[Polio, the long walk to the endgame]

Area of Science:

• * Virology and Epidemiology
• * Public Health and Infectious Diseases

Background:

• * The World Health Organization's (WHO) initial goal for global poliomyelitis eradication by 2000 was not met.
• * In 2013, polio remained endemic in Afghanistan, Pakistan, and Nigeria, with cases reported in five other countries.
• * Circulation of wild type 1 poliovirus and vaccine-derived polioviruses highlighted ongoing transmission risks.

Purpose of the Study:

• * To underscore the persistent threat of poliomyelitis despite eradication efforts.
• * To identify factors contributing to polio's continued spread, including international travel and vaccine hesitancy.
• * To emphasize the need for enhanced knowledge of poliovirus and its transmission dynamics.

Main Methods:

• * Review of the global poliomyelitis situation and associated epidemiological factors.
• * Analysis of challenges to eradication, including socio-political issues and vaccine refusal.
• * Consideration of diagnostic and surveillance strategies for poliovirus.

Main Results:

• * Poliomyelitis remains a global health concern due to endemic reservoirs and international spread.
• * Vaccine-derived polioviruses pose a significant risk, capable of causing disease.
• * Factors such as conflict, anti-vaccination movements, and low immunogenicity hinder eradication.

Conclusions:

• * Enhanced understanding of poliomyelitis and its causative agent is essential.
• * Continued vaccination programs and differential diagnosis of flaccid paralysis are critical.
• * Environmental surveillance for poliovirus serves as a valuable model for studying other viral pathogens.