Certification of the eradication of indigenous transmission of wild poliovirus in the Americas.

In May 1985, the Pan American Health Organization launched an initiative to interrupt indigenous transmission of the wild poliovirus from the Western Hemisphere by the year 1990. The strategy to achieve this goal was based on the maintenance of high levels of immunity in the population at risk and the establishment of a surveillance system to detect polio cases and respond promptly with control measures. On 23 August 1991, a 2-year-old boy with acute flaccid paralysis due to wild poliovirus was detected in Junin, Peru, the last isolation of such a virus in the entire Western Hemisphere. In 1990, an International Commission for the Certification of Eradication of Poliomyelitis Eradication (ICCPE) was established by the Pan American Health Organization to eventually determine if transmission was interrupted. After 3 years of follow-up and review of surveillance data, the ICCPE declared that wild poliovirus transmission had been interrupted in the Americas.

Selective primary health care: strategies for control of disease in the developing world. IX. Poliomyelitis.

Poliomyelitis is an acute viral disease primarily afflicting children. It can be very mild, permanently crippling, or fatal. In the developed nations, poliomyelitis is controlled by the use of trivalent vaccines: killed virus administered by injection and/or attenuated virus administered orally. The latter is cheaper. A combination of the two may be required in some tropical countries. In many developing nations poliomyelitis remains endemic and prevalent, especially in children; 37,747 cases were reported to the World Health Organization in 1979, but greater than 200,000 cases probably occurred. Socioeconomic improvement and public health measures (i.e., immunizations) remain the major strategies for control. While global eradication may be a more distant goal, poliomyelitis could be controlled better. Effective programs for control include safe, efficacious, and inexpensive vaccines; methods for successful management of vaccine delivery systems; commitment and training of health personnel; public education; commitment of funds; and research to improve vaccines and their delivery. The major obstacle to control of poliomyelitis is failure to immunize an adequate number of susceptible children. Development of strategies for immunization is crucial to elimination of poliomyelitis as a major world health problem.