A novel semi-quantitative methodology for national poliovirus reintroduction and outbreak risk assessment

• Published in: Travel medicine and infectious disease Vol. 44; p. 102181
• Main Authors: Camphor, Hendrik S., Bareja, Christina, Glynn-Robinson, Anna, Polkinghorne, Benjamin G., Durrheim, David N.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.11.2021; Elsevier Limited
• Subjects: Australia - epidemiology; Certification; Disease control; Disease Outbreaks - prevention & control; Epidemics; Health surveillance; Humanitarianism; Humans; Infectious diseases; International regulations; Laboratories; Methodology; Methods; Outbreaks; Poliomyelitis; Poliomyelitis - epidemiology; Poliomyelitis - prevention & control; Poliovirus; Population; Population Surveillance; Public health; Reintroduction; Risk Assessment; Risk management; Sanitation; Security; Travel medicine; Vaccines; Australia; Methodology; Poliovirus; Risk assessment
• ISSN: 1477-8939; 1873-0442
• DOI: 10.1016/j.tmaid.2021.102181

Under the International Health Regulations (2005), World Health Organization Member States need to verify certification of polio–free status annually. In 2018, Australia sought to reassess and comprehensively characterise the risk posed by wild-type and vaccine-derived poliovirus introductions to national health security. However formal guidelines for national polio risk assessment were not publicly available. Four risk elements were identified and weighted using an expert-informed modified Delphi method: reintroduction hazard; population susceptibility; detection capability; and response capability. Australian data and qualitative evidence were analysed, documented and scored against risk element indicators to characterise polio risk as a semi–quantitative estimate and qualitative risk category statement. The semi-quantitative risk characterisation calculated likelihood and impact scores of 0.43 and 0.13, respectively (possible range: 0.02–4.5). The assessment concluded that the risk of poliovirus reintroduction, resultant outbreaks of poliovirus infection, and sustained transmission occurring in Australia is very low. Until poliovirus is eradicated, it remains in countries’ strategic health security interest to maintain optimal investment in polio prevention, preparedness, surveillance and response capability to manage their level of risk. We present a structured, transparent and reproducible methodology for national or sub-national polio risk characterisation that generates evidence for targeted investment to maintain polio-free status. •A novel, transparent and reproducible methodology for national or sub-national polio risk characterisation was developed.•Australian data and qualitative evidence on poliomyelitis risk were analysed, documented and scored against risk element indicators.•Risk elements included reintroduction hazard, population susceptibility, detection capability; and response capability.•The risk of poliovirus reintroduction, outbreaks and sustained transmission occurring in Australia is very low.