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      The efficiency and reliability of polio surveillance.

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      Developments in biologicals

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          Abstract

          Surveillance for acute flaccid paralysis (AFP) in children younger than 15 years, and careful investigation of the cases, are the cornerstones for monitoring the progress of the poliomyelitis eradication programme. However, its sensitivity to detect wild type poliovirus (wtPV) circulation decreases when the incidence of true polio cases approaches zero. Under these conditions, only about one in 100,000 children is being investigated for poliovirus excretion. No real alternative approach which is generally exploitable has been developed. Environmental surveillance may in optimal conditions be at least as sensitive in detecting poliovirus circulation as AFP surveillance. However, optimal conditions, i.e. converging sewage systems, are not used by most people in the remaining endemic countries. Enterovirus surveillance, based on isolation of poliovirus in the routine diagnostic services, is only applicable in a few countries, where the diagnostic activity covers the entire population. Whichever approach is used, we will never reach 100% certainty of complete elimination of wtPV circulation. However, by applying all these approaches optimally, we may eventually reach a probability level allowing the safe cessation of immunisation.

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          Author and article information

          Journal
          Dev Biol (Basel)
          Developments in biologicals
          1424-6074
          1424-6074
          2001
          : 105
          Affiliations
          [1 ] National Public Health Institute (KTL), Enterovirus Laboratory, Helsinki, Finland.
          Article
          11763329
          89eaf5a5-6094-435c-9552-c3e5ad49f050
          History

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