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Global polio eradication on horizon, international efforts needed
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Eighty percent of the world population lives in regions considered polio-free by WHO, according to recent data published in the Journal of Infectious Diseases.
There were 1,604 cases of wild poliovirus reported in 23 countries in 2009; 1,352 cases reported in 20 countries in 2010; 650 cases reported in 16 countries in 2011 and 223 cases reported in 5 countries in 2012. Wild poliovirus increased in 2013 to 416 cases reported in 13 countries.
Despite increases, the number of reported polio-affected districts decreased from 481 in 2009 to 126 in 2013, indicating a 74% decrease in affected areas worldwide. The number of endemic countries affected by polio decreased from 304 in 2009 to 63 in 2013, an estimated 79% decrease.
Detection of cases of wild poliovirus type 1, reported in 19 countries in 2010, decreased to 16 countries in 2011 and 5 countries in 2012. Wild poliovirus type 1 was detected in 8 countries in 2013.
In 2010, wild poliovirus type 3 was present in 7 countries. Use of bivalent oral poliovirus vaccines significantly increased during 2010 to 2012, and its efficacy is indicated by a significant decrease in cases of wild poliovirus type 3. In 2011, wild poliovirus type 3 was detected in 6 countries; however, in 2012, wild poliovirus type 3 was detected only in Pakistan and Nigeria. As of Sept. 17, 2014, the last case of wild poliovirus type 3 globally detected was in Nigeria in November 2012.
In March 2014, WHO Southeast Asia region was certified as free of indigenous wild poliovirus, joining the American, Western Pacific and European regions.
Widespread use of bivalent oral poliovirus vaccines was a key factor in reducing wild poliovirus cases around the world, according to researchers. Implementation of emergency action plans in affected countries was another contributing factor.
Moving forward, challenges to successful polio eradication include: 1) threats to the security of vaccinators and a ban on polio vaccination in areas of Afghanistan and Pakistan; 2) possible decreased government commitment; and 3) remaining surveillance gaps, according to researchers.
“Urgently needed improvements in accessing and vaccinating children in insecure and conflict-affected areas will require enhancing the engagement of international bodies, religious leaders, and humanitarian actors to implement area-specific plans, generate greater community demand and participation, and adapt activities to local contexts,” study researcher Steven G. F. Wassilak, MD, of the CDC, and colleagues wrote.
Complete eradication of poliovirus is near, according to researchers. “All evidence points to the technical and operational feasibility of eradication. At no time in the past has this been so close,” they concluded.
Disclosure: The researchers report no relevant financial disclosures.
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