><span style=\"line-height: 1.5;\"> to be connected with the BU Research Occupational Health Program (ROHP) medical officer. ROHP will refer you to the appropriate health care location.<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">Under any of these scenarios, always inform the physician of your work in the laboratory and the agent(s) that you work with.<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">Provide the wallet-size agent ID card to the physician.<\/span><\/li>\n<\/ul>\n<h3>Vaccination<\/h3>\n<p>If potential exposure, check antibody to Polio.\u00a0 A positive antibody indicates protection.<br \/>\nIPV \u2013 Inactivated polio vaccine recommended if no antibody.<br \/>\nOPV \u2013 Oral Polio vaccine- No longer distributed in the United States<\/p>\n<h2>Information for First Responders\/Medical Personnel<\/h2>\n<h3><strong> <\/strong>Public Health Issues<\/h3>\n<p>Person to person transmission can occur through fecal oral route and via infected feces and body fluids. Contact precautions should be used.<\/p>\n<h3>Diagnosis\/Surveillance<\/h3>\n<p>Polioviruses usually can be isolated from throat secretions in the first week of illness and from feces, often for several weeks. In the absence of a viral isolate, the diagnosis of poliovirus infection can be established serologically by testing paired acute and convalescent sera for neutralizing antibodies to each of the three poliovirus serotypes. Serologic tests cannot distinguish between wild-type virus and vaccine virus infection. These viruses can be detected by PCR.<\/p>\n<h3><strong> <\/strong>First Aid\/Post Exposure Prophylaxis<\/h3>\n<p>Perform one of the following actions:<\/p>\n<div class=\"responsive-table\"><table>\n<tbody>\n<tr>\n<td>Skin Exposure (Needlestick or scratch):<\/td>\n<td>Immediately go to the sink and thoroughly wash the wound with soap and water for 15 minutes. Decontaminate any exposed skin surfaces with an antiseptic scrub solution.<\/td>\n<\/tr>\n<tr>\n<td>Mucous Membrane Splash to Eye(s), Nose or Mouth:<\/td>\n<td>Exposure should be irrigated vigorously.<\/td>\n<\/tr>\n<tr>\n<td>Splash Affecting Garments:<\/td>\n<td>Remove garments that may have become soiled or contaminated and place them in a double red plastic bag.<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n<h3>Treatment<\/h3>\n<p>There is no specific treatment for polio. Persons infected with polio need supportive therapy, such as bed rest and fluids. Severe paralytic disease impacting diaphragm may require mechanical ventilation.<\/p>\n<h3>References<\/h3>\n<p>CDC \u2013 Polio Fact sheet http:\/\/www.cdc.gov\/vaccines\/parents\/diseases\/child\/polio.html<strong>\u00a0<\/strong><\/p>\n<p>Biosafety in Microbiological and Biomedical Laboratories\u00a0(BMBL) 5th Edition. US Government Printing Office, Washington, 2007.<\/p>\n<p>Willey, Microbiology 7<sup>th<\/sup> edition, McGraw Hill, 2008<\/p>\n<p>Mandell, Douglas, and Bennett\u2019s Principles and practices of Infectious Disease 6<sup>th<\/sup> Edition, Elsevier, 2005.<\/p>\n<p>WHO Action Plan for laboratory containment of wild polio viruses, second edition &#8211; \u00a0 <a href=\"https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/68205\/WHO_V-B_03.11_eng.pdf\">https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/68205\/WHO_V-B_03.11_eng.pdf<\/a><\/p>\n<p>Pallansch, M.A. &amp; Oberste, M.S. &amp; Lindsay Whitton, J. (2013). Enteroviruses: Polioviruses, coxsackieviruses, echoviruses, and newer enteroviruses. Fields Virology. 490-530.<\/p>\n<p>Revised: 5\/13\/19<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Boston University Research Occupational Health Program (ROHP) 617-358-7647 Agent Polio virus is the type species of the Enterovirus genus in the family Picornaviridae. Enteroviruses are transient inhabitants of the gastrointestinal tract, and are stable at an acidic pH. Picornaviruses are small with an RNA genome. There are three poliovirus serotypes (P1, P2, and P3). Immunity [&hellip;]<\/p>\n","protected":false},"author":11959,"featured_media":0,"parent":5281,"menu_order":46,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/1731"}],"collection":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/users\/11959"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/comments?post=1731"}],"version-history":[{"count":12,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/1731\/revisions"}],"predecessor-version":[{"id":52746,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/1731\/revisions\/52746"}],"up":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/5281"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/media?parent=1731"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}