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Lancet. 1996 May 4; 347(9010):1250.This news brief provides the information that almost 50% of children aged under 5 years in the world received oral poliomyelitis vaccine during national immunization days (NIDs) in 1995. In 1995, 25 new countries conducted a national vaccine campaign. In 1995, polio cases were reported to be 6179, although the World Health Organization (WHO) estimated about 80,000 cases. It is hoped that the addition of more countries conducting NIDs would help to achieve the 1988 World Health Assembly target of 100% eradication by the year 2000. The actual expectation is complete elimination of polio by 2005. China had 5065 cases of polio in 1990 and no confirmed cases in 1995. The true test is whether there are no confirmed cases over a three-year period. The Progress Toward Global Eradication of Poliomyelitis meetings on April 29-May 3, 1996, considered the issue of proof of eradication. Some countries have exercised outstanding efforts at halting civil discord in order to conduct one day of national immunization. In the Sudan a truce was declared in 1996 for an NID. Unfortunately, there are countries, such as Chechnya, that are engaged in conflict. In Chechnya, immunization ceased in 1992 and polio returned in 1995. 75% of European cases occurred in Chechnya.
BMJ. British Medical Journal. 1996 May 11; 312(7040):1178-9.Mass administration of the oral polio vaccine (OPV) will effect eradicate poliomyelitis in developing countries. Since 1974 the World Health Organization (WHO) has operated the expanded program on immunization (EPI). Progress has been so successful that in 1988 WHO/EPI announced its commitment to global eradication of poliomyelitis by 2000. Strategies to achieve global eradication are increasing and sustaining coverage with PVO, conducting national immunization days, developing surveillance for acute flaccid paralysis, and mopping up vaccination campaigns. EPI helps countries change their national disease prevention programs into disease eradication programs. During 1988-94 the number of reported cases of poliomyelitis decreased by 84%. In 1994 India made up 93% of the regional total and 62% of the global total. Polio has almost disappeared from many developed countries. Since South East Asia is still a major global reservoir of polio viruses, WHO is implementing polio eradication strategies fully there. The mass polio vaccination campaign in most developing countries distributes two doses of PVO to all children aged 5 or less. In areas where wild poliovirus still circulates at low levels during the final stages of eradication, door to door administration of the two doses to all young children is undertaken in order to further reduce its circulation in these areas. This door to door campaign operates alongside routine polio vaccination. Pulse or cluster immunization is being successfully implemented in India. The effect of OPV is that it mimics natural infection and produces both humoral and intestinal immunity much faster than the inactivated polio vaccine. It blocks infection with the wild polio virus by establishing itself in the alimentary tract. Further, the vaccine virus spreads to children who have not been vaccinated, extending immunity to the wider population without additional expenditure. Improving vaccine delivery systems (improved maintenance of the cold chain) rather than changing immunization schedules is needed to achieve eradication. Wild poliovirus transmission has been interrupted in the Americas.
VACCINE WEEKLY. 1996 Apr 22; 16.Program for Appropriate Technology in Health (PATH), Seattle, Washington, has collaborated in developing a technology that improves the delivery of vaccines in the developing world. HEATmarker is a vaccine vial label which changes color with exposure to heat over time. This allows health workers to verify--at time of use--that each vial of vaccine is in usable condition and has not lost its potency due to heat exposure. Vaccine vial monitors (VVMs) have recently been mandated on all oral polio vaccine purchased and distributed by UNICEF throughout the world. "Vaccine vial monitors will revolutionize the way vaccines are delivered, enabling them to be administered in remote areas, outside the reach of the traditional 'cold chain' that extends from manufacturer to consumer. As a result, millions more children in remote parts of the world will have access to oral polio and other vaccines," states Peter Evans of the World Health Organization (WHO), Global Programme for Vaccine and Immunization. Evans adds, "WHO expects that $10 million a year will be saved for oral polio vaccine alone." VVMs will enable health workers to use vaccine that would otherwise have been discarded. Until now, health workers disposed of any polio vaccine that may not have been properly refrigerated in transport or that had been opened but not used because they were unable to tell if it was potent. In the future, WHO intends to require VVMs on vaccines for measles, hepatitis B, and other childhood diseases, which will result in millions more lives and dollars being saved. (full text)