Poliomyelitis: Eradicated From the Americas, On Its Way to Global Eradication
Washington, DC, 25 April 2002 (PAHO)-- With a sense of a mission accomplished, in September of 1994 the Pan American Health Organization (PAHO) announced that polio had been eradicated from the Americas, bringing to an end a saga of thousands of deaths and disabilities caused annually by this disease. Today a global effort is underway to put an end to the disease by 2005.
In 1994, the International Commission for the Certification of the Polio Eradication (ICCPE) declared that the transmission of wild poliovirus had been interrupted in the Americas. But the beginning of the end for polio arrived on 14 May 1985, when the then director of PAHO, Dr. Carlyle Guerra de Macedo declared that "The time has come for us to say that is unacceptable that any child in the Americas suffers from polio."
A boy named Luis Fermín Tenorio Cortez was the last case of polio in the Americas, detected in August 1991, in Junín, Peru. The child, who recovered from the disease, currently attends school in Lima, walks, and plays soccer with a brace on his leg.
"Polio eradication was a complex process, because there are two polioviruses, the vaccine against polio is not stable in heat and a minimum of three doses are required for effective protection. Against smallpox, for example, there only one dose was needed. Furthermore, this vaccine has an effectiveness between 85 and 95 percent", explained Dr. Ciro de Quadros, director of the Division of Vaccines and Immunization at PAHO.
With only 537 polio cases reported globally in 2001, efforts to eradicate the disease have driven the incidence of polio to its lowest point in history. However, an expert panel overseeing the initiative warns that given the current prevalence of conflict, the last vestiges of polio must be extinguished now, as any delay will jeopardize the success of the entire effort.
On the other hand, polio surveillance is complicated because many of the infections are not apparent and many other diseases cause symptoms similar to those of polio. A very good laboratory network was required to perform surveillance of polio or acute flaccid paralysis, noted Dr. de Quadros.
In 1990, PAHO established an independent commission to supervise regional efforts for polio eradication and to determine when that goal had been reached.
The triumph in eradication of polio was due to intensified immunization activities, with national immunization days and "door-to-door" vaccination campaigns in high-risk areas of greater risk. Also key were monitoring of acute flaccid paralysis, close monitoring of vaccine coverage, quick investigation of suspected cases, aggressive control of polio outbreaks to stop transmission and community surveillance in order to ensure the absence of the virus in humans and in the environment.
"There is a revolving fund for vaccination to ensure the supply of the quantities of vaccines that are necessary", Dr. de Quadros added, citing it as another reason for success.
Excellent national and international political commitment resulted in the donation of vaccines, human resources and funds, according to Dr. de Quadros. "In each country associations were formed to support the government in polio eradication efforts," he said.
Other factors helped polio eradication. The oral vaccine against the polio can be easily administered by health personnel. "The available interventions to combat other diseases require that only personnel skilled in injection technologies administer the vaccine, as is the case in the struggle against measles. This limits the operation," Dr. de Quadros said.
PAHO, which also serves as the Regional Office for the Americas of the World Health Organization, was established officially in 1902, It works with all the countries of the Americas to improve the health and raise the living standards of their peoples.
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