POST 00868E : POLIO ERADICATION AND INDIA

POST 00868E : POLIO ERADICATION AND INDIA Follow-up on Posts 00863E and 00865E 22 December 2005 _____________________________________ The following comment is submitted by Hans Everts (mailto:[email protected]) from WHO/Geneva. _____________________________________ When about 95% of the world's population, including 90% of Indian and 50% of Nigerian population, has not seen polio for a few years or longer, it is hard to maintain eradication is not technically feasible. For every high density area with low sanitary standards, low routine coverage and with ongoing polio transmission, there are several areas with similar sanitary, demographic or infrastructural characteristics, but without polio. Think about Bangladesh, Southern Nigeria, the Democratic Republic of Congo and many others. In Nigeria the population density is actually higher in the south, where all recent viruses do not represent indigenous transmission, but importations from the north. The difference between eradication and elimination is that with the first the disease disappears, because the pathogenic agent disappears, is eradicated. With elimination the disease may no longer occur, but its cause is still there. The authors present the fact that only 0.5% of polio cases actually develop paralysis as something that is not widely known. The requirement of a sufficiently sensitive AFP surveillance is exactly based on that fact as is the 3 years delay between the last wild virus and certification. In a setting of good surveillance, circulating virus has never remained undetected for more than a few months. Longer periods of missed transmission were only found in areas with major surveillance gaps. Hans Everts WHO Geneva Technical officer EPI ______________________________________________________________________________ ______________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (http://www.ccisd.org) ______________________________________________________________________________