WHO has confi rmed an outbreak of at least ten cases of polio in Syria, where vaccination coverage has dramatically decreased during the civil war. Furthermore, wild-type poliovirus 1 (WPV1) has been isolated from sewage and faeces from asymptomatic carriers in Israel since February, 2013. Tourists and travellers could bring the infection to other countries. Precautions during the Hajj in Saudi...

Background Recent detections of circulating serotype 2 vaccine-derived poliovirus in northern Nigeria (Borno and Sokoto states) and Pakistan (Balochistan Province) and serotype 1 wild poliovirus in Pakistan, Afghanistan, and Nigeria (Borno) represent public health emergencies that require aggressive response. Methods We demonstrate the importance of undervaccinated subpopulations, using an ex...

With eradication almost within reach, the importance of detecting every poliomyelitis case has taken on additional significance. The selected surveillance strategy must be effective and efficient. A review of polio surveillance in Australia was conducted to consider whether current strategies were optimal. Document review and semi-structured key informant interviews were used to conduct the rev...

While seven years have passed since 2000, the target set for the eradication of polio, success remains elusive. In 2006, despite coordinated international efforts, there was no major breakthrough in containing the polio virus, which persists in a few pockets in the four countries in which it is endemic. The polio eradication programme faces new hurdles such as importation, re-emergence and fail...

The Global Polio Eradication Initiative (GPEI) was established in 1988 by the World Health Assembly to interrupt transmission of wild poliovirus (WPV); completion of this initiative was declared a programmatic emergency of public health in January 2012. Polio cases are detected through surveillance for acute flaccid paralysis (AFP) with linked stool specimens tested for polioviruses (PVs) at ac...

Global efforts to eradicate polio began in 1988 and have been successful in all but two of the six World Health Organization (WHO) regions. Within these two regions (African and Eastern Mediterranean), three countries (Afghanistan, Nigeria, and Pakistan) have never interrupted transmission of wild poliovirus (WPV). Outbreaks following importation of WPV from these countries occurred in the Horn...

A fundamental complexity of polio eradication is that the elimination of wild poliovirus (WPV) alters the risk-benefit profile of using oral polio vaccine (OPV)—as WPV is eliminated, OPV produces an increasing proportion of the paralytic disease burden since, in rare instances, OPV causes paralysis in vaccine recipients and generates circulating vaccine-derived polio outbreaks (cVDPV) in under-...

With increase in the number of polio cases, Nigeria serves as the primary threat to a polio free world. The “good” the bad” and “the ugly” aspects of polio vaccination in Nigeria is discussed. In the ‘good’ aspect the number of wild poliovirus cases declined by over 90%, cVDPV 2 cases declined by 82%. Similarly, genetic clusters of both wild poliovirus type 1 and type 3 have reduced form 18 and...

1 Representative of the Director-General for Polio Eradication, World Health Organization, Geneva, Switzerland (email: [email protected]). The articles in this theme issue of the Bulletin address the complex policies of polio eradication. The end of wild poliovirus transmission is not the end of the story, as certification of eradication, laboratory containment, vaccination policy, and sustainab...

Appropriate response to polio outbreaks represents an important prerequisite for achieving and maintaining global polio eradication. We use an existing dynamic disease transmission model to evaluate the impact of different aspects of immunization campaigns in response to polio outbreaks occurring in previously polio-free areas. This analysis yields several important insights about response stra...