Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/poliomyelitis

  Polio (poliomyelitis) mainly affects children under 5 years of age. […] Cases due to wild poliovirus have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries, to two endemic countries. […] As long as a single child remains infected, children in all countries are at risk of contracting polio. […] In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems. […] The strategies for polio eradication work when they are fully implemented. […] Failure to implement strategic approaches, however, leads to ongoing transmission of the virus. […] Endemic transmission of wild poliovirus is continuing in areas of Afghanistan and Pakistan. […] The global effort to eradicate polio has been declared a Public Health Initiative of International Concern, under the International Health Regulations, and temporary recommendations by an Emergency Committee under the International Health Regulations have been issued to countries affected by poliovirus transmission or are at high risk of re-emergence of the disease. […] WHO, together with its GPEI partners, continues to support countries which remain affected by poliovirus or are at high risk of polio re-emergence in implementing eradication strategies, focusing in the first instance on immunization and disease surveillance.

• #2 Polio – Our World in Data

  https://ourworldindata.org/polio

  Polio is an infectious disease that can lead to the permanent paralysis of various body parts and can ultimately cause death by immobilizing the patients breathing muscles. It primarily affects children. […] As a response the „Global Polio Eradication Initiative” (GPEI) was founded in 1988 to fight the virus’s spread and disease burden through a global vaccination campaign. […] Since then, the world has made rapid progress against the disease. Two of the three types of wild poliovirus have been eradicated worldwide, and one remains. […] Polio is difficult to track in the population because it has a relatively long incubation period of up to 10 days and around three-quarters of infections do not cause symptoms, so the virus can spread for several months without being detected. […] Monitoring has to focus on identifying patients that suffer from symptoms or rely on stool samples. Because any single cases that have been identified might suggest there are larger outbreaks, the WHO recommends that a single case of wild polio in a child should be treated as a public health emergency, in a country that was previously declared polio-free.

• #3

  https://www.who.int/news-room/fact-sheets/detail/poliomyelitis

  Polio (poliomyelitis) mainly affects children under 5 years of age. […] Cases due to wild poliovirus have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries, to two endemic countries. […] As long as a single child remains infected, children in all countries are at risk of contracting polio. […] In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems. […] The strategies for polio eradication work when they are fully implemented. […] Failure to implement strategic approaches, however, leads to ongoing transmission of the virus. […] Endemic transmission of wild poliovirus is continuing in areas of Afghanistan and Pakistan. […] The global effort to eradicate polio has been declared a Public Health Initiative of International Concern, under the International Health Regulations, and temporary recommendations by an Emergency Committee under the International Health Regulations have been issued to countries affected by poliovirus transmission or are at high risk of re-emergence of the disease. […] WHO, together with its GPEI partners, continues to support countries which remain affected by poliovirus or are at high risk of polio re-emergence in implementing eradication strategies, focusing in the first instance on immunization and disease surveillance.

• #4 Polio – Eradication, Vaccination, & Access

  https://www.gatesfoundation.org/our-work/programs/global-development/polio

  In 1988, when the Global Polio Eradication Initiative (GPEI) was launched, polio was present in more than 125 countries and paralyzed about 1,000 children per day. Thanks to immunization efforts that have reached nearly 3 billion children, the incidence of polio has decreased by 99 percent since then. […] In 2020, the entire World Health Organization (WHO) African Region was certified free of wild poliovirus, four years after Nigeria, the last polio-endemic country in Africa, recorded its final case of wild polio. Today, wild polio is found only in Afghanistan and Pakistan. […] Despite this progress, if we fail to completely eradicate polio, within a decade we could witness a resurgence of 200,000 new cases annually, making polio a critical priority in global health. The job is not done: Efforts must continue to stop wild polio and end all forms of poliovirus globally.

• #5 Polio – Eradication, Vaccination, & Access

  https://www.gatesfoundation.org/our-work/programs/global-development/polio

  In 1988, when the Global Polio Eradication Initiative (GPEI) was launched, polio was present in more than 125 countries and paralyzed about 1,000 children per day. Thanks to immunization efforts that have reached nearly 3 billion children, the incidence of polio has decreased by 99 percent since then. […] In 2020, the entire World Health Organization (WHO) African Region was certified free of wild poliovirus, four years after Nigeria, the last polio-endemic country in Africa, recorded its final case of wild polio. Today, wild polio is found only in Afghanistan and Pakistan. […] Despite this progress, if we fail to completely eradicate polio, within a decade we could witness a resurgence of 200,000 new cases annually, making polio a critical priority in global health. The job is not done: Efforts must continue to stop wild polio and end all forms of poliovirus globally.

• #6 Polio – Our World in Data

  https://ourworldindata.org/polio

  Cases of polio have fallen dramatically over time. In 1980, there were over 50,000 reported cases of polio worldwide. But in 2021, this number was down to 649. […] The WHO certifies world regions as polio-free, rather than individual countries. The considered world regions are the six WHO world regions: Africa, Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific. […] To be certified polio-free, a WHO region needs to (i) record no wild indigenous polio case for at least three years, (ii) have a reliable surveillance system in place, and (iii) prove its capacity to detect and respond to imported polio cases.

• #7 Polio Epidemiology: Strategies and Challenges for Polio Eradication Post the COVID-19 Pandemic

  https://www.mdpi.com/2076-393X/12/12/1323

  The objective of this article is to review the polio epidemiology after the COVID-19 pandemic, the strategies and challenges to achieve global polio eradication, and the plans for the post-eradication era. […] The minimum number of AFP cases caused by WPV1 before the onset of the COVID-19 pandemic was 22, in 2017. […] In 2024, the WHO considers only Pakistan and Afghanistan as endemic countries, i.e., countries where the transmission of indigenous wild poliovirus never stopped. […] The last Polio Eradication Strategy 2022–2026 has two main goals: (1) permanently interrupting WPV1 transmission in endemic countries and (2) stopping cVDPV transmission and preventing outbreaks in non-endemic countries, both by the end of 2023, with the aim of reaching eradication by 2026. […] The challenges encountered in the substitution of tOPV for bOPV1,3 resulted in a higher number of cVDPV2 outbreaks and countries affected by them.

• #8 Polio – Our World in Data

  https://ourworldindata.org/polio

  Polio is an infectious disease that can lead to the permanent paralysis of various body parts and can ultimately cause death by immobilizing the patients breathing muscles. It primarily affects children. […] As a response the „Global Polio Eradication Initiative” (GPEI) was founded in 1988 to fight the virus’s spread and disease burden through a global vaccination campaign. […] Since then, the world has made rapid progress against the disease. Two of the three types of wild poliovirus have been eradicated worldwide, and one remains. […] Polio is difficult to track in the population because it has a relatively long incubation period of up to 10 days and around three-quarters of infections do not cause symptoms, so the virus can spread for several months without being detected. […] Monitoring has to focus on identifying patients that suffer from symptoms or rely on stool samples. Because any single cases that have been identified might suggest there are larger outbreaks, the WHO recommends that a single case of wild polio in a child should be treated as a public health emergency, in a country that was previously declared polio-free.

• #9 Rapid risk assessment – Assessing the risk to public health of multiple detections of poliovirus in wastewater in the EU/EEA

  https://www.ecdc.europa.eu/en/publications-data/multiple-detections-poliovirus-wastewater-eueea

  Poliomyelitis (polio) is a highly infectious disease caused by polioviruses, which can be prevented by vaccination. Polioviruses can be transmitted easily and silently across wide geographic areas. Most infected people do not develop symptoms, but if the virus invades the nervous system it can cause acute flaccid paralysis (AFP) within hours. Fewer than 1% of infections lead to irreversible paralysis. […] The World Health Organization European Region (WHO Europe) was declared polio-free in June 2002, because of successful immunisation programmes, surveillance and outbreak response. […] Between September and December 2024, four countries in the EU/EEA (Finland, Germany, Poland, and Spain) and the United Kingdom (UK) reported detections of a genetic cluster of circulating vaccine-derived poliovirus type 2 (cVDPV2) in sewage samples. This is the first time cVDPV2 has been detected in EU/EEA countries from environmental surveillance. No human cases of polio related to these detections of cVDPV2 have been reported in EU/EEA or the UK to date.

• #10 Poliomyelitis (Polio, Infantile Paralysis) – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/poliomyelitis-polio-infantile-paralysis/

  Polio persists in some developing countries, and travelers to these countries should be fully immunized. […] Since polio vaccination has become widespread, cases of polio are very rare with the last case of naturally occurring polio in the United States being reported in 1979. […] Patients are most infectious from 7-10 days before and after the onset of symptoms. Patients, however, are potentially contagious as long as the virus is present in the throat and feces. […] Vaccination protects people against polio. The inactivated polio vaccine (IPV) is used currently in the United States. All children should be vaccinated starting at approximately 2 months of age. Multiple doses are required to ensure protection.

• #11 Surveillance – GPEI

  https://polioeradication.org/what-we-do/

  Polio surveillance underpins the entire polio eradication initiative. Without surveillance, it would be impossible to pinpoint where and how poliovirus is still circulating. Polio surveillance identifies new cases and detects any circulation of poliovirus. […] Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. […] The number of AFP cases reported each year is used as an indicator of a countrys ability to detect polio even in countries where the disease no longer occurs. A countrys surveillance system needs to be sensitive enough to detect at least one case of AFP for every 100 000 children under 15 even in the absence of polio.

• #12 Surveillance – GPEI

  https://polioeradication.org/what-we-do/

  Polio surveillance underpins the entire polio eradication initiative. Without surveillance, it would be impossible to pinpoint where and how poliovirus is still circulating. Polio surveillance identifies new cases and detects any circulation of poliovirus. […] Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. […] The number of AFP cases reported each year is used as an indicator of a countrys ability to detect polio even in countries where the disease no longer occurs. A countrys surveillance system needs to be sensitive enough to detect at least one case of AFP for every 100 000 children under 15 even in the absence of polio.

• #13 The value of vigilance | Rotary International

  https://www.rotary.org/en/value-vigilance

  Several African countries are considered at high risk for a polio outbreak. […] The process of searching for a disease is known as surveillance, something that Rotary has supported with $73.6 million in funding over the past five years. As the worldwide eradication of polio approaches, surveillance will play a pivotal role in ensuring that the world is truly polio-free. […] Surveillance for acute flaccid paralysis is the gold standard for detecting poliomyelitis cases. […] The AFP surveillance system was the most valuable, Ahmed says. […] Environmental surveillance was also ramped up in surrounding countries, including in the outbreaks epicenter, Tete province in Mozambique. […] Environmental surveillance can only be a supplement for AFP surveillance, which is still the gold standard. […] The future of polio eradication is surveillance, and wastewater-based epidemiology will be a key tool in those monitoring efforts.

• #14 Polio Surveillance | EndPolio Pakistan

  https://www.endpolio.com.pk/polioin-pakistan/surveillance

  Surveillance is one of the main pillars of the Polio Eradication Programme. The programme is able to identify where the polio virus is circulating through its highly sensitive surveillance activities. These activities includes testing stool samples of children suffering from acute flaccid paralysis (the clearest symptom the virus) and testing samples taken from sewage water across the country. […] AFP surveillance, or finding and reporting children with acute flaccid paralysis (AFP), is fundamental in detecting polio cases. Acute flaccid paralysis (AFP) is defined as a sudden onset of paralysis/weakness in any part of the body of a child less than 15 years of age. Each case of AFP acts as a signal to the polio surveillance system where polio is circulating and who it is likely to affect. The best available method to confirm the diagnosis of poliomyelitis is the isolation and identification of poliovirus from the stool. All stool specimens collected from reported AFP cases are tested at the Regional Reference Laboratory (RRL) for polio eradication in Islamabad.

• #15 Surveillance Indicators – GPEI

  https://polioeradication.org/polio-today/surveillance-indicators/

  Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. The four steps of surveillance are: finding and reporting children with acute flaccid paralysis (AFP) […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. Systematic environmental sampling (e.g. in Egypt and Mumbai, India) provides important supplementary surveillance data. Ad-hoc environmental surveillance elsewhere (especially in polio-free regions) provides insights into the international spread of poliovirus. Effective polio surveillance requires virologists, epidemiologists, clinicians and national immunization programme staff, backed up by a global network of laboratories. The Global Polio Laboratory Network (GPLN) was established in 1990 by WHO and national governments. Its primary responsibility is to distinguish poliovirus as a cause of acute flaccid paralysis (AFP) from AFP caused by other diseases. The GPLN consists of 146 WHO accredited polio laboratories, in 92 countries across the six WHO regions of the world. National, regional and global specialized polio laboratories follow WHO-recommended procedures for detecting and characterizing polioviruses from stool and sewage samples collected from AFP cases and the environment, respectively. The laboratories follow standardized protocols to (i) isolate poliovirus, (ii) identify wild poliovirus (WPV) or screen for Sabin (vaccine) poliovirus and vaccine-derived poliovirus (VDPV), and (iii) conduct genomic sequencing. Sequencing results help monitor how poliovirus is spreading by comparing the nucleotide sequences of poliovirus isolates. The accuracy and quality of testing at GPLN member laboratories is monitored through an annual accreditation programme that includes onsite reviews of work practices, performance and proficiency testing. The GPLN processes over 220 000 stool samples from AFP cases (and their contacts), and more than 8 000 sewage samples per year. In addition to surveillance, the GPLN carries out a research agenda aimed at improving laboratory diagnostics. The GPLN meets every year to develop recommendations for improving performance and coordination and determine the research and resource needs of the network laboratories.

• #16 Surveillance – GPEI

  https://polioeradication.org/what-we-do/

  All children with acute flaccid paralysis (AFP) should be reported and tested for wild poliovirus within 48 hours of onset, even if doctors are confident on clinical grounds that the child does not have polio. […] If poliovirus is isolated, the next step is to distinguish between wild (naturally occurring) and vaccine-related poliovirus. This is necessary because the oral vaccine consists of attenuated live polioviruses and resembles wild virus in the laboratory. […] By determining the exact genetic makeup of the virus, wild viruses can be compared to others and classified into genetic families which cluster in defined geographical areas.

• #17 Surveillance – GPEI

  https://polioeradication.org/what-we-do/

  All children with acute flaccid paralysis (AFP) should be reported and tested for wild poliovirus within 48 hours of onset, even if doctors are confident on clinical grounds that the child does not have polio. […] If poliovirus is isolated, the next step is to distinguish between wild (naturally occurring) and vaccine-related poliovirus. This is necessary because the oral vaccine consists of attenuated live polioviruses and resembles wild virus in the laboratory. […] By determining the exact genetic makeup of the virus, wild viruses can be compared to others and classified into genetic families which cluster in defined geographical areas.

• #18 WHO EMRO | Surveillance | About eradication | Polio Eradication

  https://www.emro.who.int/polio-eradication/about-eradication/surveillance.html

  Quality surveillance is foundational to the polio eradication initiative. Surveillance both detects the presence of poliovirus and informs the programmes actions typically, whether to launch a vaccination campaign in response to disease detection, and if so, what sort of campaign. […] As the world moves closer to polio eradication, surveillance becomes ever more important: the final determination to certify the Eastern Mediterranean Region free of wild poliovirus will rest on the basis of surveillance data. […] Polio surveillance is the practice of exhaustively searching for poliovirus in its only known reservoir humans. […] AFP surveillance is known as the gold standard of polio surveillance, but environmental surveillance has an increasingly important role in the Region. […] The polio programme relies on a vast network of health care workers, traditional healers, pharmacists and community leaders around the Region to look for, and report, any case of AFP in their community.

• #19 Surveillance – GPEI

  https://polioeradication.org/what-we-do/

  Polio surveillance underpins the entire polio eradication initiative. Without surveillance, it would be impossible to pinpoint where and how poliovirus is still circulating. Polio surveillance identifies new cases and detects any circulation of poliovirus. […] Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. […] The number of AFP cases reported each year is used as an indicator of a countrys ability to detect polio even in countries where the disease no longer occurs. A countrys surveillance system needs to be sensitive enough to detect at least one case of AFP for every 100 000 children under 15 even in the absence of polio.

• #20 Surveillance – GPEI

  https://polioeradication.org/what-we-do/

  Polio surveillance underpins the entire polio eradication initiative. Without surveillance, it would be impossible to pinpoint where and how poliovirus is still circulating. Polio surveillance identifies new cases and detects any circulation of poliovirus. […] Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. […] The number of AFP cases reported each year is used as an indicator of a countrys ability to detect polio even in countries where the disease no longer occurs. A countrys surveillance system needs to be sensitive enough to detect at least one case of AFP for every 100 000 children under 15 even in the absence of polio.

• #21 WHO EMRO | Surveillance | About eradication | Polio Eradication

  https://www.emro.who.int/polio-eradication/about-eradication/surveillance.html

  When a person with AFP is reported, a polio surveillance officer travels to their home or the nearest health clinic to collect stool samples. […] Environmental surveillance involves testing sewage runoff for the presence of poliovirus. […] Because the majority of cases of poliomyelitis are asymptomatic, but all infected people shed virus in their stool, environmental surveillance has the benefit of allowing us to detect the presence of polio in an area before any case of paralysis appears. […] Between 2020 and 2021, the polio programme expanded its environmental surveillance network in the Region, particularly in Afghanistan, Egypt, Somalia and Sudan. […] The Eastern Mediterranean Region Polio Laboratory Network was established in 1991 by WHO and national governments. […] Its key role is to provide virological information that can be used to target resources on eradicating and, in the case of importations, containing the spread of wild polioviruses.

• #22 WHO EMRO | Surveillance | About eradication | Polio Eradication

  https://www.emro.who.int/polio-eradication/about-eradication/surveillance.html

  When a person with AFP is reported, a polio surveillance officer travels to their home or the nearest health clinic to collect stool samples. […] Environmental surveillance involves testing sewage runoff for the presence of poliovirus. […] Because the majority of cases of poliomyelitis are asymptomatic, but all infected people shed virus in their stool, environmental surveillance has the benefit of allowing us to detect the presence of polio in an area before any case of paralysis appears. […] Between 2020 and 2021, the polio programme expanded its environmental surveillance network in the Region, particularly in Afghanistan, Egypt, Somalia and Sudan. […] The Eastern Mediterranean Region Polio Laboratory Network was established in 1991 by WHO and national governments. […] Its key role is to provide virological information that can be used to target resources on eradicating and, in the case of importations, containing the spread of wild polioviruses.

• #23 Environmental Surveillance for Polioviruses in the Global Polio Eradication Initiative

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10578309/

  The main objective of environmental surveillance (ES) for polioviruses is to complement disease-based AFP surveillance for suspected polio cases. Sampling of environmental sewage or wastewater for programmatically relevant polioviruses has been used for many years to supplement AFP surveillance in many countries. ES has played a key role in documenting the elimination of WPV from Egypt and India. ES continues to play an important role in the eradication of WPV from the remaining polio-endemic countries of Pakistan, Afghanistan, and Nigeria. ES can assist in identifying residual WPV transmission, such as where WPV circulates among those who are asymptomatically infected and not showing clinical signs of paralysis. […] The rationale for ES is based on the characteristic poliovirus excretion pattern. Infected individuals excrete poliovirus in feces for periods of up to several weeks, whether or not they are symptomatic. Large numbers of excreted poliovirus particles remain infectious in the environment for varying durations, depending on the immediate conditions of the wastewater. Accordingly, ES can provide valuable information, particularly in high-density urban populations where AFP surveillance is absent or of poor quality, persistent virus circulation is suspected, or frequent virus reintroduction is perceived.

• #24 Environmental Surveillance for Polioviruses in the Global Polio Eradication Initiative

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10578309/

  This article summarizes the status of environmental surveillance (ES) used by the Global Polio Eradication Initiative, provides the rationale for ES, gives examples of ES methods and findings, and summarizes how these data are used to achieve poliovirus eradication. ES complements clinical acute flaccid paralysis (AFP) surveillance for possible polio cases. ES detects poliovirus circulation in environmental sewage and is used to monitor transmission in communities. If detected, the genetic sequences of polioviruses isolated from ES are compared with those of isolates from clinical cases to evaluate the relationships among viruses. To evaluate poliovirus transmission, ES programs must be developed in a manner that is sensitive, with sufficiently frequent sampling, appropriate isolation methods, and specifically targeted sampling sites in locations at highest risk for poliovirus transmission. After poliovirus ceased to be detected in human cases, ES documented the absence of endemic WPV transmission and detected imported WPV. ES provides valuable information, particularly in high-density populations where AFP surveillance is of poor quality, persistent virus circulation is suspected, or frequent virus reintroduction is perceived. Given the benefits of ES, GPEI plans to continue and expand ES as part of its strategic plan and as a supplement to AFP surveillance.

• #25 WHO EMRO | Surveillance | About eradication | Polio Eradication

  https://www.emro.who.int/polio-eradication/about-eradication/surveillance.html

  When a person with AFP is reported, a polio surveillance officer travels to their home or the nearest health clinic to collect stool samples. […] Environmental surveillance involves testing sewage runoff for the presence of poliovirus. […] Because the majority of cases of poliomyelitis are asymptomatic, but all infected people shed virus in their stool, environmental surveillance has the benefit of allowing us to detect the presence of polio in an area before any case of paralysis appears. […] Between 2020 and 2021, the polio programme expanded its environmental surveillance network in the Region, particularly in Afghanistan, Egypt, Somalia and Sudan. […] The Eastern Mediterranean Region Polio Laboratory Network was established in 1991 by WHO and national governments. […] Its key role is to provide virological information that can be used to target resources on eradicating and, in the case of importations, containing the spread of wild polioviruses.

• #26 Surveillance To Track Progress Toward Polio Eradication — Worldwide, 2022–2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7313a1.htm

  This surveillance update evaluated indicators from AFP surveillance, environmental surveillance for polioviruses, and Global Polio Laboratory Network performance data provided by 28 priority countries for the program during 20222023. […] During 20222023, among 28 priority countries, 20 (71.4%) met national AFP surveillance indicator targets, and the number of environmental surveillance sites increased. However, low national rates of reported AFP cases in priority countries in 2023 might have resulted from surveillance reporting lags; substantial national and subnational AFP surveillance gaps persist. […] High-quality surveillance is crucial for the timely detection of circulating polioviruses and the rapid activation of outbreak response vaccination activities to stop transmission. Countries must monitor surveillance indicators to identify gaps and enhance the sensitivity and timeliness of surveillance activities through supportive supervision and training to guide progress toward the goal of global polio eradication.

• #27 Surveillance Indicators – GPEI

  https://polioeradication.org/polio-today/surveillance-indicators/

  Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. The four steps of surveillance are: finding and reporting children with acute flaccid paralysis (AFP) […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. Systematic environmental sampling (e.g. in Egypt and Mumbai, India) provides important supplementary surveillance data. Ad-hoc environmental surveillance elsewhere (especially in polio-free regions) provides insights into the international spread of poliovirus. Effective polio surveillance requires virologists, epidemiologists, clinicians and national immunization programme staff, backed up by a global network of laboratories. The Global Polio Laboratory Network (GPLN) was established in 1990 by WHO and national governments. Its primary responsibility is to distinguish poliovirus as a cause of acute flaccid paralysis (AFP) from AFP caused by other diseases. The GPLN consists of 146 WHO accredited polio laboratories, in 92 countries across the six WHO regions of the world. National, regional and global specialized polio laboratories follow WHO-recommended procedures for detecting and characterizing polioviruses from stool and sewage samples collected from AFP cases and the environment, respectively. The laboratories follow standardized protocols to (i) isolate poliovirus, (ii) identify wild poliovirus (WPV) or screen for Sabin (vaccine) poliovirus and vaccine-derived poliovirus (VDPV), and (iii) conduct genomic sequencing. Sequencing results help monitor how poliovirus is spreading by comparing the nucleotide sequences of poliovirus isolates. The accuracy and quality of testing at GPLN member laboratories is monitored through an annual accreditation programme that includes onsite reviews of work practices, performance and proficiency testing. The GPLN processes over 220 000 stool samples from AFP cases (and their contacts), and more than 8 000 sewage samples per year. In addition to surveillance, the GPLN carries out a research agenda aimed at improving laboratory diagnostics. The GPLN meets every year to develop recommendations for improving performance and coordination and determine the research and resource needs of the network laboratories.

• #28 WHO EMRO | Surveillance | About eradication | Polio Eradication

  https://www.emro.who.int/polio-eradication/about-eradication/surveillance.html

  When a person with AFP is reported, a polio surveillance officer travels to their home or the nearest health clinic to collect stool samples. […] Environmental surveillance involves testing sewage runoff for the presence of poliovirus. […] Because the majority of cases of poliomyelitis are asymptomatic, but all infected people shed virus in their stool, environmental surveillance has the benefit of allowing us to detect the presence of polio in an area before any case of paralysis appears. […] Between 2020 and 2021, the polio programme expanded its environmental surveillance network in the Region, particularly in Afghanistan, Egypt, Somalia and Sudan. […] The Eastern Mediterranean Region Polio Laboratory Network was established in 1991 by WHO and national governments. […] Its key role is to provide virological information that can be used to target resources on eradicating and, in the case of importations, containing the spread of wild polioviruses.

• #29 Surveillance Indicators – GPEI

  https://polioeradication.org/polio-today/surveillance-indicators/

  Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. The four steps of surveillance are: finding and reporting children with acute flaccid paralysis (AFP) […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. Systematic environmental sampling (e.g. in Egypt and Mumbai, India) provides important supplementary surveillance data. Ad-hoc environmental surveillance elsewhere (especially in polio-free regions) provides insights into the international spread of poliovirus. Effective polio surveillance requires virologists, epidemiologists, clinicians and national immunization programme staff, backed up by a global network of laboratories. The Global Polio Laboratory Network (GPLN) was established in 1990 by WHO and national governments. Its primary responsibility is to distinguish poliovirus as a cause of acute flaccid paralysis (AFP) from AFP caused by other diseases. The GPLN consists of 146 WHO accredited polio laboratories, in 92 countries across the six WHO regions of the world. National, regional and global specialized polio laboratories follow WHO-recommended procedures for detecting and characterizing polioviruses from stool and sewage samples collected from AFP cases and the environment, respectively. The laboratories follow standardized protocols to (i) isolate poliovirus, (ii) identify wild poliovirus (WPV) or screen for Sabin (vaccine) poliovirus and vaccine-derived poliovirus (VDPV), and (iii) conduct genomic sequencing. Sequencing results help monitor how poliovirus is spreading by comparing the nucleotide sequences of poliovirus isolates. The accuracy and quality of testing at GPLN member laboratories is monitored through an annual accreditation programme that includes onsite reviews of work practices, performance and proficiency testing. The GPLN processes over 220 000 stool samples from AFP cases (and their contacts), and more than 8 000 sewage samples per year. In addition to surveillance, the GPLN carries out a research agenda aimed at improving laboratory diagnostics. The GPLN meets every year to develop recommendations for improving performance and coordination and determine the research and resource needs of the network laboratories.

• #30 Surveillance Indicators – GPEI

  https://polioeradication.org/polio-today/surveillance-indicators/

  Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. The four steps of surveillance are: finding and reporting children with acute flaccid paralysis (AFP) […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. Systematic environmental sampling (e.g. in Egypt and Mumbai, India) provides important supplementary surveillance data. Ad-hoc environmental surveillance elsewhere (especially in polio-free regions) provides insights into the international spread of poliovirus. Effective polio surveillance requires virologists, epidemiologists, clinicians and national immunization programme staff, backed up by a global network of laboratories. The Global Polio Laboratory Network (GPLN) was established in 1990 by WHO and national governments. Its primary responsibility is to distinguish poliovirus as a cause of acute flaccid paralysis (AFP) from AFP caused by other diseases. The GPLN consists of 146 WHO accredited polio laboratories, in 92 countries across the six WHO regions of the world. National, regional and global specialized polio laboratories follow WHO-recommended procedures for detecting and characterizing polioviruses from stool and sewage samples collected from AFP cases and the environment, respectively. The laboratories follow standardized protocols to (i) isolate poliovirus, (ii) identify wild poliovirus (WPV) or screen for Sabin (vaccine) poliovirus and vaccine-derived poliovirus (VDPV), and (iii) conduct genomic sequencing. Sequencing results help monitor how poliovirus is spreading by comparing the nucleotide sequences of poliovirus isolates. The accuracy and quality of testing at GPLN member laboratories is monitored through an annual accreditation programme that includes onsite reviews of work practices, performance and proficiency testing. The GPLN processes over 220 000 stool samples from AFP cases (and their contacts), and more than 8 000 sewage samples per year. In addition to surveillance, the GPLN carries out a research agenda aimed at improving laboratory diagnostics. The GPLN meets every year to develop recommendations for improving performance and coordination and determine the research and resource needs of the network laboratories.

• #31 Surveillance Indicators – GPEI

  https://polioeradication.org/polio-today/surveillance-indicators/

  Nationwide AFP (acute flaccid paralysis) surveillance is the gold standard for detecting cases of poliomyelitis. The four steps of surveillance are: finding and reporting children with acute flaccid paralysis (AFP) […] Environmental surveillance involves testing sewage or other environmental samples for the presence of poliovirus. Environmental surveillance often confirms wild poliovirus infections in the absence of cases of paralysis. Systematic environmental sampling (e.g. in Egypt and Mumbai, India) provides important supplementary surveillance data. Ad-hoc environmental surveillance elsewhere (especially in polio-free regions) provides insights into the international spread of poliovirus. Effective polio surveillance requires virologists, epidemiologists, clinicians and national immunization programme staff, backed up by a global network of laboratories. The Global Polio Laboratory Network (GPLN) was established in 1990 by WHO and national governments. Its primary responsibility is to distinguish poliovirus as a cause of acute flaccid paralysis (AFP) from AFP caused by other diseases. The GPLN consists of 146 WHO accredited polio laboratories, in 92 countries across the six WHO regions of the world. National, regional and global specialized polio laboratories follow WHO-recommended procedures for detecting and characterizing polioviruses from stool and sewage samples collected from AFP cases and the environment, respectively. The laboratories follow standardized protocols to (i) isolate poliovirus, (ii) identify wild poliovirus (WPV) or screen for Sabin (vaccine) poliovirus and vaccine-derived poliovirus (VDPV), and (iii) conduct genomic sequencing. Sequencing results help monitor how poliovirus is spreading by comparing the nucleotide sequences of poliovirus isolates. The accuracy and quality of testing at GPLN member laboratories is monitored through an annual accreditation programme that includes onsite reviews of work practices, performance and proficiency testing. The GPLN processes over 220 000 stool samples from AFP cases (and their contacts), and more than 8 000 sewage samples per year. In addition to surveillance, the GPLN carries out a research agenda aimed at improving laboratory diagnostics. The GPLN meets every year to develop recommendations for improving performance and coordination and determine the research and resource needs of the network laboratories.

• #32 Surveillance To Track Progress Toward Polio Eradication — Worldwide, 2022–2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7313a1.htm

  This surveillance update evaluated indicators from AFP surveillance, environmental surveillance for polioviruses, and Global Polio Laboratory Network performance data provided by 28 priority countries for the program during 20222023. […] During 20222023, among 28 priority countries, 20 (71.4%) met national AFP surveillance indicator targets, and the number of environmental surveillance sites increased. However, low national rates of reported AFP cases in priority countries in 2023 might have resulted from surveillance reporting lags; substantial national and subnational AFP surveillance gaps persist. […] High-quality surveillance is crucial for the timely detection of circulating polioviruses and the rapid activation of outbreak response vaccination activities to stop transmission. Countries must monitor surveillance indicators to identify gaps and enhance the sensitivity and timeliness of surveillance activities through supportive supervision and training to guide progress toward the goal of global polio eradication.

• #33 Polio trends promising, but surveillance gaps linger | CIDRAP

  https://www.cidrap.umn.edu/polio/polio-trends-promising-surveillance-gaps-linger

  In 2017, the number of global wild poliovirus (WPV) cases sank to its lowest level, and though surveillance markers are improving in many countries, remaining gaps mean that progress is fragile, according to a new snapshot that looked at trends for 2016 and 2017. […] The authors note that two metrics are used to measure the quality of acute flaccid paralysis (AFP) surveillance, a nonpolio AFP rate of 2 or more and adequate stool specimens from 80% or more of patients who have AFP. […] „Although overall performance improved in 2017, national-level surveillance indicators masked suboptimal surveillance performance at subnational levels in both regions,” the group wrote, acknowledging that inaccessible and conflict areas are vulnerable to gaps in tracking. […] They emphasized that the need for strong polio surveillance will remain beyond eradication certification and well after the oral poliovirus vaccine has been phased out globally. „As long as polioviruses continue to circulate in any country, all countries remain at risk,” the authors wrote. […] Though conflict situations limit standard health-facility surveillance, community-based surveillance has been effective at finding AFP cases, the team wrote.

• #34 Surveillance To Track Progress Toward Polio Eradication — Worldwide, 2022–2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7313a1.htm

  This surveillance update evaluated indicators from AFP surveillance, environmental surveillance for polioviruses, and Global Polio Laboratory Network performance data provided by 28 priority countries for the program during 20222023. […] During 20222023, among 28 priority countries, 20 (71.4%) met national AFP surveillance indicator targets, and the number of environmental surveillance sites increased. However, low national rates of reported AFP cases in priority countries in 2023 might have resulted from surveillance reporting lags; substantial national and subnational AFP surveillance gaps persist. […] High-quality surveillance is crucial for the timely detection of circulating polioviruses and the rapid activation of outbreak response vaccination activities to stop transmission. Countries must monitor surveillance indicators to identify gaps and enhance the sensitivity and timeliness of surveillance activities through supportive supervision and training to guide progress toward the goal of global polio eradication.

• #35 Polio trends promising, but surveillance gaps linger | CIDRAP

  https://www.cidrap.umn.edu/polio/polio-trends-promising-surveillance-gaps-linger

  In 2017, the number of global wild poliovirus (WPV) cases sank to its lowest level, and though surveillance markers are improving in many countries, remaining gaps mean that progress is fragile, according to a new snapshot that looked at trends for 2016 and 2017. […] The authors note that two metrics are used to measure the quality of acute flaccid paralysis (AFP) surveillance, a nonpolio AFP rate of 2 or more and adequate stool specimens from 80% or more of patients who have AFP. […] „Although overall performance improved in 2017, national-level surveillance indicators masked suboptimal surveillance performance at subnational levels in both regions,” the group wrote, acknowledging that inaccessible and conflict areas are vulnerable to gaps in tracking. […] They emphasized that the need for strong polio surveillance will remain beyond eradication certification and well after the oral poliovirus vaccine has been phased out globally. „As long as polioviruses continue to circulate in any country, all countries remain at risk,” the authors wrote. […] Though conflict situations limit standard health-facility surveillance, community-based surveillance has been effective at finding AFP cases, the team wrote.

• #36 WHO EMRO | Surveillance | About eradication | Polio Eradication

  https://www.emro.who.int/polio-eradication/about-eradication/surveillance.html

  Although surveillance systems across the Region were impacted by the COVID-19 pandemic, regional surveillance have continued to function through the pandemic and have done so in line with special guidelines set by the GPEI to ensure the safety of workers. […] Even alongside this increase in workload and the complexities wrought by the COVID-19 pandemic, most countries in the Region have met and continue to meet global standards for surveillance indicators.

• #37 Global Polio Surveillance Status Report 2019 – World | ReliefWeb

  https://reliefweb.int/report/world/global-polio-surveillance-status-report-2019

  Global efforts to eradicate polio began in 1988 and, to date, four of the six World Health Organization (WHO) regions have achieved polio-free certification. […] Ensuring polio surveillance reach is sensitive and expansive enough to identify poliovirus circulation in every region and every country is a priority for the Global Polio Eradication Initiative (GPEI) and a prerequisite for the global certification of the eradication of poliomyelitis. […] Polio surveillance is complicated by the inability of the GPEI to maintain adequate sensitivity in all countries, especially in regions that have been polio-free for some time. […] To address ongoing challenges, the Global Polio Surveillance Action Plan (GPSAP) 20182020 was developed to support countries in evaluating and increasing the sensitivity of their surveillance systems; to share supplemental strategies that may help close the gaps in detecting polioviruses; to strengthen coordination across surveillance field teams, the laboratory and data information systems; and to leverage activities across functional areas to create a more effective, efficient programme and document zero cases worldwide.

• #38 Surveillance To Track Progress Toward Polio Eradication — Worldwide, 2022–2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7313a1.htm

  This surveillance update evaluated indicators from AFP surveillance, environmental surveillance for polioviruses, and Global Polio Laboratory Network performance data provided by 28 priority countries for the program during 20222023. […] During 20222023, among 28 priority countries, 20 (71.4%) met national AFP surveillance indicator targets, and the number of environmental surveillance sites increased. However, low national rates of reported AFP cases in priority countries in 2023 might have resulted from surveillance reporting lags; substantial national and subnational AFP surveillance gaps persist. […] High-quality surveillance is crucial for the timely detection of circulating polioviruses and the rapid activation of outbreak response vaccination activities to stop transmission. Countries must monitor surveillance indicators to identify gaps and enhance the sensitivity and timeliness of surveillance activities through supportive supervision and training to guide progress toward the goal of global polio eradication.

• #39 Polio trends promising, but surveillance gaps linger | CIDRAP

  https://www.cidrap.umn.edu/polio/polio-trends-promising-surveillance-gaps-linger

  In 2017, the number of global wild poliovirus (WPV) cases sank to its lowest level, and though surveillance markers are improving in many countries, remaining gaps mean that progress is fragile, according to a new snapshot that looked at trends for 2016 and 2017. […] The authors note that two metrics are used to measure the quality of acute flaccid paralysis (AFP) surveillance, a nonpolio AFP rate of 2 or more and adequate stool specimens from 80% or more of patients who have AFP. […] „Although overall performance improved in 2017, national-level surveillance indicators masked suboptimal surveillance performance at subnational levels in both regions,” the group wrote, acknowledging that inaccessible and conflict areas are vulnerable to gaps in tracking. […] They emphasized that the need for strong polio surveillance will remain beyond eradication certification and well after the oral poliovirus vaccine has been phased out globally. „As long as polioviruses continue to circulate in any country, all countries remain at risk,” the authors wrote. […] Though conflict situations limit standard health-facility surveillance, community-based surveillance has been effective at finding AFP cases, the team wrote.

• #40 Surveillance Review System to Track Progress Towards Polio Eradication in the Horn of Africa

  https://www.immunologyresearchjournal.com/articles/surveillance-review-system-to-track-progress-towards-polio-eradication-in-the-horn-of-africa.html

  The WPV and cVDPV has not been reported in Kenya in the one year surveillance review period. […] However, during the period some of the AFP cases were delayed (pending) to be finally classified since week 3. […] The Surveillance system structure was well established from the National level down to the community level. […] However, only 89% of the Health facilities visited have designated surveillance Focal Points. […] The National surveillance action plan was not activity-specific; timelines and deliverables were absent as were specific budget lines for surveillance. […] Sixty-day follow-up reports were missing for most inadequate AFP cases (14 reports conducted /60 inadequate cases), and surveillance review meetings were not held regularly (40% of counties and 70% in sub counties).

• #41 Surveillance Review System to Track Progress Towards Polio Eradication in the Horn of Africa

  https://www.immunologyresearchjournal.com/articles/surveillance-review-system-to-track-progress-towards-polio-eradication-in-the-horn-of-africa.html

  The surveillance system in Somalia is based on the arrangement of the village Polio Volunteers who are community based and detect nearly 70% of all AFP cases. […] The advocacy for disease surveillance to the county assembly is inadequate. […] There was a general lack of analysis and feedback of data on operational surveillance aspects, at County (80%) and Sub-County (80%) levels. […] The review led to recommendations that helped the national programmes to strengthen surveillance through trainings and prioritizing of hard-to-reach and migratory populations, as well as use of short message service (SMS) and other reporting technologies, active surveillance at the community level, environmental surveillance, and strengthening partnerships with other health programmes.

• #42 Global Polio Surveillance Status Report 2019 – World | ReliefWeb

  https://reliefweb.int/report/world/global-polio-surveillance-status-report-2019

  Global efforts to eradicate polio began in 1988 and, to date, four of the six World Health Organization (WHO) regions have achieved polio-free certification. […] Ensuring polio surveillance reach is sensitive and expansive enough to identify poliovirus circulation in every region and every country is a priority for the Global Polio Eradication Initiative (GPEI) and a prerequisite for the global certification of the eradication of poliomyelitis. […] Polio surveillance is complicated by the inability of the GPEI to maintain adequate sensitivity in all countries, especially in regions that have been polio-free for some time. […] To address ongoing challenges, the Global Polio Surveillance Action Plan (GPSAP) 20182020 was developed to support countries in evaluating and increasing the sensitivity of their surveillance systems; to share supplemental strategies that may help close the gaps in detecting polioviruses; to strengthen coordination across surveillance field teams, the laboratory and data information systems; and to leverage activities across functional areas to create a more effective, efficient programme and document zero cases worldwide.

• #43 Polio surveillance in real time – World | ReliefWeb

  https://reliefweb.int/report/world/polio-surveillance-real-time

  In order to ensure that active search is conducted timely with real time evidence the polio surveillance systems in Kenya, Ethiopia, Uganda, Eritrea, South Sudan, and Tanzania have adopted an easy-to-use, portable disease surveillance monitoring tool. […] The tool is known as Integrated Surveillance and Routine Immunization Supervision. […] This provides real-time monitoring in the field. […] Now, we are sure we are not missing things. said Christopher Kamugisha, WHOs Horn of Africa Outbreak Coordinator. […] It also means health workers actively searching for AFP do not have to spend extra time ensuring the information gathered in the field is being shared with the right people for them to take action. For the ongoing outbreak of circulating vaccine-derived poliovirus in the Horn of Africa, this means better disease surveillance and a better chance to protect children against polio.

• #44 Polio surveillance in real time – World | ReliefWeb

  https://reliefweb.int/report/world/polio-surveillance-real-time

  In order to ensure that active search is conducted timely with real time evidence the polio surveillance systems in Kenya, Ethiopia, Uganda, Eritrea, South Sudan, and Tanzania have adopted an easy-to-use, portable disease surveillance monitoring tool. […] The tool is known as Integrated Surveillance and Routine Immunization Supervision. […] This provides real-time monitoring in the field. […] Now, we are sure we are not missing things. said Christopher Kamugisha, WHOs Horn of Africa Outbreak Coordinator. […] It also means health workers actively searching for AFP do not have to spend extra time ensuring the information gathered in the field is being shared with the right people for them to take action. For the ongoing outbreak of circulating vaccine-derived poliovirus in the Horn of Africa, this means better disease surveillance and a better chance to protect children against polio.

• #45 New tools for polio surveillance could aid eradication efforts | Environmental & Occupational Health Sciences

  https://deohs.washington.edu/news/new-tools-polio-surveillance-could-aid-eradication-efforts

  New tools for polio surveillance could aid eradication efforts. With grant funding made possible by the Paul G. Allen Family Foundation, two new tools to help detect the poliovirus may soon strengthen global efforts to eradicate the disease. The tools, a system to improve environmental surveillance and a simplified diagnostic test, were developed by PATH, a leading international health organization, and researchers at the University of Washington (UW). They have the potential to help workers identify and stop polio by making it easier to find the virus in sewage and among people. […] The recent WHO declaration, and periodic outbreaks, point to the importance of strong surveillance. The poliovirus can spread quickly, facilitated by sewage-contaminated floodwaters, travelers with the infection, and gaps in immunization coverage.

• #46 New tools for polio surveillance could aid eradication efforts | Environmental & Occupational Health Sciences

  https://deohs.washington.edu/news/new-tools-polio-surveillance-could-aid-eradication-efforts

  Good surveillance is crucial to monitor this approach and push the global eradication strategy forward. […] Today, the CDC and WHO lead a coordinated, state-of-the art global surveillance program. This includes the Global Polio Laboratory Network (GPLN), a web of facilities that monitor and test for the virus worldwide. Although this program is bringing eradication within reach, enhanced surveillance methods are still needed. […] To detect polio as early as possible, health workers monitor the virus by collecting and testing water samples (environmental surveillance) and by testing individuals who have symptoms that suggest polio infection. […] The improved system could decrease the time required to process an environmental sample from one month to two days. […] An inexpensive, easier-to-use test has the potential to complement existing options. PATH is developing a simplified diagnostic tool to detect the poliovirus that is fast, reliable, and can be used in local laboratories without complex equipment. […] Together, the bag-mediated filtration system and poliovirus diagnostic tool provide a good example of PATHs work to push innovative health solutions to scale.

• #47 Sewage surveillance is the next frontier in the fight against polio

  https://theconversation.com/sewage-surveillance-is-the-next-frontier-in-the-fight-against-polio-105012

  A mathematical model allows epidemiologists to use what we know about a situations underlying biological mechanisms to better interpret or extract more information from data. […] Our goal was to come up with a model that would explain how the disease was transmitted through the population in Israel that would match the observed changes in sewage polio levels over time. […] Positive polio samples from the environment only alert public health officials that transmission is happening. […] As we approach the final stages of polio eradication, environmental measures will become the only feasible way to detect polio transmission. […] Environmental surveillance efforts are growing in all three polio-endemic countries. […] WHO is working toward developing organized environmental surveillance standards akin to the well-established standards for acute flaccid paralysis. […] Epidemiologists can then use modeling approaches to translate surveillance data to describe population patterns, allowing public health officials to respond rapidly to outbreaks.

• #48 Sewage surveillance is the next frontier in the fight against polio

  https://theconversation.com/sewage-surveillance-is-the-next-frontier-in-the-fight-against-polio-105012

  A mathematical model allows epidemiologists to use what we know about a situations underlying biological mechanisms to better interpret or extract more information from data. […] Our goal was to come up with a model that would explain how the disease was transmitted through the population in Israel that would match the observed changes in sewage polio levels over time. […] Positive polio samples from the environment only alert public health officials that transmission is happening. […] As we approach the final stages of polio eradication, environmental measures will become the only feasible way to detect polio transmission. […] Environmental surveillance efforts are growing in all three polio-endemic countries. […] WHO is working toward developing organized environmental surveillance standards akin to the well-established standards for acute flaccid paralysis. […] Epidemiologists can then use modeling approaches to translate surveillance data to describe population patterns, allowing public health officials to respond rapidly to outbreaks.

• #49 Surveillance To Track Progress Toward Polio Eradication – Worldwide, 2022-2023 – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38573841/

  The reliable and timely detection of poliovirus cases through surveillance for acute flaccid paralysis (AFP), supplemented by environmental surveillance of sewage samples, is a critical component of the polio eradication program. […] This surveillance update evaluated indicators from AFP surveillance, environmental surveillance for polioviruses, and Global Polio Laboratory Network performance data provided by 28 priority countries for the program during 2022-2023. […] Maintaining high-quality surveillance is critical to achieving the goal of global polio eradication. Monitoring surveillance indicators is important to identifying gaps and guiding surveillance-strengthening activities, particularly in countries at high risk for poliovirus circulation.

• #50 Polio trends promising, but surveillance gaps linger | CIDRAP

  https://www.cidrap.umn.edu/polio/polio-trends-promising-surveillance-gaps-linger

  In 2017, the number of global wild poliovirus (WPV) cases sank to its lowest level, and though surveillance markers are improving in many countries, remaining gaps mean that progress is fragile, according to a new snapshot that looked at trends for 2016 and 2017. […] The authors note that two metrics are used to measure the quality of acute flaccid paralysis (AFP) surveillance, a nonpolio AFP rate of 2 or more and adequate stool specimens from 80% or more of patients who have AFP. […] „Although overall performance improved in 2017, national-level surveillance indicators masked suboptimal surveillance performance at subnational levels in both regions,” the group wrote, acknowledging that inaccessible and conflict areas are vulnerable to gaps in tracking. […] They emphasized that the need for strong polio surveillance will remain beyond eradication certification and well after the oral poliovirus vaccine has been phased out globally. „As long as polioviruses continue to circulate in any country, all countries remain at risk,” the authors wrote. […] Though conflict situations limit standard health-facility surveillance, community-based surveillance has been effective at finding AFP cases, the team wrote.

• #51 Polio trends promising, but surveillance gaps linger | CIDRAP

  https://www.cidrap.umn.edu/polio/polio-trends-promising-surveillance-gaps-linger

  In 2017, the number of global wild poliovirus (WPV) cases sank to its lowest level, and though surveillance markers are improving in many countries, remaining gaps mean that progress is fragile, according to a new snapshot that looked at trends for 2016 and 2017. […] The authors note that two metrics are used to measure the quality of acute flaccid paralysis (AFP) surveillance, a nonpolio AFP rate of 2 or more and adequate stool specimens from 80% or more of patients who have AFP. […] „Although overall performance improved in 2017, national-level surveillance indicators masked suboptimal surveillance performance at subnational levels in both regions,” the group wrote, acknowledging that inaccessible and conflict areas are vulnerable to gaps in tracking. […] They emphasized that the need for strong polio surveillance will remain beyond eradication certification and well after the oral poliovirus vaccine has been phased out globally. „As long as polioviruses continue to circulate in any country, all countries remain at risk,” the authors wrote. […] Though conflict situations limit standard health-facility surveillance, community-based surveillance has been effective at finding AFP cases, the team wrote.

• #52 Role of environmental poliovirus surveillance in global polio eradication and beyond | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/role-of-environmental-poliovirus-surveillance-in-global-polio-eradication-and-beyond/DBB1EC7A25FBB252D7EDF9F2F7939FE3

  ENV should be available and in place during the critical period between interruption of WPV transmission and certification of polio eradication, and, should continue into the post-eradication and OPV cessation periods to monitor for the emergence of VDPVs, re-emergence of WPVs, or disappearance of all OPV-related strains.

• #53 The Future of Polio Surveillance

  https://www.csis.org/analysis/future-polio-surveillance

  The polio program’s surveillance success has been possible because of the significant financial and technical resources devoted to polio eradication. […] Maintaining a polio-free world will require vigilance for some time post eradication. […] Significant attention and resources for polio-related tasks such as vaccination and virus containment in research and manufacturing facilities must continue for at least an additional 10 years after eradication is declared. […] The polio surveillance system has the reach and technical capacity to serve as the foundation for the most effective global surveillance system ever developed.

• #54 The Future of Polio Surveillance

  https://www.csis.org/analysis/future-polio-surveillance

  The polio program’s surveillance success has been possible because of the significant financial and technical resources devoted to polio eradication. […] Maintaining a polio-free world will require vigilance for some time post eradication. […] Significant attention and resources for polio-related tasks such as vaccination and virus containment in research and manufacturing facilities must continue for at least an additional 10 years after eradication is declared. […] The polio surveillance system has the reach and technical capacity to serve as the foundation for the most effective global surveillance system ever developed.

• #55 Disease surveillance: from field to laboratory – Africa Kicks Out Wild Polio

  https://www.africakicksoutwildpolio.com/polio-pillars-disease-surveillance-from-field-to-laboratory/

  Among the first measures taken to improve detection of poliovirus was the development of a system for spotting and registering cases of acute flaccid paralysis (AFP), and the creation of a global polio laboratory network to confirm diagnoses. […] By 2011, the use of environmental surveillance meant that the poliovirus could also be identified in sewage, providing an important supplement to case reporting. […] The vast disease surveillance network built up over the years through the polio programme has left a far-reaching legacy for Africa’s healthcare systems and the continent’s capacity to respond to other diseases. […] Polio disease surveillance has equipped Africa with skilled healthcare professionals and scientists, including epidemiologists and virologists.

• #56 Surveillance Review System to Track Progress Towards Polio Eradication in the Horn of Africa

  https://www.immunologyresearchjournal.com/articles/surveillance-review-system-to-track-progress-towards-polio-eradication-in-the-horn-of-africa.html

  Some of the strengths of the surveillance system in Kenya include the fact that the surveillance system structure was well established from the National level down to the community level. […] Surveillance activities were integrated with other public health activities, e.g. Malaria, Maternal health services, etc. in some Counties and Sub-Counties. […] The review team noted that there is a well-established Surveillance structure in all regions with designated Public health emergency management (PHEM) focal persons at all levels. […] Surveillance is considered as a priority health activity in all the regions. […] The team observed a functioning integrated surveillance system at all levels with the availability of NNT/Measles guidelines, forms and Kits prepositioned at various levels and a high knowledge of standard case definitions for NNT and Measles for case detection among staff.

• #57 Surveillance To Track Progress Toward Polio Eradication — Worldwide, 2022–2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7313a1.htm

  This surveillance update evaluated indicators from AFP surveillance, environmental surveillance for polioviruses, and Global Polio Laboratory Network performance data provided by 28 priority countries for the program during 20222023. […] During 20222023, among 28 priority countries, 20 (71.4%) met national AFP surveillance indicator targets, and the number of environmental surveillance sites increased. However, low national rates of reported AFP cases in priority countries in 2023 might have resulted from surveillance reporting lags; substantial national and subnational AFP surveillance gaps persist. […] High-quality surveillance is crucial for the timely detection of circulating polioviruses and the rapid activation of outbreak response vaccination activities to stop transmission. Countries must monitor surveillance indicators to identify gaps and enhance the sensitivity and timeliness of surveillance activities through supportive supervision and training to guide progress toward the goal of global polio eradication.

• #58 Polio surveillance in real time – World | ReliefWeb

  https://reliefweb.int/report/world/polio-surveillance-real-time

  In order to ensure that active search is conducted timely with real time evidence the polio surveillance systems in Kenya, Ethiopia, Uganda, Eritrea, South Sudan, and Tanzania have adopted an easy-to-use, portable disease surveillance monitoring tool. […] The tool is known as Integrated Surveillance and Routine Immunization Supervision. […] This provides real-time monitoring in the field. […] Now, we are sure we are not missing things. said Christopher Kamugisha, WHOs Horn of Africa Outbreak Coordinator. […] It also means health workers actively searching for AFP do not have to spend extra time ensuring the information gathered in the field is being shared with the right people for them to take action. For the ongoing outbreak of circulating vaccine-derived poliovirus in the Horn of Africa, this means better disease surveillance and a better chance to protect children against polio.

• #59 WHO EMRO | Surveillance | About eradication | Polio Eradication

  https://www.emro.who.int/polio-eradication/about-eradication/surveillance.html

  Quality surveillance is foundational to the polio eradication initiative. Surveillance both detects the presence of poliovirus and informs the programmes actions typically, whether to launch a vaccination campaign in response to disease detection, and if so, what sort of campaign. […] As the world moves closer to polio eradication, surveillance becomes ever more important: the final determination to certify the Eastern Mediterranean Region free of wild poliovirus will rest on the basis of surveillance data. […] Polio surveillance is the practice of exhaustively searching for poliovirus in its only known reservoir humans. […] AFP surveillance is known as the gold standard of polio surveillance, but environmental surveillance has an increasingly important role in the Region. […] The polio programme relies on a vast network of health care workers, traditional healers, pharmacists and community leaders around the Region to look for, and report, any case of AFP in their community.

• #60 Role of environmental poliovirus surveillance in global polio eradication and beyond | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/role-of-environmental-poliovirus-surveillance-in-global-polio-eradication-and-beyond/DBB1EC7A25FBB252D7EDF9F2F7939FE3

  ENV should be available and in place during the critical period between interruption of WPV transmission and certification of polio eradication, and, should continue into the post-eradication and OPV cessation periods to monitor for the emergence of VDPVs, re-emergence of WPVs, or disappearance of all OPV-related strains.

• #61 Role of environmental poliovirus surveillance in global polio eradication and beyond | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/role-of-environmental-poliovirus-surveillance-in-global-polio-eradication-and-beyond/DBB1EC7A25FBB252D7EDF9F2F7939FE3

  ENV offers an anonymous, non-invasive approach for monitoring PV circulation in populations at risk. […] Criteria for considering environmental PV surveillance as a supplementary approach in GPEI were published in WHO Guidelines for Environmental Poliovirus Surveillance. […] The Guidelines describe situations when it might be necessary to consider ENV as a supplementary approach, contain principles for selecting sampling sites, propose methods for sample processing, and suggest possible programme responses to PV detection in sewage. […] Experiences from several countries confirm that ENV can detect introduction and silent circulation of WPV and VDPV, sometimes before any AFP cases occur. […] ENV can be used to monitor the efficacy of immunization interventions when it is required. […] After eradication of WPV transmission, the risk of re-emergence of polio remains extremely high as long OPV continues to be used routinely or in campaigns organized for any reason, and thus provides a potential source of circulating neurovirulent VDPV strains.

• #62 Disease surveillance: from field to laboratory – Africa Kicks Out Wild Polio

  https://www.africakicksoutwildpolio.com/polio-pillars-disease-surveillance-from-field-to-laboratory/

  Among the first measures taken to improve detection of poliovirus was the development of a system for spotting and registering cases of acute flaccid paralysis (AFP), and the creation of a global polio laboratory network to confirm diagnoses. […] By 2011, the use of environmental surveillance meant that the poliovirus could also be identified in sewage, providing an important supplement to case reporting. […] The vast disease surveillance network built up over the years through the polio programme has left a far-reaching legacy for Africa’s healthcare systems and the continent’s capacity to respond to other diseases. […] Polio disease surveillance has equipped Africa with skilled healthcare professionals and scientists, including epidemiologists and virologists.

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