Has Poliomyelitis Been Eradicated?

Has Poliomyelitis Been Eradicated?

by Blandina Steinhauslin, AILO Florence

Polio in a few words

Polio (poliomyelitis) is a highly infectious viral disease. The poliovirus invades the nervous system and can cause irreversible paralysis in a matter of hours. Polio is spread through person-to-person contact. When a child is infected with wild poliovirus, the virus enters the body through the mouth and multiplies in the intestine. It is then shed into the environment through the feces where it can spread rapidly through a community, especially in situations of poor hygiene and sanitation. If a sufficient number of children are fully immunized against polio, the virus is unable to find susceptible children to infect, and dies out.

There is no cure for polio, only treatment to alleviate the symptoms. Heat and physical therapy are used to stimulate the muscles and antispasmodic drugs are given to relax the muscles. While this can improve mobility, it cannot reverse permanent polio paralysis.

The eradication initiative

The Global Polio Eradication Initiative (GPEI) was launched in 1988 worldwide, supported by governments, WHO, Rotary International, UNICEF, etc. This followed the eradication of smallpox in 1980. Since then, the number of cases has fallen by over 99%, from an estimated 350,000 cases in more than 125 endemic countries in 1988, to 29 reported cases in 2018.

There are 3 types of wild poliovirus (WPV) - types 1, 2 and 3. In September 2015, WPV type 2 was officially declared eradicated. Since WPV type 3 has not been detected since November 2012, WPV type 1 is probably the only wild poliovirus type that remains in circulation.

Polio-free certification occurred as follows:

-          1994 the Americas and western Pacific region

-          2002 European region

-          2014 South-East Asia region

This means that 80% of the world’s population now lives in certified polio-free regions.

Polio can be prevented through immunization. Polio vaccine, given multiple times, almost always protects a child for life. The development of effective vaccines to prevent paralytic polio was one of the major medical breakthroughs of the 20th century.

If enough people in a community are immunized, the virus will be deprived of susceptible hosts and will die out. High levels of vaccination coverage must be maintained to stop transmission and prevent outbreaks occurring.

Endemic countries

Polio remains endemic in three countries: Afghanistan, Nigeria and Pakistan. Until poliovirus transmission is interrupted in these countries, all countries remain at risk of importation of polio, especially vulnerable countries with weak public health and immunization services and travel or trade links to endemic countries. All governments are seriously committed to eradicating polio.

To slow the spread of polio in their countries, Nigeria, Pakistan and Afghanistan have implemented national emergency plans overseen by their heads of state. These programs increase accountability and improve the quality of polio vaccination campaigns from the national to the local level. WHO is providing unprecedented levels of technical assistance to these countries and improved vaccination campaigns are helping reach more children.

The importance of women

Women are critical in the fight against polio. From reaching every child with polio vaccines to ensuring their children receive the protection they deserve, women are at the heart of polio eradication efforts.

In GPEI’s immunization activities, women frontline workers have increased the effectiveness of health service delivery. In many settings, only women can access households to vaccinate children. Female social mobilizers have improved attitudes toward polio vaccination and the perceptions of risks associated with the disease. Women on the frontline communicate directly with female caregivers and indirectly with other women in the community. The recruitment of local women, in particular, enables a larger capacity for trust.

The Global Polio Eradication Initiative has continually developed and adapted local strategies to engage women in the critical decision to vaccinate their children – as caregivers of children and as the workers on the frontline of eradication.

The progress the polio program has witnessed in the past years would not have been possible without the hard work and commitment of courageous women who are dedicated to protecting children and making polio history.


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