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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 291-293
Polio continues to be a public health emergency of international concern: Current updates


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

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Date of Web Publication5-May-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Polio continues to be a public health emergency of international concern: Current updates. Ann Trop Med Public Health 2017;10:291-3

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Polio continues to be a public health emergency of international concern: Current updates. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Nov 19];10:291-3. Available from: http://www.atmph.org/text.asp?2017/10/1/291/205583
Dear Editor,

The international spread of polio has been declared as a public health emergency of international concern (PHEIC) in May 2014 and since then significant advancement has been achieved by the nations toward both interruption of wild poliovirus transmission and implementation of temporary recommendations.[1] Moreover, any subsequent transmission of type 2 vaccine-derived polioviruses (cVDPVs) also constitutes a public health emergency as type-2 Oral polio vaccine has been withdrawn globally.[1]

The ninth meeting of the Emergency Committee encouraged the programme managers of Pakistan and Afghanistan to further intensify the efforts, including improved cooperation across the international border (in terms of immunizing children under 10 years of age, and travelers from all age-groups) to ensure that transmission of wild poliovirus is interrupted.[1],[2] In-fact, two cases have been exported from Pakistan to Afghanistan in October 2015 and February 2016, although no new exportation has been reported the other way.[1],[2] In addition, it has been envisaged to improve the routine immunization campaigns, especially in conflict-affected regions, to prevent reintroduction of the virus due to the lacuna in the public health system.[3],[4]

Further, detection of even a single case of cVDPV indicates a significant gap in the immune status of the population due to the shortcomings in the routine immunization activities in polio-free nations.[1] However, there is a definite risk of missing a chain of transmission owing to the gaps present in the surveillance system and defective monitoring and supervision activities.[1],[4] In addition, weaknesses have also been observed in the microplanning for routine immunization activities, existing communication and social mobilization plan, logistics, and practical difficulties in reaching remote settings.[2],[3],[4]

After thoroughly assessing the global scenario, it was decided to continue the international spread of polio as a PHEIC, because of the continuing international spread of wild poliovirus in 2015 and 2016, proximity to achieving the polio eradication, anticipated risk and subsequent costs of failure to eradicate globally, serious consequences if the disease emerges in nations with weaker immunization activities, necessity to sustain comprehensive surveillance, risk of emergence of outbreaks of type-2 cVDPVs due to the withdrawal of type-2 component of OPV, and global shortage of IPV.[1],[5]

Simultaneously, specific recommendations have been released to prevent the risk of international spread of poliovirus, depending on their status of exporting virus; being infected, but not exporting cases; and being no longer infected, yet vulnerable to the international spread.[1],[4] Some of the important recommendations include giving national importance to ensure interruption of virus transmission, administering vaccine to travelers and the residents depending on the prevalent risk in the nation, issuing an International Certificate of Vaccination or Prophylaxis, isolating travelers who lack desired certification, intensify immunization activities across international borders, which are exporting cases, and do monthly reporting.[1],[4],[6]

To conclude, as the disease is a public health emergency and very much near to global eradication, there is an immense need to strengthen the existing immunization activities and international travel-related recommendations.

Acknowledgement

S.R.S. contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

P.S.S. contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

J.R. contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil

Conflicting to Interest:

There are no conflicts of interest to declare.

 
   References Top

1.
World Health Organization Statement on the 9th IHR Emergency Committee meeting regarding the international spread of poliovirus; 2016. Available from: http://who.int/mediacentre/news/statements/2016/ihr-poliovirus-spread/en/. [Last accessed on 2016 May 22].  Back to cited text no. 1
    
2.
Mushtaq A, Mehmood S, Rehman MA, Younas A, Rehman MS, Malik MF. Polio in Pakistan: Social constraints and travel implications. Travel Med Infect Dis 2015;13:360-6.  Back to cited text no. 2
    
3.
Joseph B, Watts H. Polio revisited: reviving knowledge and skills to meet the challenge of resurgence. J Child Orthop 2015;9:325-38.  Back to cited text no. 3
    
4.
World Health OrganizationProgress towards polio eradication worldwide, 2015–2016. Wkly Epidemiol Rec 2016;91:250-56.  Back to cited text no. 4
    
5.
Snider CJ, Diop OM, Burns CC, Tangermann RH, Wassilak SG. Surveillance systems to track progress toward polio eradication - worldwide, 2014-2015. MMWR Morb Mortal Wkly Rep 2016;65:346-51.  Back to cited text no. 5
[PUBMED]    
6.
Simons H, Patel D. Polio in Pakistan: a public health event of international concern with implications for travellers' vaccination. Travel Med Infect Dis 2015;13:357-59.  Back to cited text no. 6
[PUBMED]    

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Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Thiruporur: Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.205583

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