Feature Infectious diseases

Polio: an end in sight?

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39367.426655.AD (Published 25 October 2007) Cite this as: BMJ 2007;335:852
  1. Toby Reynolds, journalist
  1. London
  1. Toby.reynolds{at}gmail.com

    Eradication of polio is proving more difficult than WHO expected, as the recent outbreak in Nigeria shows. Toby Reynolds takes a look at the current global situation

    By the end of 2001 a massive immunisation campaign had driven poliomyelitis out of all but a few isolated pockets of resistance, and the world looked set to rid itself of one of the most feared diseases of the 20th century. Cases of paralytic polio had fallen from more than 350 000 in 125 infected countries in 1988 to under 500 in 10 endemic countries in 2001: India, Pakistan, Nigeria, Afghanistan, Niger, Somalia, Egypt, Angola, Ethiopia, and Sudan.1 Optimists hoped that the next three years would be entirely free of infection, meaning that by 2005 the virus could be consigned to history books alongside smallpox—the only disease to be eradicated by a vaccination programme.

    Those hopes were dashed as the disease flared up first in 2002 in northern India, where vaccination efforts had been scaled back, and then in northern Nigeria a year later, after rumours that the vaccine caused infertility led to a sharp fall in coverage. These outbreaks meant the 2005 goal for a polio-free world was not met, even though it had already been put back five years. By 2006, at least 20 countries had become reinfected and the number of cases worldwide had risen to almost 2000 (figure).1

    International spread of wild polioviruses, 2003-2007 (data from Global Polio Eradication Initiative)

    Signs of hope

    However, things may be looking up. So far this year there have been 545 cases of polio, most of them in countries with endemic disease, compared with 1353 for the same period last year.1 Eight countries (Nepal, Cameroon, Bangladesh, Kenya, Ethiopia, Namibia, Indonesia, and Yemen) that had polio cases in 2006 have not yet had …

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