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WHO global polio eradication effort recovers from setbacks
The WHO resolution to eradicate poliovirus worldwide saw significant progress during 2014 and earlier this year, after rebounding from major outbreaks the previous year.
“In 2013, the global polio eradication effort suffered setbacks with outbreaks in the Horn of Africa, Central Africa, and the Middle East; however, significant progress was made in 2014 in response to all three outbreaks,” investigator José E. Hagan, MD, of the CDC’s Epidemic Intelligence Service, and colleagues wrote. “Nonetheless, the affected regions remain vulnerable to wild poliovirus [WPV] re-importation from endemic areas and to low-level, undetected WPV circulation. Continued response activities are needed in these regions to further strengthen acute flaccid paralysis surveillance and eliminate immunity gaps.”
In 2012, WHO called the global eradication of poliovirus “a programmatic emergency for public health,” then reiterated in 2014 that the international spread of polio is “a public health emergency.”
WPV remains endemic in Nigeria, Afghanistan, and Pakistan, and there were 359 WPV cases reported worldwide during 2014 across nine countries. Significant progress has been made in Nigeria since 2012, with only six WPV cases reported during 2014, compared with 53 cases in 2013. Nigeria also has reported no new WPV cases since July 2014. These numbers indicate that the goal of eliminating indigenous WPV transmission, as well as eradicating all WPV transmission, is possible in the near term, the investigators wrote.
Afghanistan and Pakistan represent the largest challenges for WPV eradication. During 2014, cases reported in Afghanistan doubled to 28, with all but four cases resulting from importation from Pakistan. An alarming 306 WPV cases were reported in Pakistan during 2014, a 230% increase vs. 2013. However, from January through March 2015, only one case of WPV was detected in Afghanistan and 22 cases in Pakistan, compared with four and 59 cases, respectively, during the same time in 2014.
Violence against polio workers presented unprecedented challenges for the eradication of WPV in these areas. The researchers suggested that increased efforts to enhance security for public health workers and increased public demand are required for further progress to be made.
The remaining 19 cases of WPV reported during 2014, occurred in six polio-free countries, compared with 256 cases reported in five polio-free countries the previous year.
“With the progress achieved in 2014 to interrupt endemic WPV transmission in Nigeria and polio outbreaks in Africa and the Middle East, permanent interruption of global poliovirus transmission appears possible in the near future, provided that similar progress can be made in Afghanistan and Pakistan,” Hagan and colleagues wrote “Progress there would also reduce the risk for future importation-related outbreaks in polio-free countries.” – by David Costill
Disclosure: The researchers report no relevant financial
