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This podcast is presented by The Centers for Disease Control and Prevention. CDC - Safer. Healthier. People.

DONNA WEAVER:

For our last vaccine brief, we would like to update you on the status of global polio eradication. The Global Polio Eradication Initiative was launched by the World Health Assembly in 1988. At that time there were 125 polio endemic countries. The World Health Organization, CDC, Rotary International, and UNICEF are the principal partners in the initiative. National governments, private foundations, nongovernmental organizations, corporations, and volunteers are all collaborating to achieve eradication.

The last known case of paralytic disease caused by wild poliovirus in the United States occurred in 1979. The Pan American Health Organization devised an aggressive- and successful- OPV mass vaccination program in 1985. The last case of wild poliovirus in the entire western hemisphere occurred in Peru in 1991. Due largely to the success of the polio elimination program in the Americas, the World Health Organization established a polio eradication program in 1988.

This map shows in red the countries with poliovirus transmission in 1988, the year the global eradication program began. That year, more than 350,000 cases occurred in at least 125 countries, including much of central and south America, parts of Europe, all of Africa and most of Asia. At the end of 2005 polio was considered to be endemic in only six countries shown on this map in red -Afghanistan, Pakistan, India, Niger, Egypt, and Nigeria.

In 2005 a total of 1,948 confirmed cases of polio were reported from these 6 countries and 10 other countries where the virus was reintroduced due to importation. The total for 2005 was 55 percent higher than for 2004 due to large outbreaks of polio in Yemen, Indonesia and Somalia. All three of these outbreaks were a result of importation of poliovirus from Nigeria. In fact, 94 percent of ALL poliovirus cases worldwide were caused by viruses that originated in Nigeria. The outbreak in Nigeria has been going on since 2004 and was a result of cessation of vaccination activities in one northern state of the country. Immunization activities were greatly intensified in Nigeria in 2005. But WHO estimates that more than 40% of children in some northern states of Nigeria have never been vaccinated.

Several polio eradication landmarks were achieved in 2005 or early 2006. In February 2006 Egypt was removed from the list of polio endemic countries. The last isolate of indigenous poliovirus in Egypt was in January 2005. The number of cases in India and Pakistan, the two largest polio endemic countries in Asia, declined by more than 50 percent compared to 2004. Finally, WHO has begun using monovalent type 1 and type 3 polio vaccines in some areas rather than the trivalent vaccine. Type 2 poliovirus is believed to have already been eradicated, with the last isolate in India in October 1999.

There have been challenges during the past two years, in particular the outbreak in Nigeria and subsequent importation into previously polio free areas. But the world moved closer to eradicating polio in 2005. With continued progress we look forward to the day when the scourge of polio is relegated to the history books.

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