Lessons from poliovirus control: strategies for eradication
Resolutions of the questions of how and where eradication of poliomyelitis can bc achieved will continue to be major objectivcs in the next few years. The World Health Organization Expanded Programme on Immunization was initiated with the aim of reducing morbidity and mortality rates from seven target diseases, including poliomyelitis, by providing immunization against them forcvery child in the world. The program depends heavily upon technical Cooperation with and among developing countries, particularly those in tropical regions. Results are already being seen: increasing numbers of countries now participate in the EPI program or are otherwise enhancing their polio vaccination efforts. Better and more complete surveillance programs have been implemented to detect and assess cases that occur, as global efforts increase to control polio.
Eradication of polio is part of the EPI goal of universal immunization of children. There have been significant increases in recent years with regard to OPV -from the Situation in 1986, when 45% of all children in the world received the required 3 doses of OPV in the first year of life, to that in April, 1992, when this percentage had increased to over 84%. Based on an expected worldwide annual polio incidence of 5 cases per 1000 infants, the global OPV program is currently preventing an estimated 528000 cases of paralytic disease per year. The disease has almost been eliminated from the Western Hemisphere since universal vaccination has led to a curtailment of the circulation of wild poliovirus.
In some countries previously rccorded as places of high prevalence, the use of a combined OPV/IPV schedule early in life has led to the prompt elimination of polio in the area. The combined schedule takes advantage of the desirable properties of both vaccines and overcomes the disadvantages of each.
KeywordsVillage Doctor Acute Flaccid Paralysis Oral Trivalent Poliovirus Vaccine Inactivate Poliovirus Vaccine Paralytic Poliomyelitis
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