[41] Even with the express support of political leaders, polio workers or their accompanying security guards have been kidnapped, beaten, or assassinated. Well over 10 million cases have been averted since large-scale administration of oral polio vaccine began 20 years ago.”. [29] Czechoslovakia became the first country in the world to scientifically demonstrate nationwide eradication of poliomyelitis in 1960. [78], Much of the work towards eradication was documented by Brazilian photographer Sebastião Salgado, as a UNICEF Goodwill Ambassador, in the book The End of Polio: Global Effort to End a Disease. This page was last edited on 8 March 2021, at 20:10. Wild poliovirus has nearly been eradicated in Africa thanks to successful vaccination efforts in Nigeria, the Centers for Disease Control and Prevention revealed in a new report Thursday. [161][166] Wild poliovirus of Pakistani origin[167] also spread to Iran where it was detected in several environmental samples. Cases caused by vaccine-derived poliovirus were reported in seven countries, with almost 100 total cases. There were 176 WPV1 paralysis cases detected in 2019: 29 in Afghanistan and 147 in Pakistan. Officials credit the drop in new infections to improved political control in the southern states and resumed immunisation in the north, where Muslim clerics led a boycott of vaccination in late 2003. [97], In July 2007, a student traveling from Pakistan imported the first polio case to Australia in over 20 years. [174] While in the past cVDPV outbreaks tended to remain localized, significant international spread of these strains is now being observed. Polio now survives only among the world's poorest and most marginalized communities, where it stalks the most vulnerable children. Must I stay with him? Further, a novel oral vaccine targeting type 2 (nOPV2) that has been genetically stabilized to make it less prone to give rise to circulating vaccine-derived strains is under development. Succ… At this time, the Indian state Uttar Pradesh accounted for nearly two-thirds of total worldwide cases reported. There were 32 circulating vaccine-derived poliovirus (cVDPV) cases in 2015. [58] This can be due to chance, limited surveillance and under-vaccinated populations. Surging cases have dashed all hope that polio might be eradicated in 2019. The weakened virus used to make the oral vaccine can sometimes survive in populations that are under-immunized, and if it circulates long enough, it can morph back into a dangerous form. According to the concept of herd immunity, the population for whom the vaccine fails is still protected by the immunity of those around them. CS1 maint: DOI inactive as of January 2021 (, Centers for Disease Control and Prevention, United States Agency for International Development, List of diseases eliminated from the United States, Mathematical modelling of infectious disease, "Rinderpest virus has been wiped out, scientists say", "GPEI-Two out of three wild poliovirus strains eradicated", "Eradication versus control: the economics of global infectious disease policies", "Recommendations of the International Task Force for Disease Eradication", "Global Disease Elimination and Eradication as Public Health Strategies. "[41], One factor contributing to the continued circulation of polio immunization programs has been opposition in some countries. [39] The risk of vaccine-derived polio will persist long after the switch to inactivated vaccine, as a small number of chronic excretors continue to produce active virus for years (or even decades) after their initial exposure to the oral vaccine. [153] The majority of cases were caused by cVDPV2 strains that were able to arise or spread as a consequence of the withdrawal of the PV2 strain from the standard vaccination regimen. [87], In 2002, an outbreak of polio occurred in India. These were limited to five countries—Nigeria, Pakistan, Afghanistan, Chad, and Niger—of which all except Nigeria had fewer cases than in 2011. [160][161] Transborder migration continued to play a role in polio transmission in the two countries. [1] These organizations, along with the U.S. Centers for Disease Control and Prevention (CDC) and The Gates Foundation, have spearheaded the campaign through the Global Polio Eradication Initiative (GPEI). Polio incidence has dropped more than 99 percent since the launch of global polio eradication efforts in 1988. Good news for a gloomy time: Polio has been eradicated from Africa. On Tuesday, Africa has been declared free of the last remaining strain of wild poliovirus. With the start of World Polio Eradication Initiative in 1988, the number of polio cases has been reduced up to 99% worldwide until now. An acute outbreak in Tajikistan gave rise to 460 cases (34% of the global total), and was associated with a further 18 cases across Central Asia (Kazakhstan and Turkmenistan) and the Russian Federation, with the most recent case from this region being reported from Russia 25 September. India has not had a case single case of wild polio virus since 2011. Eradication of polio has been defined in various ways—as elimination of the occurrence of poliomyelitis even in the absence of human intervention,[8] as extinction of poliovirus, such that the infectious agent no longer exists in nature or in the laboratory,[9] as control of an infection to the point at which transmission of the disease ceased within a specified area,[8] and as reduction of the worldwide incidence of poliomyelitis to zero as a result of deliberate efforts, and requiring no further control measures. [20] This combined IPV/OPV approach has also been used in outbreak suppression. Two out of three strains of wild polio virus have been eradicated worldwide. Children in developed countries only get the shot, but they need four doses to be completely protected. Stopping polio transmission has been pursued through a combination of routine immunization, supplementary immunization campaigns and surveillance of possible outbreaks. (1993) The Immunological Basis for Immunization Series. Prevention of disease spread is accomplished by vaccination. Two distinct methods are used in tandem: acute flaccid paralysis (AFP) surveillance and environmental surveillance. [60] Therefore, even a single case is considered an epidemic. [17][18] Because of its route of administration, it induces an immunization of the intestinal mucosa that protects against subsequent infection, though multiple doses are necessary to achieve effective prophylaxis. This resulted in the suspension of immunization efforts in the state, causing a dramatic rise in polio rates in the already endemic country. [170] Individual new outbreaks of cVDPV2 also caused more than a dozen paralysis cases each in Pakistan[153] and the Philippines,[171][172] while smaller outbreaks struck Chad, China and Zambia. [79], In 1988, the World Health Organization (WHO), together with Rotary International, UNICEF, and the U.S. Centers for Disease Control and Prevention (CDC) passed the Global Polio Eradication Initiative (GPEI), with the goal of eradicating polio by the year 2000. The reemergence of polio led to stepped up vaccination campaigns. Recent polio cases arise from two sources, the original 'wild' poliovirus (WPV), and mutated oral vaccine strains, so-called circulating vaccine-derived poliovirus (cVDPV). Active surveillance for poliovirus through reporting and laboratory testing of all cases of acute flaccid paralysis. Several international organizations like the WHO, the UNICEF, CDC, Rotary International, an… As a result of such circulating vaccine-derived poliovirus (cVDPV) strains, polio outbreaks have periodically recurred in regions that have long been free of the wild virus, but where vaccination rates have fallen. Polio is a debilitating disease caused by the poliovirus. In Afghanistan and Pakistan, the researchers concluded that the most significant barrier was insecurity, but that managing human resources, political pressures, the movement of large populations between and within both countries, and inadequately resourced health facilities also posed problems, as did technical issues with the vaccine. Two out of three strains of wild polio virus have been eradicated worldwide. In 2009, a total of 1,606 cases were reported in 23 countries. The solution is the same for all polio outbreaks: immunize every child several times with the oral vaccine to stop polio transmission, regardless of the origin of the virus,” WHO said. [58], The WPV2 virus was declared eradicated in September 2015 as it had not been detected in circulation since 1999[68] and WPV3 was declared eradicated in October 2019,[7] having last been detected in 2012. The poliovirus type 1 infection occurred in an unvaccinated, immunocompromised infant girl aged seven months (the index patient) in an Amish community whose members predominantly were not vaccinated for polio. Then came a threat from President Trump", https://en.wikipedia.org/w/index.php?title=Polio_eradication&oldid=1011059603, Infectious diseases with eradication efforts, Public Health Emergency of International Concern, CS1 maint: DOI inactive as of January 2021, Articles containing potentially dated statements from 2020, All articles containing potentially dated statements, Wikipedia articles scheduled for update tagging, Wikipedia articles needing clarification from February 2021, All articles with vague or ambiguous time, Vague or ambiguous time from October 2019, Articles with unsourced statements from May 2017, Articles with unsourced statements from July 2018, Creative Commons Attribution-ShareAlike License, High infant immunization coverage with four doses of oral. [135] The country experienced a total of 20 cases in 2018. COVID: Will revolt over Blue Shield cost Santa Clara County access to vaccine? During the ban the virus spread across Nigeria and into 12 neighboring countries that had previously been polio-free. WHO says 16 African countries are currently fighting outbreaks of this vaccine-derived strain. [67] Wild poliovirus type 2 was certified eradicated in 2015, the last case having been detected in 1999. The number of planned polio vaccination campaigns had recently been reduced, and populations in northern India, particularly from the Islamic background, engaged in mass resistance to immunization. Globally, there's also been impressive progress against polio. Type 3 (WPV3) is last known to have caused polio in 2012, and was declared eradicated in 2019. In spite of a significant drop in detected cases in Pakistan, there was an increase in the percentage of environmental samples that test positive for the polio virus, suggesting gaps in identification of infected individuals. Polio was eliminated in the United States with vaccination, and continued use of polio vaccine has kept this country polio-free. [80] This achievement was a milestone in efforts to eradicate the disease. Local governments and clerics allowed vaccinations to resume on the condition that the vaccines be manufactured in Indonesia, a majority Muslim country, and not in the United States. READ MORE: When Polio Triggered Fear and Panic Among Parents. He said each country must continue to vaccinate to sustain high levels of protection against vaccination. In 2018, the GPEI conducted environmental surveillance in 44 countries, 24 of which are in Africa. [citation needed], In May 2004 the first case of the polio outbreak in Sudan was detected. By Naomi Thomas and Aisha Salaudeen | CNN. [42], Polio vaccination efforts have also faced resistance in another form. He said that the biggest hurdle preventing Pakistan from becoming polio-free was holding district health officials properly accountable—in national eradication campaigns officials had hired their own relatives, even young children. [144] Viral circulation across much of the country, including several major urban areas, led to wild poliovirus detection in 20% of the year's environmental samples. The Republic of Congo (Brazzaville) saw an outbreak with 441 cases (30% of the global total). [91] All other countries had less than one hundred cases: Pakistan had 89 cases, Afghanistan 38, Chad 65, Sudan 45, Guinea 42, Angola 29, Côte d'Ivoire 26, Benin 20, Kenya 19, Niger 15, Central African Republic 14, Mauritania 13 and Sierra Leone and Liberia both had 11. [26] For polio to occur in a population, there must be an infecting organism (poliovirus), a susceptible human population, and a cycle of transmission. As a consequence, vaccinated individuals are protected from contracting polio, but their intestinal mucosa may still be infected and serve as a reservoir for the excretion of live virus. [59][60] Sensitivity of monitoring for circulation can be improved by sampling sewage. [20] Likewise, mutation during the course of persistent circulation in undervaccinated populations can lead to vaccine-derived poliovirus strains (cVDPV) that can induce polio at much higher rates. The second of three forms of the polio virus has been eradicated, experts have announced. ... No poliovirus has been found to exist and spread among animals despite repeated attempts to document this. The plan called for mass immunization campaigns in the three remaining endemic countries, and also dictated a switch to inactivated virus injections, to avoid the risk of the vaccine-derived outbreaks that occasionally occur from use of the live-virus oral vaccine. [43][44] Concerns were addressed through extensive outreach, directed both toward the communities involved and respected clerical bodies, as well as promoting local ownership of the eradication campaign in each region. [30], While vaccination has played an instrumental role in the reduction of polio cases worldwide, the use of attenuated virus in the oral vaccine carries with it an inherent risk. Polio does still exist, although polio cases have decreased by over 99% since 1988, from an estimated more than 350 000 cases to 22 reported cases in 2017. Meghan and Harry spark questions about racist comments regarding Archie, Here are the countries that are welcoming U.S. tourists back, Harriette Cole: They said their kids were 'a little difficult.' It can induce vaccine-associated paralytic poliomyelitis (VAPP) in approximately one individual per every 2.4 million doses administered. It's been a long time coming. [114], During 2015, 74 cases of wild poliomyelitis were reported worldwide, 54 in Pakistan and 20 in Afghanistan. [15], The primary disadvantage of the OPV derives from its inherent nature as an attenuated but active virus. [68] Wild poliovirus type 3 has not been detected since 2012, and was certified eradicated in 2019. Since the World Health Assembly's 1988 launch of the Global Polio Eradication Initiative, the number of cases has been reduced by 99.9 percent, saving more than 13 million children from paralysis. Polio transmission recurred in Angola, Chad and the Democratic Republic of the Congo. [22], There were 22 reported WPV1 polio cases with onset of paralysis in 2017, down from 37 in 2016. This vaccine cannot induce VAPP nor do cVDPV strains arise from it, but it likewise cannot induce contact immunity and thus must be administered to every individual. The last region to eradicate wild polio was Southeast Asia. [126][127] In the third country where polio remains endemic, Nigeria, there were no cases, though as few as 7% of infants were fully vaccinated in some districts. [108][109], In April 2013, the WHO announced a new $5.5 billion, 6-year cooperative plan (called the 2013–18 Polio Eradication and Endgame Strategic Plan) to eradicate polio from its last reservoirs. Acute flaccid paralysis (AFP) is a clinical manifestation of poliomyelitis characterized by weakness or. [78] By 2006, this ban would be blamed for 1,500 children being paralyzed and had cost $450 million for emergency activities. It’s called a circulating vaccine-derived poliovirus. Then came the coronavirus. Proceedings of a conference. [151] Global WPV3 eradication was certified in October 2019, the virus not having been seen since 2012. In 2015, Pakistan has shown a decrease of 70-75% in number of polio cases as compare to last year which is the result of good government's initiatives. Oral vaccines can also give rise to persistent infection in immunodeficient individuals, with the virus eventually mutating into a more virulent immunodeficiency-associated vaccine-derived poliovirus (iVDPV). [113] With the addition of this region, the proportion of world population living in polio-free regions reached 80%. [48] Pakistan reported the world's highest number of polio cases (198)[41][49] in 2011. According to figures updated in April 2012, the WHO reported that there were 1,352 cases of wild polio in 20 countries in 2010. [178] Subsequent statistical analysis indicated that the COVID pandemic would also result in decreases of more than 30% globally in both AFP and environmental surveillance. In 1960, the first country to eradicate polio … Polio once was a common virus. [52] There have been several instances of threatened boycotts by health workers in Pakistan over payment disputes. The early success of these mass vaccination campaigns suggested that polioviruses could be globally eradicated. The total number of wild-virus cases reported in 2012 was 223, lower than any previous year. [19] The oral administration does not require special medical equipment or training. [17], An independent evaluation of obstacles to polio eradication requested by the WHO and conducted in 2009 considered the major obstacles in detail by country. [84] In 2000, the Western Pacific Region (including China) was certified polio-free. Vaccines against each of the three types have given rise to emergent strains of cVDPV, with cVDPV2 being most prominent, and such strains caused over 1000 polio cases in 2020. With the start of World Polio Eradication Initiative in 1988, the number of polio cases has been reduced up to 99% worldwide until now. Polio is a debilitating disease caused by the poliovirus. There were 37 reported WPV1 cases with an onset of paralysis in 2016, half as many as in 2015, with the majority of the cases in Pakistan and Afghanistan. These vaccines are more expensive and more difficult to deliver, and they lack the ability to induce contact immunity because they contain only killed virus, but they likewise are incapable of giving rise to vaccine-derived viral strains. Wild polio has been almost eradicated. [128][129] An April 2017 spill at a vaccine production facility in the Netherlands only resulted in one asymptomatic WPV2 infection, despite release into the sewer system.[130]. [4] WHO Director-General Tedros Adhanom called it a "great day... but not the end of polio,"[182] as there remain major continuing outbreaks of the vaccine derived poliovirus in West Africa and Ethiopia in addition to wild cases in Afghanistan and Pakistan. The disease has been eliminated from several parts of the world including the Americas, Southeast Asia and India, Europe, the Western Pacific region, and the Indo-West Pacific. [125] In Pakistan, transmission of several genetic lineages of WPV1 seen in 2015 had been interrupted by September 2017, though at least two genetic clusters remain. “The small risk of circulating vaccine-derived poliovirus pales in significance to the tremendous public health benefits associated with the oral polio vaccine,” WHO says on its website. Of these, 1,506 occurred in the four endemic countries and 146 elsewhere. Somalia's continuing outbreaks caused a half-dozen cases there and in neighboring Ethiopia, with a separate Ethiopia outbreak adding one case. Get Morning Report and other email newsletters. Some of these were caused by so-called 'orphan' strains, resulting from long undetected transmission and indicating gaps in monitoring. I’m confident to say that in the region, for the last four years we haven’t seen one poliovirus,” she said. [21], While IPV does not itself induce mucosal immunity, it has been shown to boost the mucosal immunity from OPV,[24] and the WHO now favors a combined protocol. [26] If routine immunization were to be stopped, the number of unvaccinated, susceptible individuals would soon exceed the capability of herd immunity to protect them. [98] Other countries with significant numbers of wild polio virus cases include the Democratic Republic of the Congo, which reported 41 cases, Chad with 22 cases, and Niger and Myanmar, each of which reported 11 cases. “You have demonstrated how much can be achieved when determination, partnership and resources come together, no matter the circumstances,” he said. The news comes today—World Polio Day—and means two of the three wild poliovirus strains are now eradicated. Gezari asked, "How do you expect a seven-year-old thumb-sucking kid to implement a polio campaign of the government?" “The work has gone on for years and now we can see the results. September 15, 2020 — 5:41pm ... India has been polio-free since 2014. Because cVDPV2 strains continued to arise from trivalent oral vaccine that included attenuated PV2, this vaccine was replaced with a bivalent version lacking WPV2 as well as trivalent injected inactivated vaccine that cannot lead to cVDPV cases. Officials wanted to make sure polio was really gone and have waited four years since the last case of wild virus was diagnosed. “Circulating vaccine-derived polioviruses in the past have been rapidly stopped with 2–3 rounds of high-quality immunization campaigns. [141], There were 33 reported WPV1 paralysis cases with an onset of paralysis in 2018 – 21 in Afghanistan and 12 in Pakistan. [90], In 2005 there were 1,979 cases of wild poliovirus (excludes vaccine-derived polio viruses). [165] Opponents to vaccination in Pakistan launched a series of attacks in April that left a vaccinator and two security men dead, while false rumors and hoax videos reporting vaccine toxicity also disrupted vaccination efforts there. [42], In the context of the United States invasion of Afghanistan and the subsequent 2003 invasion of Iraq, rumours arose in the Muslim world that immunization campaigns were using intentionally-contaminated vaccines to sterilize local Muslim populations or to infect them with HIV. Governments and nonprofits have been working since 1996 to try to eradicate the virus from the African continent with sustained vaccination campaigns. [84], In October 1999, the last isolation of type 2 poliovirus occurred in India. Cases in other countries are attributed to importation. The world officially became a slightly safer place in October, when the World Health Organization declared that polio’s type 3 strain had been eradicated. [148][149] Virus involved in several Afghanistan cases had a closest relative in Pakistan, suggesting significant trans-border spread, but the majority represented spread within Afghanistan. This includes Europe and the Americas. [92], Yemen, Indonesia, and Sudan, countries that had been declared polio-free since before 2000, each reported hundreds of cases—probably imported from Nigeria. In April, a case of wild polio in Mogadishu was reported, the first in Somalia since 2007. In Somalia, cVDPV2 continued to circulate, causing several polio cases and detected in environmental samples from as far as Nairobi, Kenya. [78] The last case of wild poliovirus poliomyelitis in the Americas was reported in Peru, August 1991.[78]. The news comes today—World Polio Day—and means two of the three wild poliovirus strains are now eradicated. The presence of multiple infections with the same strain in the upstream area may not be detectable, so there are some saturation effects when monitoring the number of positive environmental samples. The last case of WPV3 was detected in northern Nigeria in 2012. But "2020 has been a terrible year," the head of the Global Polio Eradication Initiative says. [115][116], On 25 September 2015, the WHO declared that Nigeria was no longer considered endemic for wild polio virus,[56] with no reported case of wild polio virus having been reported since 24 July 2014. In reality, there are distinct biological features of the organisms and technical factors of dealing with them that make their potential eradicability more or less likely. Surveillance detected nine strains of cVDPV in 2018 in seven countries. The oral polio vaccine (OPV, or Sabin vaccine) contains an attenuated poliovirus, 10,000 times less able to enter the circulation and cause polio,[15] delivered as oral drops or infused into sugar cubes. However, by 2004, India had adopted strategies to increase ownership of polio vaccinations in marginalized populations, and the immunity gap in vulnerable groups rapidly closed. On Tuesday, Africa has been declared free of the last remaining strain of wild poliovirus. The development of the vaccine against the viral disease in the 1950s helped in controlling the disease to a great extent. The Carter Center International Task Force for Disease Eradication has declared six additional diseases as potentially eradicable: lymphatic filariasis (Elephantiasis), polio, measles, mumps, rubella, and pork tapeworm. Using the Pulse Polio campaign to increase polio immunization rates, India recorded just 66 cases in 2005, down from 135 cases reported in 2004, 225 in 2003, and 1,600 in 2002.