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WPV1 resurgence and the dominant threat of cVDPV2: a 10-year global epidemiological analysis (2017-2026)
1Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China; Department of Pathogen Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Objectives:
Poliovirus primarily causes central nervous system diseases in children. Currently, among the three wild polioviruses (WPVs), only WPV1 remains, distributed in Pakistan and Afghanistan. However, vaccine-associated paralytic poliomyelitis and vaccine-derived poliovirus (VDPV) pose a threat to the global polio eradication goal. Understanding the shifting epidemiology of both WPV and VDPV is critical for guiding final elimination strategies.
Methods:
We retrieved data from the Global Polio Eradication Initiative (GPEI) and analyzed WPV1 cases from 2017 to January 28, 2026, along with circulating VDPV (cVDPV) cases from 2021 to January 28, 2026.
Results:
cVDPV2 was the dominant subtype, accounting for 4819 of 5585 cases (86.3%) across 57 countries, confirming its significant challenge to eradication efforts. WPV1 transmission intensified, with cases rising to 871 in 2024 and 769 in 2025, primarily in Pakistan (n = 3005) and Afghanistan (n = 683). cVDPV1 and cVDPV3 exhibited limited geographical circulation.
Conclusions:
The prevalence and wide distribution of cVDPV2, along with the resurgence of WPV1 in its remaining strongholds, highlight the dual challenges facing the GPEI. These findings underscore the urgent need to maintain high vaccination coverage, improve environmental surveillance, and develop subtype-specific intervention strategies for sustained eradication.
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