Polio eradication - Knowledge

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limited surveillance and under-vaccinated populations. Moreover, for WPV1—the only type of the virus which is currently circulating following the eradication of WPV2 and WPV3—only 1 in 200 infection cases exhibit symptoms of polio paralysis in non-vaccinated children, and possibly even fewer in vaccinated children. Therefore, even a single case is indicative of an epidemic. According to modeling, it can take four to six months of no reported cases to achieve only a 50% chance of eradication, and one to two years for e.g. 95% chance. Sensitivity of monitoring for circulation can be improved by sampling sewage. In Pakistan in the last couple of years, the number of paralysis cases has dropped relatively faster than the positive environmental samples, which has shown no progress since 2015. The presence of multiple infections with the same strain in the upstream area may not be detectable, so there are some saturation effects when monitoring the number of positive environmental samples. Furthermore, virus may shed beyond the expected duration of several weeks in certain individuals. Contagiousness can not be readily excluded. For a polio virus to be certified as eradicated worldwide, at least three years of good surveillance without cases needs to be achieved, though this period may need to be longer for a strain like WPV3, where a lower proportion of those infected demonstrate symptoms, or if virus-positive environmental samples continue to be reported. Wild poliovirus type

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cVDPV2 outbreaks in Nigeria, the Democratic Republic of Congo, and Somalia continued into 2019 and spread to neighboring countries, while several countries experienced new outbreaks. In addition to eighteen reported paralysis cases in Nigeria, the cVDPV2 outbreaks there spread to Benin, Burkina Faso, Chad, Ghana, Niger, and Togo, while the virus was also detected in environmental samples from Cameroon and Ivory Coast. Somalia's continuing outbreaks caused a half-dozen cases there and in neighboring Ethiopia, with a separate Ethiopia outbreak adding one case. The Democratic Republic of the Congo had numerous new and continuing outbreaks, producing more than 80 cases, while multiple new cVDPV2 outbreaks in Angola and the Central African Republic resulted in more than a hundred cases. Individual new outbreaks of cVDPV2 also caused more than a dozen paralysis cases each in Pakistan and the Philippines, while smaller outbreaks struck Chad, China, and Zambia. A separate cVDPV1 outbreak in the Philippines also caused cases in Malaysia, where cVDPV2 of Filipino origin was also detected in environmental samples, while additional cVDPV1 outbreaks caused six cases in Myanmar and one case in Yemen.

3293:, and on poor quality surveillance extant in Southeast Africa 684 confirmed cVDPV2 cases were seen across twenty countries during 2022, in addition to 189 cases of cVDPV1 and one case of cVDPV3 in Israel. The first case since 2013 was reported in the United States, tied to cVDPV2 strains found in Israel and the United Kingdom. In Burundi and the Democratic Republic of the Congo, two outbreaks of cVDPV2 that caused a combined seven cases were identified as having a link to the nOPV2 vaccine, the first outbreaks with ties to nOPV2 after its initial deployment in 2021; according to an assessment reported by the GPEI, an estimated 30–40 additional outbreaks of cVDPV2 would have occurred from March 2021 – March 2023 without the nOPV2 rollout. Vaccine-derived viral strains were also detected in environmental samples from a number of additional countries without diagnosed cases. From February to May, traces of cVDPV2 were discovered in sewage in London, United Kingdom. This led the United Kingdom to declare a "national incident". However, authorities have said that the risk to the general public is "extremely low", and no cases have been reported. 1046: 568:

carry the disease, allowing polio to spread widely before cases are seen. In 2000, using new screening techniques for the molecular characterization of outbreak viral strains, it was discovered that some of the outbreaks were actually caused by circulating vaccine-derived poliovirus, following mutations or recombinations in the attenuated strain used for the oral polio vaccine. This discovery altered the strategy for the discontinuation of vaccination following polio eradication, necessitating an eventual switch to the more expensive and logistically more problematic inactivated polio vaccine, as continued use of the oral inactivated virus would continue to produce such revertant infection-causing strains. The risk of vaccine-derived polio will persist long after the switch to inactivated vaccine, as a small number of

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false narrative in both nations, blaming the other for the presence and spread of polio in their own country. Environmental sampling in Pakistan showed the virus' presence in eight urban areas, a setback officials attributed primarily to vaccine refusal. Opponents to vaccination in Pakistan launched a series of attacks in April that left a vaccinator and two security men dead, while false rumors and hoax videos reporting vaccine toxicity also disrupted vaccination efforts there. Wild poliovirus of Pakistani origin also spread to Iran where it was detected in several environmental samples. Overall, the eradication efforts in Pakistan and Afghanistan have been characterized as having become a "horror show", undermined by "public suspicion, political infighting, mismanagement and security problems".

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least in part by politicization of vaccination and bad governance during the pandemic, may result in a general pattern of undervaccination, including for polio. In Pakistan, a contributing factor to the resurgence of wild virus cases in the country has been threats of violence both from those with anti-vaccine sentiment and from religious extremists. A vaccination worker was assassinated in March 2022, and a vaccinator and two accompanying police officers providing security for a door-to-door vaccination campaign were murdered in June. However, the situation had improved compared to previous years as the government and law-enforcement increased their focus. By October 2022, endemic transmission was restricted to seven districts in southern

581:, Dr. Hussain A. Gezari, the WHO's special envoy on global polio eradication and primary healthcare, gave his views on obstacles to eradication. He said that the biggest hurdle preventing Pakistan from becoming polio-free was holding district health officials properly accountable—in national eradication campaigns officials had hired their own relatives, even young children. Gezari asked, "How do you expect a seven-year-old thumb-sucking kid to implement a polio campaign of the government?" and added that, in spite of this, "the first national campaign was initiated by your government in 1994 and that year Pakistan reported 25,000 polio cases, and the number was just 198 last year, which clearly shows that the programme is working." 1913:, recognizing that this would adversely affect its efforts at eradicating polio. All vaccination efforts, both routine and targeted, were postponed for several months, with staff reassigned to COVID-19 control. Subsequent statistical analysis indicated that the COVID pandemic resulted in decreases of more than 30% globally in both AFP and environmental surveillance, with only 23 of 43 priority countries meeting their surveillance targets for 2020. Additional challenges were a conspiracy theory circulating on social media claiming that the polio vaccine contained coronavirus, and moves by President Donald Trump of the United States to cut funding for the World Health Organization. 471:

contact immunity. However, under conditions of long-term circulation in undervaccinated populations, the virus can accumulate mutations that reverse the attenuation and result in vaccine virus strains that themselves cause polio. As a result of such circulating vaccine-derived poliovirus (cVDPV) strains, polio outbreaks have periodically recurred in regions that have long been free of the wild virus, but where vaccination rates have fallen. Oral vaccines can also give rise to persistent infection in immunodeficient individuals, with the virus eventually mutating into a more virulent immunodeficiency-associated vaccine-derived poliovirus (iVDPV). In particular, the type

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lineages of WPV1 seen in 2015 had been interrupted by September 2017, though at least two genetic clusters remain. In spite of a significant drop in detected cases in Pakistan, there was an increase in the percentage of environmental samples that test positive for the polio virus, suggesting gaps in identification of infected individuals. In the third country where polio remained endemic, Nigeria, there were no cases, though as few as 7% of infants were fully vaccinated in some districts. An April 2017 spill at a vaccine production facility in the Netherlands only resulted in one asymptomatic WPV2 infection, despite release into the sewer system.

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Essential Facilities (PEFs) across 24 countries where work on poliovirus can be carried out. These facilities are currently involved in producing materials to assist the eradication initiative, and perform crucial research which may prevent future outbreaks. After certification, these facilities retain the equipment and materials to continue vaccine production in the event of deliberate or accidental release. Work on Poliovirus outside of the PEFs will be prohibited, and stocks in laboratories that are not designated as PEFs must either be transferred to a PEF or destroyed.

312: 396: 442: 370:) contains trivalent fully inactivated virus, administered by injection. This vaccine cannot induce VAPP nor do cVDPV strains arise from it, but it likewise cannot induce contact immunity and thus must be administered to every individual. Added to this are greater logistical challenges. Though a single dose is sufficient for protection, administration requires medically trained vaccinators armed with single-use needles and syringes. Taken together, these factors result in substantially higher delivery costs. Original protocols involved 458: 1369:, that the vaccine caused sterility in girls. This resulted in the suspension of immunization efforts in the state, causing a dramatic rise in polio rates in the already endemic country. On 30 June 2004, the WHO announced that after a 10-month ban on polio vaccinations, Kano had pledged to restart the campaign in early July. During the ban the virus spread across Nigeria and into 12 neighboring countries that had previously been polio-free. By 2006, this ban would be blamed for 1,500 children being paralyzed and had cost $ 450 1859:

environmental samples. In Afghanistan different strains were largely responsible for the cases in the northeast and south of the country. In Nigeria, the third country classified as having endemic transmission, security concerns continued to limit access to some areas of the country, though migration and novel vaccination approaches would reduce the number of unreached children. The nation passed two full years without a detected wild-virus case, though elimination of WPV transmission could not be confirmed.

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governmental authorities. In Nigeria this has taken the form of 'block rejection' of vaccination that is only resolved when state officials agree to repair or improve schools and health-care facilities, pave roads or install electricity. There have been several instances of threatened boycotts by health workers in Pakistan over payment disputes. Some governments have been accused of withholding vaccination or the necessary accompanying infrastructure from regions where opposition to their rule is high.

1497:) were reported to have endemic polio. Cases in other countries are attributed to importation. A total of 1,997 cases worldwide were reported in 2006; of these the majority (1,869 cases) occurred in countries with endemic polio. Nigeria accounted for the majority of cases (1,122 cases) but India reported more than ten times more cases in 2006 than in 2005 (676 cases, or 30% of worldwide cases). Pakistan and Afghanistan reported 40 and 31 cases respectively in 2006. Polio re-surfaced in 636:(forbidden) in Islam, concern that vaccine production may have involved a prohibited taking of animal life, or a resistance to interfering with disease processes perceived to be divinely-directed. Concerns were addressed through extensive outreach, directed both toward the communities involved and respected clerical bodies, as well as promoting local ownership of the eradication campaign in each region. In early 2012, some parents refused to get their children vaccinated in 40: 4000: 3312: 2600: 1940: 1784: 1645: 1385: 2577:

but the virus continued to be detected in environmental samples through December, and was present in most provinces of the country during the year. The case in Malawi, the country's first in almost three decades and the first in Africa in five years, was seen as a significant setback to the eradication effort. Based on similarity to a strain last detected in Pakistan in 2019, it is thought that WPV1 has been circulating undetected in the country for some time.

1875:, Kenya. This virus, along with newly detected cVDPV3, caused twelve total cases in the country, including one patient infected by both strains. The large number of children residing in areas inaccessible to health workers represent a particular risk for undetected cVDPV outbreaks. A cVDPV2 outbreak in Mozambique resulted in a single case. Response to the Syrian cVDPV2 outbreak continued into 2018, and virus transmission was successfully interrupted. In 1653: 2581:

and the first half of 2021 attributed them to 38 distinct emergences, representing a mix of novel strains and previously detected strains that continued to circulate, while several previously circulating strains were no longer found. 14 cases of cVDPV1 were identified in Madagascar and 3 in Yemen. No cases of cVDPV3 were observed, though it was detected in environmental samples from China, Israel, and its adjacent occupied territories.

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two with OPV2 proved insufficient: not only did they continue, but the vaccination efforts gave rise to a novel cVDPV2 outbreak. The country experienced a total of 20 cases in 2018. Two separate cVDPV2 outbreaks in northern Nigeria produced 34 cases, as well as giving rise to 10 cases in the neighboring Niger. In Somalia, cVDPV2 continued to circulate, causing several polio cases and detected in environmental samples from as far as

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after extensive assessments of the certifications of National Polio Certification Commissions (NCCs) and confirmation that at least 95% of Africa's population had been immunised. WHO Director-General Tedros Adhanom called it a "great day... but not the end of polio", as there remain major continuing outbreaks of vaccine-derived poliovirus in West Africa and Ethiopia in addition to wild cases in Afghanistan and Pakistan.

1465:, and the virus strain was suspected to be the same as the one that has caused outbreaks in Nigeria. New public fears over vaccine safety, which were unfounded, impeded vaccination efforts in Indonesia. In summer 2005, the WHO, UNICEF and the Indonesian government made new efforts to lay the fears to rest, recruiting celebrities and religious leaders in a publicity campaign to promote vaccination. 4524: 4512: 180:" poliovirus (WPV), and the much more prevalent mutated oral vaccine strains, known as circulating vaccine-derived poliovirus (cVDPV) or variant poliovirus. Vaccines against each of the three wild strains of polio have given rise to strains of cVDPV, with cVDPV2 being most prominent. cVDPV caused 524 confirmed paralytic polio cases worldwide in 2023, and was detected in 32 countries. 506:

in the Global Polio Laboratory Network. Since rates of non-polio AFP are expected to be constant and large compared to the number of polio cases, the frequency of non-polio AFP reported in a population is indicative of the effectiveness of surveillance, as is the proportion of AFP patients from whom high-quality stool samples are collected and tested, with a target of at least 80%.

493:. Eradication efforts will eventually require all oral vaccination to be discontinued in favor of the use of injectable vaccines. These vaccines are more expensive and more difficult to deliver, and they lack the ability to induce contact immunity because they contain only killed virus, but they likewise are incapable of giving rise to vaccine-derived viral strains. 667:, the InterAction Alliance, a union of about 200 U.S.-based non-government organizations, deplored the actions of the CIA in using a vaccination campaign as a cover. Pakistan reported the world's highest number of polio cases (198), in 2011. and more than 60 polio vaccination workers were killed between December 2012 and April 2014. In May 2014, CIA director 3981:, after no cases for over a year, raised concerns about the vaccination campaign quality in Pakistan. The report found it was highly likely that the goal of interrupting wild poliovirus transmission in 2023 would be missed and it was certain that ending transmission of vaccine-derived poliovirus will not be possible this year. 1724:, sparking a major vaccination push there. The strain spread to Israel, where there was widespread environmental detection, but like Egypt, no paralysis cases. It had more severe consequences when it spread to neighboring Syria, with the total number of cases eventually reaching 35, the first outbreak there since 1999. 1509:

the southern states and resumed immunisation in the north, where Muslim clerics led a boycott of vaccination in late 2003. Local governments and clerics allowed vaccinations to resume on the condition that the vaccines be manufactured in Indonesia, a majority Muslim country, and not in the United States.

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immunity threshold for poliovirus eradication ranges from approximately 75% in wealthy high-hygiene populations to 97% in poorer environments. If routine immunization were to be stopped, the number of unvaccinated, susceptible individuals would soon exceed the capability of herd immunity to protect them.

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Certification of wild poliovirus eradication requires three consecutive years without case reports, in the presence of reliable disease surveillance networks. Beginning at certification of WPV eradication, the post-certification strategy will come into effect, with program priorities shifting towards

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There were 33 reported WPV1 paralysis cases with an onset of paralysis in 2018 – 21 in Afghanistan and 12 in Pakistan. Polio in Pakistan resurged in the latter part of the year, due in part to the rates of parental refusal for vaccination increasing, with wild poliovirus detected in 20% of the year's

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In 2017 there were 22 reported WPV1 polio cases with onset of paralysis in 2017, down from 37 in 2016. Eight of the cases were in Pakistan and 14 in Afghanistan, where genetic typing showed repeated introduction from Pakistan as well as local transmission. In Pakistan, transmission of several genetic

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Because cVDPV2 strains continued to arise from trivalent oral vaccine that included attenuated PV2, during 2016 this vaccine was replaced with a bivalent version lacking WPV2 as well as trivalent injected inactivated vaccine that cannot lead to cVDPV cases. This was expected to prevent new strains of

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The WPV2 virus was declared eradicated in September 2015 as it had not been detected in circulation since 1999, and WPV3 was declared eradicated in October 2019, having last been detected in 2012. However, both types persist as circulating vaccine-derived strains, the product of years of evolution of

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3 case of polio worldwide had its onset 11 November 2012 in Nigeria; the last wild case outside Nigeria was in April 2012 in Pakistan, and its absence from sewage monitoring in Pakistan suggests that active transmission of this strain has ceased there. A total of 416 wild-virus cases were reported in

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In 2007, there were 1,315 cases of poliomyelitis reported worldwide. Over 60% of cases (874) occurred in India. In Nigeria, the number of polio cases fell dramatically, from 1,122 cases reported in 2006 to 285 cases in 2007. Officials credit the drop in new infections to improved political control in

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A country is regarded as polio-free or non-endemic if no cases have been detected for a year. However, it is still possible for polio to circulate under these circumstances, as was the case for Nigeria, where a particular strain of virus resurfaced after five years in 2016. This can be due to chance,

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response seen from the vaccine. In Nigeria, the most critical barriers identified were management issues, in particular the highly variable importance ascribed to polio by different authorities at the local government level, although funding issues, community perceptions of vaccine safety, inadequate

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Monitoring for AFP aims at identifying outbreaks of polio by screening patients displaying symptoms consistent with, but not exclusive to, severe poliovirus infection. Stool samples are collected from children presenting with AFP and evaluated for the presence of poliovirus by accredited laboratories

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In theory, if the right tools were available, it would be possible to eradicate all infectious diseases that reside only in a human host. In reality, there are distinct biological features of the organisms and technical factors of dealing with them that make their potential eradicability more or less

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agreed to allow United Nations healthcare workers to carry out door-to-door vaccination nationwide for the first time in three years, including a commitment to allowing women to participate in the effort, and to provide safety guarantees to eradication staff. Pakistan's lone case dated from January,

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Laos was declared free of cVDPV1 in March 2017, but three distinct cVDPV2 outbreaks occurred in the Democratic Republic of the Congo, one of them of recent origin, the other two having circulated undetected for more than a year. Together they caused 20 cases by year's end. In Syria, a large outbreak

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has been viewed as a projection of the power of western nations. Refusal of vaccination came to be viewed as resistance to western expansionism, and when the contamination rumours led the Nigerian Supreme Council for Sharia to call for a region-wide boycott of polio vaccination, polio cases in the

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million doses administered. The live virus can circulate in under-vaccinated populations (circulating vaccine-derived poliovirus, cVDPV) and over time can revert to a neurovirulent form causing paralytic polio. Until recent times, a trivalent OPV containing all three virus strains was used, but with

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to the virus. Because of its route of administration, it induces an immunization of the intestinal mucosa that protects against subsequent infection, though multiple doses are necessary to achieve effective prophylaxis. Attenuated poliovirus derived from the oral polio vaccine is excreted, infecting

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On very rare occasions, if a population is seriously under-immunized, there are enough susceptible children for the excreted vaccine-derived polioviruses to begin circulating in the community. If the vaccine-virus is able to circulate for a prolonged period of time uninterrupted, it can mutate and,

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The residual effects of the COVID-19 pandemic continued to be a cause for concern, due to an increased risk of undetected outbreaks due to COVID's interference with routine health care, disease detection, and childhood vaccinations, as well as a concern that an increased fear of vaccines, caused at

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In 2022, there were 30 confirmed cases of WPV1 reported to WHO, with two and 20 cases in Pakistan and Afghanistan respectively, while eight non-endemic cases were recorded in Mozambique, the first cases in the country since 1992. The Mozambique cases derived from the strain of Pakistani origin that

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2021 saw a partial recovery from the challenges to monitoring brought on by the COVID pandemic, with 74% of high-priority countries meeting surveillance targets, an improvement of over 20% from the previous year. March 2021 also saw the first use of the modified nOPV2 vaccine in selected countries,

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Cases caused by vaccine-derived poliovirus were reported in seven countries in 2018, with over 100 total cases, representing nine strains of cVDPV. In the Democratic Republic of the Congo, one of the outbreaks of cVDPV2 first detected in 2017 caused no additional cases, but suppression of the other

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Environmental surveillance is used to supplement AFP surveillance. This entails the routine testing of sewage samples for the presence of virus, which not only allows the effectiveness of vaccination efforts to be evaluated in countries with active transmission, but also allows the detection of new

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to infect another host is reduced; the cycle of transmission is interrupted, and the pathogen cannot reproduce and dies out. This concept, called community immunity or herd immunity, is important to disease eradication, because it means that it is not necessary to inoculate 100% of the population—a

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While IPV does not itself induce mucosal immunity, it has been shown to boost the mucosal immunity from OPV, and the WHO now favors a combined protocol. It is recommended that vulnerable children receive a dose of OPV at birth, then beginning at the age of six weeks a 'primary series' consisting of

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2 OPV in regions with documented cVDPV2 circulation. A novel OPV2 vaccine (nOPV2) genetically modified to reduce the likelihood of disease-causing activating mutations was granted emergency licencing in 2021, and subsequently full licensure in December 2023. Genetically stabilsed vaccines targeting

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Expanded environmental surveillance to detect the presence of poliovirus in communities. Sewage samples are collected at regular and random sites and tested in laboratories for the presence of WPV or cVDPV. Since most polio infections are asymptomatic, transmission can occur in spite of the absence

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Where possible, the number of facilities conducting operations with poliovirus is to be reduced significantly; and the use of wild poliovirus is to be abandoned altogether in favour of genetically stabilized attenuated strains where possible. As of May 2021, there are 74 designated Poliovirus

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In 2021, reported cVDPV2 cases declined to 685 across 22 countries, over half occurring in Nigeria. The virus was also found in environmental samples or in those from symptom-free people in several additional African and Asian nations without reported cases. An analysis of cVDPV2 strains from 2020

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In 2019 there were 176 WPV1 paralysis cases detected: 29 in Afghanistan and 147 in Pakistan. In particular, in Pakistan the number of cases was surging and cross-border migration played a role in polio transmission between the two countries. While itself problematic, this also fostered a dangerous

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The total number of wild-virus cases reported in 2012 was 223, lower than any previous year. These were limited to five countries—Nigeria, Pakistan, Afghanistan, Chad, and Niger—of which all except Nigeria had fewer cases than in 2011. Several additional countries, Chad, the Democratic Republic of

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In 2008, 18 countries reported cases and the total number of cases was 1,651. Of these, 1,505 occurred in the four endemic countries and 146 elsewhere. The largest numbers were in Nigeria (798 cases) and India (559 cases): these two countries combined had 82.2 percent of all cases. Outside endemic

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One factor contributing to the continued circulation of polio immunization programs has been opposition to vaccination in some countries. In one country, Pakistan, "more than 200 polio team workers" have been killed (team members include not only vaccinators but police and security personnel) from

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Two additional challenges are found in unobserved polio transmission and in vaccine-derived poliovirus. First, most individuals infected with poliovirus are asymptomatic or exhibit minor symptoms, with fewer than 1% of infections leading to paralysis, and most infected people are unaware that they

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Herd immunity is an important supplement to vaccination. According to the concept of herd immunity, the population for whom the vaccine fails is still protected by the immunity of those around them, and it can only be achieved when vaccination levels are high. It is estimated that the minimum herd

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IPV, fIPV) has been found to be effective, lowering costs and also allowing for more convenient and cost-effective delivery systems. The use of IPV results in serum immunity, but no intestinal immunity arises. As a consequence, vaccinated individuals are protected from contracting polio, but their

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Nigeria was removed from the list of countries with endemic wild poliovirus in June 2020, four years after the last recorded case in the Northern State of Borno in 2016. Two months later, the World Health Organization declared the African continent free of wild poliovirus. This certification came

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In addition to the WPV resurgence in Pakistan and Afghanistan, 2019 saw a resurgence of cVDPV, with 378 cases. The majority of cases were caused by cVDPV2 strains that were able to arise or spread as a consequence of the withdrawal of the PV2 strain from the standard vaccination regimen. Previous

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In 2014, there were 359 reported cases of wild poliomyelitis, spread over twelve countries. Pakistan had the most with 306, an increase from 93 in 2013, which was blamed on Al Qaeda and Taliban militants preventing aid workers from vaccinating children in rural regions of the country. On 27 March

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According to figures updated in April 2012, the WHO reported that there were 1,352 cases of wild polio across 20 countries in 2010. Reported cases of polio were down 95% in Nigeria (to a historic low of 21 cases) and 94% in India (to a historic low of 42 cases) compared to the previous year, with

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In 2009, a total of 1,604 cases were reported across 23 countries. Four endemic countries accounted for 1,256 of these, with the remaining 348 in 19 sub-Saharan countries with imported cases or re-established transmission. Once again, the largest numbers were in India (741) and Nigeria (388). All

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billion, 6-year cooperative plan (called the 2013–18 Polio Eradication and Endgame Strategic Plan) to eradicate polio from its last reservoirs. The plan called for mass immunization campaigns in the three remaining endemic countries, and also dictated a switch to inactivated virus injections, to

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Over 1000 cases caused by both continuing and novel outbreaks of cVDPV2 were reported in 2020 across twenty-four countries, with 31 additional cases of cVDPV1, and environmental detections in several additional countries with no diagnosed polio cases. While in the past cVDPV outbreaks tended to

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Polio vaccination efforts have also faced resistance in another form. The priority placed on vaccination by national authorities has turned it into a bargaining chip, with communities and interest groups resisting vaccination, not due to direct opposition, but to leverage other concessions from

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An independent evaluation of obstacles to polio eradication requested by the WHO and conducted in 2009 considered the major obstacles in detail by country. In Afghanistan and Pakistan, the researchers concluded that the most significant barrier was insecurity, but that managing human resources,

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While vaccination has played an instrumental role in the reduction of polio cases worldwide, the use of attenuated virus in the oral vaccine carries with it an inherent risk. The oral vaccine is a powerful tool in fighting polio in part because of its person-to-person transmission and resulting

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In the third remaining country in which polio was classified as endemic, Nigeria, wild poliovirus has not been detected since October 2016, and levels of AFP surveillance are sufficient, even in security-compromised regions, to suggest transmission of WPV may have been interrupted. Global WPV3

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Among the greatest obstacles to global polio eradication are the lack of basic health infrastructure, which limits vaccine distribution and delivery, the crippling effects of civil war and internal strife, and the sometimes oppositional stance that marginalized communities take against what is

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in unvaccinated individuals, and thus amplifying the effects of the doses delivered. The oral administration does not require special medical equipment or training. Taken together, these advantages have made it the favored vaccine of many countries, and it has long been preferred by the global

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In 2016 there were 37 reported WPV1 cases, half as many as in 2015, with the majority of the cases in Pakistan and Afghanistan. A small number of additional cases in Nigeria, caused by WPV1, were viewed as a setback, the first being detected there in almost two years, yet the virus had been

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against polio vaccination. Religious boycotts based on contamination concerns have not been limited to the Muslim world. In 2015, after claiming that a tetanus vaccine contained a contraceptive, a group of Kenyan Catholic bishops called on their followers to boycott a planned round of polio

415:. There is no animal reservoir for poliovirus, and the transmission cycle of polio is from one infected person to another person susceptible to the disease, usually through the fecal-oral route. If the vast majority of the population is immune to a particular agent, the ability of that 501:

A global program of surveillance for the presence of polio and the poliovirus plays a critical role in assessment of eradication and in outbreak detection and response. Two distinct methods are used in tandem: acute flaccid paralysis (AFP) surveillance and environmental surveillance.

1852:, and also spreading to neighboring districts saw 74 confirmed cases from a viral strain that had circulated undetected for about two years. Circulation of multiple genetic lines of cVDPV2 was also detected in Banadir province, Somalia, but no infected individuals were identified. 564:, the key issues identified were underdeveloped health systems and low routine vaccine coverage, although the low level of resources committed to Angola and South Sudan for the purpose of curtailing the spread of polio and climatic factors was also identified as playing a role. 3963:, with only a handful of cases in Indonesia, Yemen, and Israel being the exception. cVDPV1 is now concentrated in three countries, 105 cases in the Democratic Republic of the Congo, 24 in Madagascar and four in Mozambique. No cVDPV3 virus has been detected for two years now. 1353:

In 2002, an outbreak of polio occurred in India. The number of planned polio vaccination campaigns had recently been reduced, and populations in northern India, particularly from the Islamic background, engaged in mass resistance to immunization. At this time, the Indian state

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potentially leading to a large outbreak, if the virus reappears there. In Pakistan, they estimate that the long-standing and intractable poliovirus circulation in most of the traditional endemic reservoirs has been eliminated. However, a positive environmental probe in

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On 25 September 2015, the WHO declared that Nigeria was no longer considered endemic for wild polio virus, with no reported case of wild polio virus having been reported since 24 July 2014. A WPV1 strain not seen in five years resurfaced in Nigeria the following year.

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province. All but one wild polio generic cluster remains in Afghanistan in a much improved immunity (>90%) of the population. Levels of access in the country are the best they have been since 2018. However, a large pool of unvaccinated children remain in the

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intestinal mucosa may still be infected and serve as a reservoir for the excretion of live virus. For this reason, IPV is ineffective at halting ongoing outbreaks of WPV or cVDPV, but it has become the vaccine of choice for industrialized, polio-free countries.

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outbreak preparedness and containment of existing virus material rather than circulating disease. Vaccination for WPV1 will cease one year following eradication certification, and eradication of vaccine-derived poliovirus is then targeted for 2030.

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In 2011, 650 WPV cases were reported across sixteen countries: the four endemic countries—Pakistan, Afghanistan, Nigeria, and India—as well as twelve others. Polio transmission recurred in Angola, Chad and the Democratic Republic of the Congo.

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As of 5 September 2024, there have been 34 reported cases of WPV1 with eighteen from Afghanistan and sixteen from Pakistan. Additionally, 295 positive environmental samples have been collected in Pakistan and 69 in Afghanistan.

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cVDPV2 from arising and allow eventual cessation of WPV2 vaccination. The resulting global use of the injectable vaccine caused shortages, and led the WHO in April 2017 to recommend general use of the fIPV vaccination protocol, involving

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country increased more than five-fold between 2002 and 2006, with the uncontrolled virus then spreading across Africa and globally. In Afghanistan and Pakistan, fears that the vaccine contained contraceptives were one reason given by the

644:(FATA) but religious refusals in the rest of the country had "decreased manifold". Even with the express support of political leaders, polio workers or their accompanying security guards have been kidnapped, beaten, or assassinated. 1468:

In the United States on 29 September 2005, the Minnesota Department of Health identified the first occurrence of vaccine-derived poliovirus (VDPV) transmission in the United States since OPV was discontinued in 2000. The poliovirus

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Vaccine-derived cases continue to circulate, particularly in the African and Eastern Mediterranean WHO regions. Concern is focused on Ukraine, where cVDPV had been detected in fall 2021, vaccination efforts were halted due to the

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likely. Three indicators, however, are considered of primary importance in determining the likelihood of successful eradication: that effective interventional tools are available to interrupt transmission of the agent, such as a

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began using the oral vaccine in a series of nationwide polio campaigns. The early success of these mass vaccination campaigns suggested that polioviruses could be globally eradicated. The Pan American Health Organization

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Active surveillance for poliovirus through reporting and laboratory testing of all cases of acute flaccid paralysis. Acute flaccid paralysis (AFP) is a clinical manifestation of poliomyelitis characterized by weakness or

488:

2 (nOPV2) that has been genetically stabilized to make it less prone to give rise to circulating vaccine-derived strains received full licensure in December 2023, with similar vaccines targeting types 1 and 3 undergoing

475:

2 strain seems prone to reversions, so in 2016 the eradication effort abandoned the trivalent oral vaccine containing attenuated strains of all three virus types and replaced it with a bivalent oral vaccine lacking the

7471: 3966:

The Independent Monitoring Board of the GPEI in its September 2023 Report mentioned a continued, geographically restricted, endemic transmission in the east of Afghanistan and in the southern districts of Pakistan's

1780:. With the addition of this region, the proportion of world population living in polio-free regions reached 80%. The last case of wild polio in the South-East Asia Region was reported in India on 13 January 2011. 1342:

million children (almost one-tenth the world's population) had received some two billion doses of oral polio vaccine. The World Health Organization announced that Europe was polio-free on 21 June 2002, in the

11046: 3277:

caused two confirmed cases in Malawi in 2021. The cases in Pakistan were the first seen in the country in 15 months, though the virus had been detected in environmental samples during the intervening period.

11923: 1628:) and the Russian Federation, with the most recent case from this region being reported from Russia 25 September. These were the first cases in the WHO European region since 2002. The Republic of the Congo ( 348:

The primary disadvantage of OPV derives from its inherent nature. As an attenuated but active virus, it can induce vaccine-associated paralytic poliomyelitis (VAPP) in approximately one individual per every

7401: 11267: 11145: 1457:, countries that had been declared polio-free since before 2000, each reported hundreds of cases—probably imported from Nigeria. On 5 May 2005, news reports broke that a new case of polio was diagnosed in 10987: 11175: 9527: 596:"targeted killing and terrorism" while working on polio campaigns, (the killers motivated by the belief, spread by "radical clerics", that the vaccine is part of "a Western plot to sterilize Muslims"). 12124: 527:

political pressures, the movement of large populations between and within both countries, and inadequately resourced health facilities also posed problems, as did technical issues with the vaccine. In

6850: 11118: 10609: 1832:. There was also a cVDPV1 outbreak in Laos, while new strains of cVDPV2 arose separately in Nigeria's Borno and Sekoto states, and in the Quetta area of Pakistan, collectively causing five cases. 7062: 4481:

Twelve additional countries have positive environmental samples only: Algeria, Cote D'Ivoire, Egypt, Equatorial Guinea, Gambia, Kenya, Liberia, Senegal, Sierra Leone, Sudan, Uganda and Zimbabwe.

5596: 1855:

WHO's Strategic Advisory Group of Experts on Immunization recommended that cVDPV2 suppression be prioritized over targeting WPV1, and according to protocol OPV2 is restricted to this purpose.

1501:

after nearly six years of absence with 18 new cases reported. "Our country is not safe, as neighbours India and Pakistan are not polio free", declared Health Minister ASM Matiur Rahman. (See:

13701: 11326: 9920: 7344: 1690:

2013, almost double the previous year. Of these, cases in endemic countries dropped from 197 to 160, while those in non-endemic countries jumped from 5 to 256. This was due to outbreaks in

8337: 9268: 7828: 10882: 1791:

During 2015, 74 cases of wild poliomyelitis were reported worldwide, 54 in Pakistan and 20 in Afghanistan. There were 32 circulating vaccine-derived poliovirus (cVDPV) cases in 2015.

1632:) saw an outbreak with 441 cases (30% of the global total). At least 179 deaths were associated with this outbreak, which is believed to have been an importation from the ongoing type 12095: 10078: 8664: 8617: 1362:.) However, by 2004, India had adopted strategies to increase ownership of polio vaccinations in marginalized populations, and the immunity gap in vulnerable groups rapidly closed. 10348: 11687: 11568: 6922: 11605: 9501: 10954: 12155: 7024: 5866: 11293: 10659: 9599: 7223:... for each case ..., the community is further threatened by another 2,000 to 3,000 contagious carriers ... rendering even a single documented case indicative of an epidemic 420:

goal that is often logistically very difficult—to achieve the desired result. If the number of susceptible individuals can be reduced to a sufficiently small number through

11672: 9007: 7681: 607:, rumours arose in the Muslim world that immunization campaigns were using intentionally-contaminated vaccines to sterilize local Muslim populations or to infect them with 9237: 7430: 523:

of live (attenuated) vaccines in extremely hot or remote areas. The oral polio vaccine must be kept at 2 to 8 °C (36 to 46 °F) for vaccination to be successful.

10714: 3956:

Twelve cases of WPV1 have been reported in 2023, six in Afghanistan and Pakistan each. Additionally, 187 positive environmental samples were reported in those countries.

13944: 12478: 9174: 7496: 4716: 13572: 11020: 10055: 9472: 9075: 7374: 143:. IPV, being inactivated, does not carry these risks, but does not induce contact immunity. IPV is more costly and the logistics of its delivery are more challenging. 9395: 6805: 1799:

the attenuated "live" virus (which makes up the oral vaccine) as it transmits from the vaccinated to the unvaccinated and circulates in an under-immunized community.

9436: 9337: 9301: 5487: 7397: 230:, be available to detect infections that can lead to transmission of the disease; and that humans are required for the life-cycle of the agent, which has no other 11259: 11141: 9732: 13737: 10413: 6955: 387:

three OPV doses at least four weeks apart, along with one dose of IPV after 14 weeks. This combined IPV/OPV approach has also been used in outbreak suppression.

12064: 11967: 11087: 10977: 10381: 11167: 9538: 8154: 12120: 11236: 6678: 13934: 10832: 8005: 5149: 8943: 1381:

have complicated WHO's polio eradication goal. In 2004, almost two-thirds of all the polio cases in the world occurred in Nigeria (760 out of 1,170 total).

12268: 10750: 256:, supplementary immunization campaigns, and surveillance of possible outbreaks. Several key strategies have been outlined for stopping polio transmission: 11110: 1416:

In May 2004, the first case of the polio outbreak in Sudan was detected. The reemergence of polio led to stepped up vaccination campaigns. In the city of

10605: 7051: 6055: 1713:

was reported, the first in Somalia since 2007. By October, over 170 cases had been reported in the country, with more cases in neighboring Kenya and the

10279: 7246: 6739: 5364: 12753: 11497: 10921: 5592: 4546: 1205: 1057:

Following the widespread use of poliovirus vaccine in the mid-1950s, the incidence of poliomyelitis declined rapidly in many industrialized countries.

127:

polio vaccine (IPV), which is injected. OPV is less expensive and easier to administer, and can spread immunity beyond the person vaccinated, creating

12368: 12004: 9138: 510:

outbreaks in countries without known transmission. In 2018, the GPEI conducted environmental surveillance in 44 countries, 24 of which are in Africa.

12722: 11114: 8807: 7270:"The role of supplementary environmental surveillance to complement acute flaccid paralysis surveillance for wild poliovirus in Pakistan - 2011-2013" 552:

also played a role. In those countries where international spread from endemic countries had resulted in the reestablishment of transmission, namely

9904: 7328: 161:

3 (WPV3) is last known to have caused polio in 2012, and was declared eradicated in 2019. All wild-virus cases since that date have been due to type

11316: 8093:

Yamazaki S, Toraya H (2001). "(General News) Major Milestone reached in Global Polio Eradication: Western Pacific Region is certified Polio-Free".

12246: 9632: 8850:

Likewise, in Kenya, two cases in Garissa County were reported in 2006, 19 cases in Turkana County in 2009, and one case in Rongo district in 2011.

8553: 8450: 8376: 8351: 8210: 12471: 8678: 8628: 8302: 6980: 5266:

Nathanson N, Martin JR (December 1979). "The epidemiology of poliomyelitis: enigmas surrounding its appearance, epidemicity, and disappearance".

4995:"Global Disease Elimination and Eradication as Public Health Strategies. Proceedings of a conference. Atlanta, Georgia, USA. 23-25 February 1998" 1061:

became the first country in the world to scientifically demonstrate nationwide eradication of poliomyelitis in 1960. In 1962—just one year after

9260: 4798: 13849: 13615: 13517: 13235: 12178: 6604: 1373:

million for emergency activities. In addition to the rumors of sterility and the ban by Nigeria's Kano state, civil war and internal strife in

11545: 11197: 9666: 5988: 5107: 671:

prohibited his agency both from using vaccinations to cover operations and from testing samples collected by authentic vaccination campaigns.

213:

As reduction of the worldwide incidence of poliomyelitis to zero as a result of deliberate efforts, and requiring no further control measures.

131:. It has been the predominant vaccine used. However, under conditions of long-term vaccine virus circulation in under-vaccinated populations, 11878: 7804: 6081: 5074: 627:

vaccination. This did not have a major effect on vaccination rates, and dialog along with vaccine testing forestalled further boycott calls.

153:

transmission of wild poliovirus, with its last reported case in 2016. Of the three strains of WPV, the last recorded wild case caused by type

11766: 10858: 9757: 7778: 7143:"Modeling undetected live poliovirus circulation after apparent interruption of transmission: implications for surveillance and vaccination" 4828: 12826: 12317: 12087: 10249: 10082: 9365: 4551: 4500:

By 2022 all stocks of WPV2 had been transferred to PEFs and full containment is in effect. All other strains are in a transitionary status.

267:

Organization of "national immunization days" to provide supplementary doses of oral polio vaccine to all children less than five years old.

9569: 13535: 13427: 11988: 10684: 10334: 1208:(USAID)—launched its effort to support national eradication efforts at the grassroots level. The CORE Group commenced this initiative in 1045: 656: 12285: 11945: 11767:"In new setback for eradication campaign, poliovirus from Pakistan shows up in Africa: Health officials hope to squash outbreak quickly" 10304: 4586: 13707: 13378: 12464: 9688: 8772: 8718: 7923: 6912: 1118: 85: 11601: 9497: 7897: 611:. In Nigeria these rumours fit in with a longstanding suspicion of modern biomedicine, which since its introduction during the era of 176:

are the only two countries where the disease is still classified as endemic. Recent polio cases arise from two sources, the original "

13731: 10943: 9515:

over the course of 12-18 months, reacquire neurovirulence. These viruses are called circulating vaccine-derived polioviruses (cVDPV).

6111: 4655: 1616:

little change in Afghanistan (from 38 to 25 cases) and an increase in cases in Pakistan (from 89 to 144 cases). An acute outbreak in

17: 12147: 11901: 9829: 8803:"Preventing Importation of Poliovirus in the Horn of Africa: The Success of the Cross-Border Health Initiative in Kenya and Somalia" 8417: 8180: 8060: 7016: 5858: 5420: 4616: 1736:

2014, the WHO announced the eradication of poliomyelitis in the South-East Asia Region, in which the WHO includes eleven countries:

1144:

On 20 August 1994, the Americas were certified as polio-free. This achievement was a milestone in efforts to eradicate the disease.

13671: 13579: 13499: 13331: 11289: 10648: 10156: 9591: 6309: 1879:, a cVDPV1 strain arose, causing twenty-six polio cases across nine provinces, while a single diagnosed cVDPV1 case in neighboring 335:

per dose in 2024) and its availability has bolstered efforts to eradicate polio. The vaccine confers long-term, possibly lifelong,

135:

can reactivate the virus to produce a polio-inducing strain, while OPV can also, in rare circumstances, induce polio or persistent

13647: 7629: 6708: 6546:"Did the call for boycott by the Catholic bishops affect the polio vaccination coverage in Kenya in 2015? A cross-sectional study" 363:

poliovirus types 1 and 3 are in development, with the intention that these will eventually completely replace the Sabin vaccines.

13677: 13241: 12737: 9206: 9097: 8999: 7927: 7670: 358:

2 this was phased out in 2016 and replaced with bivalent vaccine containing just types 1 and 3, supplemented with monovalent type

12693: 12203: 12061:"New York State Department of Health and Rockland County Department of Health Alert the Public to A Case of Polio In the County" 9229: 7423: 5447:"Intradermal Administration of Fractional Doses of Inactivated Poliovirus Vaccine: A Dose-Sparing Option for Polio Immunization" 659:

in order to confirm the genetic identity of the children living there, and by implication his own presence, leading directly to

13641: 13025: 10000:"Response to a wild poliovirus type 2 (WPV2)-shedding event following accidental exposure to WPV2, the Netherlands, April 2017" 8595: 8531: 7460: 12229: 9164: 7207: 299:

of polio-related AFP cases, and such monitoring helps to evaluate the degree to which virus continues to circulate in an area.

13366: 13271: 13199: 13144: 9065: 8763: 8709: 7772: 7504: 7366: 5068: 5017: 4720: 600: 11709: 11009: 10047: 9461: 9039: 8128: 7805:"[Global eradication of poliomyelitis. On the 80th anniversary of the founding of the National Institute of Health]" 6795: 4691: 2569:

2 poliovirus without the frequent spawning of cVDPV2 seen with the original OPV2. Full rollout was not expected until 2023.

13621: 13565: 13390: 13337: 12763: 12303: 10487: 9403: 8496: 7807:[Global eradication of poliomyelitis. On the 80th anniversary of the founding of the National Institute of Health] 2561:

In 2021, there were just six confirmed cases of wild poliovirus — one in Pakistan, four in Afghanistan, and one in Malawi.

13396: 9425: 9326: 9290: 5446: 13505: 13301: 13295: 13277: 13175: 13095: 12896: 12727: 11016: 10744: 10051: 9728: 9628: 9532: 9468: 9432: 9333: 9297: 8976: 8896: 8867: 8672: 8624: 8558: 8345: 8030: 7500: 7465: 7240: 7089:"A spatial model of Wild Poliovirus Type 1 in Kano State, Nigeria: calibration and assessment of elimination probability" 6116: 5862: 5360: 4533: 3959:

There have been 391 confirmed cases of cVDPV2 reported to the WHO in 2023, across 22 countries, nineteen of which lie in

1122: 1090: 641: 93: 7973: 7530: 6270: 4968: 630:

Other religion-inspired refusals arise from concern over whether the virus contains pig-derived products, and hence are

264:(OPV) in the first year of life in developing and endemic countries, and routine immunization with OPV or IPV elsewhere. 13559: 13319: 13205: 12487: 9721: 6772: 5784: 5561: 5328: 97: 11840: 10406: 8939: 6945: 1521:

in July 2007, Turai Yar'Adua urged parents to vaccinate their children and stressed the safety of oral polio vaccine.

331:

poliovirus. OPV is delivered as oral drops or infused into sugar cubes. It is highly effective and inexpensive (about

13742: 13713: 13603: 13547: 13463: 12060: 11079: 10373: 1359: 8158: 13855: 13659: 13529: 13493: 13481: 13384: 13307: 12846: 11228: 10407:

The Art of Survival: The Polio Virus Continues to Exploit Human Frailties. 17th Independent Monitoring Board Report

7998: 6668: 4129: 3395: 3290: 2721: 2127: 1601: 1529: 10821: 6731: 5650: 5130: 1620:

gave rise to 460 cases (34% of the global total), and was associated with a further 18 cases across Central Asia (

13725: 13719: 13689: 13609: 13511: 13451: 13414: 13402: 13313: 13138: 12924: 12758: 12732: 10193:"Update on Vaccine-Derived Poliovirus Outbreaks - Democratic Republic of the Congo and Horn of Africa, 2017-2018" 6029: 1732:

avoid the risk of the vaccine-derived outbreaks that occasionally occur from use of the live-virus oral vaccine.

10739: 8968: 13837: 13825: 13819: 13807: 13801: 13795: 13683: 13627: 13597: 13585: 8384: 5890:"Managing the risk of circulating vaccine-derived poliovirus during the endgame: oral poliovirus vaccine needs" 4566: 572:

continue to produce active virus for years (or even decades) after their initial exposure to the oral vaccine.

12586: 10271: 6890: 6387:"The History and Current Killings of Polio Vaccinators in Pakistan: A Need for Targeted Surveillance Strategy" 6059: 5514:"Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame" 5301: 5187: 1151:

Campaign to eliminate polio. The current campaign involves annual vaccination of all children under age five.

484:

2 vaccine (mOPV2) was to be used only to target existing cVDPV2 outbreaks. A novel oral vaccine targeting type

13553: 13469: 13071: 12537: 11646: 7235: 7201: 5356: 1240: 12841: 11493: 10911: 9128: 8890:

Hui-Ming Luo, Yong Zhang, Xin-Qi Wang, Wen-Zhou Yu, Ning Wen, Dong-Mei Yan, et al. (21 November 2013).

8294: 7424:

Global Commission for the Certification of Poliomyelitis Eradication (GCC) Report from the Sixteenth Meeting

13523: 13343: 13229: 13223: 13132: 11726: 10106:"Vaccine-Derived Poliovirus Outbreaks and Events - Three Provinces, Democratic Republic of the Congo, 2017" 6950: 5131:

Polio environmental surveillance expansion plan: global expansion plan under the endgame strategy 2013-2018

4489:

As of 2023, WPV2 and WPV3 are certified as eradicated, while certification of WPV1 is expected for 2026/7.

5388:"Fractional-Dose Inactivated Poliovirus Vaccine Immunization Campaign - Telangana State, India, June 2016" 13907: 13901: 13695: 13665: 13475: 13445: 13325: 13101: 1685:

the Congo, Somalia, and Yemen, saw outbreaks of circulating vaccine-derived polio. The last reported type

1517:, made the eradication of polio one of her priorities. Attending the launch of immunization campaigns in 648: 519:

perceived as a potentially hostile intervention by outsiders. Another challenge has been maintaining the

379: 223: 12591: 8802: 8440: 8221: 5214:"Long-Term Immunogenicity of Inactivated and Oral Polio Vaccines: An Italian Retrospective Cohort Study" 13487: 13156: 13126: 11263: 11229:"Polio makes a comeback in the Philippines 19 years after the country was declared free of the disease" 10774:"Strategic Response to an Outbreak of Circulating Vaccine-Derived Poliovirus Type 2 - Syria, 2017-2018" 9621: 8564: 6991: 668: 660: 1443:

recorded just 66 cases in 2005, down from 135 cases reported in 2004, 225 in 2003, and 1,600 in 2002.

13929: 13211: 12874: 12821: 12671: 11201: 10948: 10828: 10688: 10606:"Nigeria not lowering guards against Polio, two years after last detection of cases in the Northeast" 10342: 10308: 10160: 9761: 9693: 9399: 9369: 9101: 8380: 8215: 8184: 8064: 8034: 7625: 7141:

Kalkowska DA, Duintjer Tebbens RJ, Pallansch MA, Cochi SL, Wassilak SG, Thompson KM (February 2015).

7056: 7020: 6985: 6594: 6085: 5565: 5137: 5052: 4794: 4620: 1106: 73: 6488:"Listening to the rumours: what the northern Nigeria polio vaccine boycott can tell us ten years on" 2572:

Despite previous resistance to eradication efforts, after their takeover of Afghanistan in 2021 the

688:

2 was certified eradicated in 2015, the last case having been detected in 1999. Wild poliovirus type

13879: 13861: 12853: 12773: 12628: 11537: 11205: 9658: 6089: 5947: 5099: 3539: 2888: 1573: 531:, the major challenge appeared to be the high efficiency of transmission within the populations of 227: 11348:

Zomahoun DJ, Burman AL, Snider CJ, Chauvin C, Gardner T, Lickness JS, et al. (January 2021).

9765: 8705:"Evaluating Surveillance Indicators Supporting the Global Polio Eradication Initiative, 2011–2012" 5043: 4745:

Geiger K, Stehling-Ariza T, Bigouette JP, Bennett SD, Burns CC, Quddus A, et al. (May 2024).

302:

Targeted "mop-up" campaigns once poliovirus transmission is limited to specific geographical foci.

283:) among children less than fifteen years old. Other pathogenic agents can also cause AFP, such as 13885: 13789: 13783: 13150: 13083: 13065: 12889: 12836: 12606: 12514: 11461:"Polio was almost eradicated. Then came the coronavirus. Then came a threat from President Trump" 9905:"'What the hell is going on?' Polio cases are vanishing in Pakistan, yet the virus won't go away" 7759: 7329:"'What the hell is going on?' Polio cases are vanishing in Pakistan, yet the virus won't go away" 4820: 4594: 1845: 1821: 1528:

in over 20 years. Other countries with significant numbers of wild polio virus cases include the

1435:. Eradication efforts in the Indian sub-continent met with a large measure of success. Using the 412: 371: 249: 207: 10241: 9373: 7429:(Report). Global Commission for the Certification of Poliomyelitis Eradication. September 2017. 5445:

Okayasu H, Sein C, Chang Blanc D, Gonzalez AR, Zehrung D, Jarrahian C, et al. (July 2017).

1909:

In March 2020, the GPEI announced polio eradication resources were being redeployed against the

13831: 13777: 13182: 13168: 12985: 12557: 10692: 9561: 8862: 6851:"Polio is back in Nigeria, and the next vaccination campaign may have a surprising consequence" 1817: 1347: 520: 375: 150: 12336: 11791:

Alleman MM, Jorba J, Henderson E, Diop OM, Shaukat S, Traoré MA, et al. (December 2021).

11142:"Campaign to stamp out polio in remaining hot spots has become 'a horror story', report warns" 10335:"Summary of the April 2017 meeting of the Strategic Advisory Group of Experts on Immunization" 10312: 10104:

Alleman MM, Chitale R, Burns CC, Iber J, Dybdahl-Sissoko N, Chen Q, et al. (March 2018).

9854:

Elhamidi Y, Mahamud A, Safdar M, Al Tamimi W, Jorba J, Mbaeyi C, et al. (November 2017).

1636:

1 outbreak in Angola (33 cases in 2010) and the Democratic Republic of the Congo (100 cases).

1201:

2 poliovirus occurred in India. This type of poliovirus was subsequently declared eradicated.

13813: 13771: 13349: 10772:

Mbaeyi C, Wadood ZM, Moran T, Ather F, Stehling-Ariza T, Nikulin J, et al. (June 2018).

9699: 9562:"As hopes for polio eradication rise, the endgame gets complicated, and a vaccine runs short" 6301: 3187: 2449: 1502: 604: 252:

of poliovirus. Stopping polio transmission has been pursued through a combination of routine

12623: 12392:

Bigouette JP, Wilkinson AL, Tallis G, Burns CC, Wassilak SG, Vertefeuille JF (August 2021).

7893: 5128: 5041: 1133:

million toward immunising all of the world's children against the disease. The last case of

1125:(GPEI), with the goal of eradicating polio by the year 2000. The initiative was inspired by 192:

As elimination of the occurrence of poliomyelitis even in the absence of human intervention.

13949: 13420: 13217: 13162: 13077: 12633: 9787:

Martinez M, Shukla H, Nikulin J, Wadood MZ, Hadler S, Mbaeyi C, et al. (August 2017).

9595: 8102: 8061:"WHO European Region celebrates three polio-free years: certification within reach in 2002" 7281: 4911: 1236: 1126: 1110: 569: 89: 11924:"Pakistan's fight against polio threatened by extremist violence, anti-vaccine sentiments" 10015: 7758:

Centers for Disease Control and Prevention (2015). Hamborsky J, Kroger A, Wolfe S (eds.).

6122: 5638: 5386:

Bahl S, Verma H, Bhatnagar P, Haldar P, Satapathy A, Kumar KN, et al. (August 2016).

4647: 4624: 1086: 395: 311: 8: 13653: 13283: 13048: 13001: 12995: 12567: 11465: 11051: 10164: 9788: 8801:

Ahmed Arale, Mercy Lutukai, Somane Mohamed, Lydia Bologna, Katherine V. Stamidis (2019).

8758: 8704: 8413: 8188: 8068: 7268:

Cowger TL, Burns CC, Sharif S, Gary HE, Iber J, Henderson E, et al. (25 July 2017).

6917: 6855: 5387: 1428: 124: 43:

A child receives oral polio vaccine during a 2002 campaign to immunize children in India.

12204:"U.K. declares 'national incident' after 'vaccine derived' polio strain found in sewage" 11968:"Meeting of the Technical Advisory Group (TAG) on Poliomyelitis Eradication in Pakistan" 10438:

Hsu C, Mahamud A, Safdar M, Nikulin J, Jorba J, Bullard K, et al. (November 2018).

8106: 7285: 6411: 6386: 5946:

Patel JC, Diop OM, Gardner T, Chavan S, Jorba J, Wassilak SG, et al. (April 2019).

5760: 5725: 4915: 4771: 4746: 1862: 1553: 1544:

other countries had less than one hundred cases: Pakistan had 89 cases, Afghanistan 38,

1420:, 78,654 children were immunized and 20,432 more in southern Sudan (Yirol and Chelkou). 1378: 13634: 13541: 13289: 13120: 13089: 12882: 12420: 12393: 11817: 11792: 11727:"GPEI Statement on WPV1 in Malawi: Wild poliovirus type 1 detected in Lilongwe, Malawi" 11673:"Independent experts advise move to next use phase for novel oral polio vaccine type 2" 11436: 11411: 11389: 11376: 11349: 10916: 10874: 10798: 10773: 10582: 10557: 10530: 10505: 10464: 10439: 10217: 10192: 10191:

Mbaeyi C, Alleman MM, Ehrhardt D, Wiesen E, Burns CC, Liu H, et al. (March 2019).

10130: 10105: 10024: 9999: 9971: 9946: 9880: 9855: 9816: 9169: 9105: 9070: 8829: 8727: 8271: 8244: 7621: 7581: 7304: 7269: 7169: 7142: 7115: 7088: 6700: 6570: 6545: 6512: 6487: 6460: 6435: 6362: 6337: 6257: 6172: 6145: 5975: 5916: 5889: 5835: 5810: 5701: 5676: 5538: 5513: 5474: 5279: 5240: 5213: 4879: 4854: 3968: 3960: 3282: 637: 336: 328: 120: 11010:"How to Cut a Long Story Short (Sixteenth Report of the Independent Monitoring Board)" 9196: 8891: 7919: 7729: 6544:

Njeru I, Ajack Y, Muitherero C, Onyango D, Musyoka J, Onuekusi I, et al. (2016).

5212:

Larocca AM, Bianchi FP, Bozzi A, Tafuri S, Stefanizzi P, Germinario CA (August 2022).

1891:

eradication was certified in October 2019, the virus not having been seen since 2012.

13891: 13372: 13037: 12974: 12785: 12456: 12425: 12121:"GPEI Statement on cVDPV2 detections in Burundi and Democratic Republic of the Congo" 11822: 11441: 11393: 11381: 11321: 10907: 10878: 10803: 10587: 10556:

Adamu US, Archer WR, Braka F, Damisa E, Siddique A, Baig S, et al. (July 2019).

10535: 10469: 10222: 10135: 10029: 9976: 9945:

Bolu O, Nnadi C, Damisa E, Braka F, Siddique A, Archer WR, et al. (March 2018).

9885: 9821: 9160: 9061: 8913: 8834: 8776: 8732: 8488: 8474:"Poliovirus infections in four unvaccinated children--Minnesota, August-October 2005" 8276: 7965: 7867: 7863: 7820: 7768: 7586: 7309: 7174: 7120: 6649: 6575: 6517: 6465: 6416: 6367: 6262: 6218: 6177: 5980: 5921: 5840: 5765: 5747: 5706: 5642: 5543: 5479: 5412: 5283: 5245: 5064: 5009: 4960: 4927: 4884: 4776: 4561: 4556: 3973: 1910: 1514: 1510: 1474: 1187: 441: 234: 81: 11793:"Update on Vaccine-Derived Poliovirus Outbreaks - Worldwide, January 2020-June 2021" 11569:"Africa Declares Wild Polio Is Wiped Out — Yet It Persists In Vaccine-Derived Cases" 8587: 8521: 7561: 6827: 1720:

Routine sewage monitoring in 2012 had detected a WPV1 strain of Pakistani origin in

647:

Skepticism in the Muslim world was exacerbated when it was learned that in 2011 the

13873: 13007: 12962: 12913: 12791: 12688: 12415: 12405: 12042: 11812: 11804: 11688:"Taliban will allow a national polio vaccination campaign in Afghanistan, says WHO" 11519: 11431: 11423: 11371: 11361: 10866: 10793: 10785: 10577: 10569: 10525: 10517: 10459: 10451: 10440:"Progress Toward Poliomyelitis Eradication - Pakistan, January 2017-September 2018" 10212: 10204: 10125: 10117: 10019: 10011: 9966: 9958: 9912: 9875: 9867: 9856:"Progress Toward Poliomyelitis Eradication - Pakistan, January 2016-September 2017" 9811: 9803: 8905: 8824: 8816: 8800: 8722: 8266: 8256: 8110: 7859: 7576: 7336: 7299: 7289: 7193: 7164: 7154: 7110: 7100: 6639: 6565: 6561: 6557: 6507: 6499: 6455: 6447: 6406: 6398: 6357: 6349: 6252: 6208: 6167: 6157: 5970: 5962: 5911: 5901: 5830: 5822: 5755: 5737: 5696: 5688: 5634: 5533: 5525: 5469: 5461: 5402: 5275: 5235: 5225: 5141: 5056: 4919: 4874: 4866: 4766: 4758: 4747:"Progress Toward Poliomyelitis Eradication - Worldwide, January 2022-December 2023" 1906:

140 cases of WPV1 paralysis were reported in 2020, all in Afghanistan or Pakistan.

1876: 1849: 576: 457: 341: 128: 10157:"Circulating vaccine-derived poliovirus type 2 – Democratic Republic of the Congo" 5529: 4994: 4923: 1921:

remain localized, significant international spread of these strains was observed.

13457: 13013: 12968: 12941: 12601: 11740: 10079:"Polio update: Two cVDPV2 outbreaks reported in Democratic Republic of the Congo" 9789:"Progress Toward Poliomyelitis Eradication - Afghanistan, January 2016-June 2017" 9201: 9133: 9034: 9029: 8591: 8526: 8261: 8132: 7294: 6767: 6704: 6626:

Ahmed A, Lee KS, Bukhsh A, Al-Worafi YM, Sarker MM, Ming LC, et al. (2018).

6503: 5811:"Engineering the Live-Attenuated Polio Vaccine to Prevent Reversion to Virulence" 5809:

Yeh MT, Bujaki E, Dolan PT, Smith M, Wahid R, Konz J, et al. (13 May 2020).

4855:"Eradication versus control: the economics of global infectious disease policies" 4683: 4651: 4528: 1524:

In July 2007, a student traveling from Pakistan imported the first polio case to

1075: 590: 280: 203:, such that the infectious agent no longer exists in nature or in the laboratory. 140: 12618: 12030: 11412:"Surveillance to Track Progress Toward Polio Eradication - Worldwide, 2020-2021" 11317:"'We have no choice.' Pandemic forces polio eradication group to halt campaigns" 10506:"Progress Toward Poliomyelitis Eradication - Afghanistan, January 2018-May 2019" 8756: 8702: 8473: 8471: 7948: 5948:"Surveillance to Track Progress Toward Polio Eradication - Worldwide, 2017-2018" 4992: 246: 13939: 12949: 12798: 12533: 10245: 9565: 7850:

Hinman AR (June 1984). "Landmark perspective: Mass vaccination against polio".

6644: 6627: 6146:"Ending Use of Oral Poliovirus Vaccine - A Difficult Move in the Polio Endgame" 5826: 5593:"Combination of oral, injectable polio vaccine used for first time in outbreak" 4539: 4516: 1699: 1691: 1058: 544: 490: 12613: 10504:

Martinez M, Shukla H, Nikulin J, Mbaeyi C, Jorba J, Ehrhardt D (August 2019).

8038: 7159: 7105: 6595:"Polio cases jump in Pakistan as clerics declare vaccination an American plot" 6402: 5906: 5742: 5692: 1652: 1085:

Much of the work towards eradication was documented by Brazilian photographer

13923: 13867: 13019: 12005:"Ukraine War and Other Crises Threaten Polio Eradication, Health Experts Say" 11366: 7950: 6762: 6238:"Update on Vaccine-Derived Polioviruses - Worldwide, January 2014-March 2015" 6237: 5751: 5569: 5230: 5129:

Global Polio Eradication Initiative, World Health Organization (April 2015).

4945: 3233: 2357: 1714: 1458: 1355: 1175: 1159: 536: 404: 320: 261: 116: 69: 31: 12445: 11410:

Wilkinson AL, Diop OM, Jorba J, Gardner T, Snider CJ, Ahmed J (April 2022).

11111:"Four new polio cases in Pakistan as study tackles partial-dose vaccination" 10870: 10558:"Progress Toward Poliomyelitis Eradication - Nigeria, January 2018-May 2019" 9947:"Progress Toward Poliomyelitis Eradication - Nigeria, January-December 2017" 9916: 8889: 7538: 7340: 7017:"The poliovirus transmission in Lao People's Democratic Republic has ceased" 5465: 1358:

accounted for nearly two-thirds of total worldwide cases reported. (See the

12429: 12410: 11826: 11808: 11445: 11427: 11385: 10982: 10859:"Surging cases have dashed all hope that polio might be eradicated in 2019" 10807: 10789: 10591: 10573: 10539: 10521: 10473: 10455: 10226: 10208: 10139: 10121: 10033: 9980: 9962: 9889: 9871: 9825: 9807: 9689:"Circulating vaccine-derived poliovirus – Lao People's Democratic Republic" 8917: 8892:"Identification and Control of a Poliomyelitis Outbreak in Xinjiang, China" 8838: 8780: 8736: 8492: 8445: 8280: 8114: 7824: 7590: 7313: 7178: 7124: 6800: 6673: 6653: 6599: 6579: 6521: 6469: 6420: 6371: 6353: 6266: 6222: 6181: 5984: 5966: 5925: 5844: 5769: 5710: 5547: 5483: 5416: 5407: 5249: 5013: 4931: 4888: 4780: 4762: 3752: 2403: 2288: 1625: 1585: 1565: 1518: 1062: 1050: 664: 407:. For polio to occur in a population, there must be an infecting organism ( 324: 253: 136: 8909: 8820: 7969: 7871: 7757: 6451: 5646: 4964: 1065:'s oral polio vaccine (OPV) was licensed in most industrialized countries— 692:

3 has not been detected since 2012, and was certified eradicated in 2019.

39: 13843: 13031: 12858: 12778: 12290:

World Health Organization - Regional Office for the Eastern Mediterranean

11855: 7052:"Government of Nigeria reports 2 wild polio cases, first since July 2014" 6213: 6196: 6162: 5287: 4946:"Recommendations of the International Task Force for Disease Eradication" 4204: 4037: 3775: 3608: 3349: 2698: 2242: 1977: 1777: 1745: 1629: 1494: 1436: 1182:

became the last case of polio reported in Europe. In 1997, Mum Chanty of

1148: 1049:

Kindergarten children receive a very early oral polio vaccine in 1960 in

652: 612: 561: 421: 284: 276: 169: 112: 12046: 11080:"Pakistan's anti-vaccination movement leads to string of deadly attacks" 8211:"WHO Director-General calls India 'number 1' polio eradication priority" 6796:"CIA tactics to trap Bin Laden linked with polio crisis, say aid groups" 5512:

Parker EP, Molodecky NA, Pons-Salort M, O'Reilly KM, Grassly NC (2015).

5145: 4870: 1828:

circulating undetected in regions inaccessible due to the activities of

1588:

both had 11. The following countries had single-digit numbers of cases:

13408: 13256: 12667: 12394:"Progress Toward Polio Eradication - Worldwide, January 2019-June 2021" 9995: 7140: 6669:"The CIA's fake vaccination drive has damaged the battle against polio" 6628:"Outbreak of vaccine-preventable diseases in Muslim majority countries" 5619: 5329:"Two New Vaccines Join the Fight to Eradicate Polio | UC San Francisco" 5060: 5042:

Global Polio Eradication Initiative, World Health Organization (2003).

4411: 3999: 3844: 3677: 3493: 3311: 2819: 2660: 2599: 2426: 2196: 2104: 1939: 1898: 1829: 1807: 1783: 1737: 1644: 1621: 1617: 1577: 1498: 1384: 1366: 1344: 1209: 549: 408: 367: 292: 231: 200: 196: 105: 61: 51: 12904: 10978:"Polio spreads in Afghanistan and Pakistan 'due to unchecked borders'" 10912:"To Calm Nervous Families, Pakistan Changes Polio Vaccination Tactics" 6033: 5511: 12123:(Press release). Global Polio Eradication Initiative. 16 March 2023. 8245:"What led to the Nigerian boycott of the polio vaccination campaign?" 8181:"Europe achieves historic milestone as Region is declared polio-free" 6436:"Health workers murdered as Pakistan vaccinates 8.4 million children" 4434: 4250: 3631: 3141: 1880: 1769: 1753: 1710: 1525: 1481:

community whose members predominantly were not vaccinated for polio.

1462: 1450: 1134: 288: 272: 177: 12063:(Press release). New York State Department of Health. 21 July 2022. 11879:"WHO Cautions Against Complacency as Pakistan Marks Polio-Free Year" 11047:"Pakistan, on verge of eradicating polio virus, faces human hurdles" 7920:"The End of Polio: Photographs of Sebastião Salgado Opens to Public" 4744: 1365:

In August 2003, rumors spread in some states in Nigeria, especially

157:

2 (WPV2) was in 1999, and WPV2 was declared eradicated in 2015. Type

27:

Effort to permanently eliminate all cases of poliomyelitis infection

13763: 12909: 12905: 12863: 12831: 12510: 9233: 6882: 4158: 4060: 3913: 3729: 3372: 3118: 2980: 2637: 2334: 2219: 2027: 1773: 1757: 1695: 1678: 1597: 1490: 1221: 1183: 1163: 1079: 416: 245:

The most important step in eradication of polio is interruption of

173: 132: 101: 8757:

Centers for Disease Control and Prevention (CDC) (23 March 2012).

8703:

Centers for Disease Control and Prevention (CDC) (12 April 2013).

6913:"Up in arms: EPI workers threaten to boycott polio drives in FATA" 4993:

Centers for Disease Control and Prevention (CDC) (December 1999).

1170:) was launched; National Immunization Days were coordinated in 19 12638: 12596: 12553: 10275: 8472:

Centers for Disease Control and Prevention (CDC) (October 2005).

7949:

Centers for Disease Control and Prevention (CDC) (October 1994).

4342: 4319: 4083: 3978: 3867: 3654: 3424: 3095: 3072: 2957: 2911: 2773: 2573: 2518: 2495: 2472: 2380: 2173: 2054: 1872: 1841: 1761: 1670: 1605: 1581: 1533: 1432: 1424: 1155: 617: 315:

Somali boy receiving injection of inactivated polio vaccine (IPV)

219: 146: 12088:"Polio found in New York wastewater as state urges vaccinations" 7951:"Certification of poliomyelitis eradication--the Americas, 1994" 7562:"Polio eradication: mobilizing and managing the human resources" 6883:"Protesting health workers threaten to boycott anti-polio drive" 4902:

Cockburn TA (April 1961). "Eradication of infectious diseases".

1427:-derived poliovirus). Most cases were located in two areas: the 1411: All cases in were due to circulating vaccine-derived virus 539:

states, set against the low (~80% after three doses against type

139:

infection in vaccinated individuals, particularly those who are

11946:"Gunmen in northwest Pakistan kill polio worker, two policemen" 11715:(Report). Pakistan Polio Eradication Programme. September 2022. 11350:"Impact of COVID-19 Pandemic on Global Poliovirus Surveillance" 11260:"Labs confirm 1st new case of polio in Philippines in 26 years" 9993: 6236:

Diop OM, Burns CC, Sutter RW, Wassilak SG, Kew OM (June 2015).

5306:

Global Polio Eradication Initiative - World Health Organization

4296: 4273: 3890: 3821: 3470: 3164: 2934: 2265: 2004: 1741: 1589: 1549: 1417: 1225: 1217: 1179: 1171: 1167: 1114: 553: 77: 60:, the goal of permanent global cessation of circulation of the 12179:"Polio in US, UK and Israel reveals rare risk of oral vaccine" 11198:

Circulating vaccine-derived poliovirus type 2 – African Region

10493:(Report). Pakistan Polio Eradication Programme. February 2019. 10412:(Report). Global Polio Eradication Initiative. November 2019. 9853: 7194:"Case 5: Eliminating Polio in Latin America and the Caribbean" 5444: 1423:

In 2005, there were 1,979 cases of wild poliovirus (excluding

12543: 12391: 11602:"Statement of the twenty-fifth polio IHR Emergency Committee" 10272:"WHO says child from Raqqa among 15 new polio cases in Syria" 7767:(13th ed.). Washington, D.C.: Public Health Foundation. 5045:

Global polio eradication initiative: strategic plan 2004–2008

4388: 4181: 4106: 3798: 3706: 3585: 3562: 3210: 3003: 2865: 2842: 2750: 2311: 2150: 2077: 1765: 1749: 1721: 1703: 1674: 1666: 1662: 1569: 1561: 1557: 1532:, which reported 41 cases, Chad with 22 cases, and Niger and 1478: 1454: 1446: 1440: 1374: 1213: 1191: 632: 622: 532: 528: 65: 12342:. Seventy-Fifth World Health Assembly. 6 May 2022. p. 5 12337:"Poliomyelitis eradication — Report by the Director-General" 9230:"Polio strain in Syria originated in Pakistan, WHO confirms" 7398:"WHO experts signal victory over one of three polio strains" 7086: 4511: 655:

immunization campaign, hoping to collect blood samples from

12563: 12148:"Burundi officials detect polio outbreak linked to vaccine" 11741:"Malawi finds Africa's first wild polio case in five years" 11347: 10503: 10190: 9786: 8004:. Government of India; Department of Family Welfare. 2013. 7761:

Epidemiology and Prevention of Vaccine-Preventable Diseases

6543: 4365: 4227: 3516: 3447: 3049: 3026: 2796: 1609: 1593: 1545: 1489:

In 2006, only four countries in the world (Nigeria, India,

1204:

Also in October 1999, The CORE Group—with funding from the

1138: 1071: 1066: 557: 183: 12230:"Poliovirus detected in sewage from North and East London" 11977:. Muscat, Oman: World Health Organization. 4 October 2022. 9098:"Poliovirus detected from environmental samples in Israel" 7087:

McCarthy KA, Chabot-Couture G, Shuaib F (September 2016).

6848: 6384: 6030:"Eradicating Polio: A Model for International Cooperation" 4717:"GPEI-Two out of three wild poliovirus strains eradicated" 403:

Polio vaccination is also important in the development of

260:

High infant immunization coverage with four doses of oral

12232:(Press release). UK Health Security Agency. 22 June 2022. 11790: 11409: 11232: 11083: 10685:"Circulating vaccine-derived poliovirus type 2 – Nigeria" 10305:"Circulating vaccine-derived poliovirus type 2 – Somalia" 9264: 9221: 8759:"Progress Toward Global Polio Eradication — Africa, 2011" 8554:"First Lady of Nigeria inaugurates vaccination campaigns" 7367:"This Man Has Been Shedding The Polio Virus For 28 Years" 6485: 5211: 1540:

countries, Chad reported the greatest number (37 cases).

1137:

poliovirus poliomyelitis in the Americas was reported in

608: 6385:

Wahid B, Kumari B, Saifullah KM, Idrees M (March 2023).

5887: 5562:"International travel and health: Poliomyelitis (Polio)" 5385: 1477:

infant girl aged seven months (the index patient) in an

47: 11647:"Global Circulating Vaccine-derived Poliovirus (cVDPV)" 10649:"Global Circulating Vaccine-derived Poliovirus (cVDPV)" 10437: 10103: 7461:"Global Eradication Of Wild Poliovirus Type 2 Declared" 6849:

Grossman S, Phillips J, Rosenzweig L (23 August 2016).

6625: 6331: 6329: 6327: 6235: 5674: 1243:

for poliomyelitis per 100,000 inhabitants in 2004

1190:

region. In 2000, the Western Pacific Region (including

188:

Eradication of polio has been defined in various ways:

12486: 10771: 10555: 9758:"Summary of poliovirus circulation in 2016 – Pakistan" 9622:

Global Polio Eradication Initiative Annual Report 2016

9090: 9000:"Somalia records its first wild polio case since 2007" 6828:"White House: CIA has ended use of vaccine programmes" 6295: 6293: 6291: 5945: 5675:

Shaw L, Spears W, Billings L, Maxim P (October 2010).

5104:

Public Health Notifiable Disease Management Guidelines

4711: 4709: 4543:, a 2009 documentary film about the eradication effort 1866:

Polio vaccination in the Democratic Republic of Congo.

548:

mobilisation of community groups, and issues with the

449:(before 2000 may include small numbers of cVDPV cases) 11989:"Afghanistan's Security Challenges under the Taliban" 8940:"Pakistan close to getting rid of a polio virus: WHO" 8377:"WHO Vaccine Preventable Diseases: Monitoring system" 7497:"Two out of three wild poliovirus strains eradicated" 7267: 4648:"Rinderpest virus has been wiped out, scientists say" 1078:, launched an initiative to eradicate polio from the 11494:"Stakeholders celebrate Nigeria's polio-free status" 10944:"Statement of the Twentieth IHR Emergency Committee" 10048:"End of Outbreak in Lao Peoples Democratic Republic" 9944: 6723: 6324: 5785:"Two New Vaccines Join the Fight to Eradicate Polio" 4677: 4675: 4673: 584: 11520:"Africa declared free of wild polio in 'milestone'" 10715:

Somalia cVDPV Outbreak Response Situation Report #3

10551: 10549: 9940: 9938: 6288: 5888:Duintjer Tebbens RJ, Thompson KM (September 2015). 5808: 4706: 13945:Public health emergencies of international concern 12003: 11760: 11758: 10643: 10641: 10639: 10637: 10635: 10633: 10631: 10629: 10627: 9722:"Semi-Annual Status Report: July to December 2016" 9261:"A $ 5.5 Billion Road Map To Banish Polio Forever" 6701:"Bin Laden death: 'CIA doctor' accused of treason" 6378: 4547:List of diseases eliminated from the United States 1206:United States Agency for International Development 411:), a susceptible human population, and a cycle of 12723:London Declaration on Neglected Tropical Diseases 12370:WHO Global Action Plan for Poliovirus Containment 12079: 11786: 11784: 11458: 11115:Center for Infectious Disease Research and Policy 9366:"WHO South-East Asia Region certified polio-free" 9153: 9120: 8808:American Journal of Tropical Medicine and Hygiene 6486:Ghinai I, Willott C, Dadari I, Larson HJ (2013). 5554: 4670: 206:As control of an infection to the point at which 149:is the latest country to have officially stopped 68:(polio) it causes, is the aim of a multinational 13921: 12115: 12113: 11856:"Pakistan Detects First Polio Case in 15 Months" 10608:(Press release). WHO:Africa. 13 September 2018. 10546: 10233: 9935: 9592:"WHO urges polio vaccine dose cut amid shortage" 8610: 7082: 7080: 6732:"American NGOs assail CIA over fake polio drive" 5106:. Alberta Government Health and Wellness. 2018. 1186:became the last person to contract polio in the 1095:The End of Polio: Global Effort to End a Disease 111:Prevention of disease spread is accomplished by 11755: 11641: 11639: 11637: 11635: 11633: 11631: 11629: 11627: 11625: 11623: 11405: 11403: 10624: 10299: 10297: 10242:"Polio outbreak is reported in Syria, WHO says" 9396:"Polio-free certification: WHO South-East Asia" 9360: 9358: 9126: 9066:"Egypt: Polio Virus Is Found in Cairo's Sewers" 8299:International Committee of the Red Cross (ICRC) 8147: 7455: 7453: 7451: 7136: 7134: 5265: 1439:campaign to increase polio immunization rates, 11781: 9165:"Polio Virus Discovered in Sewage From Israel" 8092: 7724: 7722: 7665: 7663: 7661: 7659: 7657: 7655: 7653: 7651: 7649: 7647: 7559: 6975: 6973: 6946:"Syria's Polio Epidemic: The Suppressed Truth" 6763:"'Emergency plan' to eradicate polio launched" 2565:engineered to allow vaccination against strain 1513:, wife of recently elected Nigerian president 210:of the disease ceased within a specified area. 13895: 12890: 12472: 12110: 12053: 11841:"GPEI statement on Mozambique WPV1 detection" 11665: 11596: 11594: 11044: 10822:Papua New Guinea Polio Outbreak Response 2018 10497: 9498:"GPEI-Circulating vaccine-derived poliovirus" 9462:Semi-Annual Status Report, July-December 2015 9327:Semi-Annual Status Report, July-December 2014 8991: 8963: 8961: 8659: 8657: 8655: 8653: 8651: 8649: 8220:(Press release). 7 April 2003. Archived from 7720: 7718: 7716: 7714: 7712: 7710: 7708: 7706: 7704: 7702: 7077: 6981:"WHO Removes Nigeria from Polio-Endemic List" 4740: 4738: 4681: 678: 575:In a 2012 interview with Pakistani newspaper 431: 424:, then the pathogen will eventually die off. 13935:Infectious diseases with eradication efforts 11719: 11620: 11400: 10327: 10294: 9426:Semi-Annual Status Report, January-June 2015 9355: 9291:Semi-Annual Status Report, January-June 2014 9252: 9129:"More polio virus traces detected in Israel" 8411: 8332: 8330: 8328: 8326: 8324: 8322: 8320: 7553: 7448: 7131: 6660: 5122: 4552:Mathematical modelling of infectious disease 3998: 3310: 2598: 1938: 1727:In April 2013, the WHO announced a new $ 5.5 1147:In 1994, the Indian Government launched the 92:, have spearheaded the campaign through the 12398:MMWR. Morbidity and Mortality Weekly Report 12263: 12261: 12259: 12139: 12001: 11797:MMWR. Morbidity and Mortality Weekly Report 11416:MMWR. Morbidity and Mortality Weekly Report 11354:MMWR. 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Morbidity and Mortality Weekly Report 5726:"Population Immunity and Polio Eradication" 5395:MMWR. Morbidity and Mortality Weekly Report 5351: 5349: 5182: 5180: 5178: 5176: 5174: 5172: 5170: 4751:MMWR. Morbidity and Mortality Weekly Report 4609: 1681:, the first non-imported cases since 1994. 1399: Polio had re-established transmission 1197:In October 1999, the last isolation of type 704:International wild poliovirus cases by year 84:. These organizations, along with the U.S. 12897: 12883: 12479: 12465: 11591: 11108: 10151: 10149: 8958: 8773:Centers for Disease Control and Prevention 8719:Centers for Disease Control and Prevention 8646: 8514: 8465: 8407: 8405: 8236: 8088: 8086: 7924:Centers for Disease Control and Prevention 7699: 7185: 6787: 6048: 5789:The University of California San Francisco 5620:"Herd immunity: history, theory, practice" 5333:The University of California San Francisco 5192:Global Polio Eradication Initiative (GPEI) 4735: 1820:of a lower dose than used in the standard 1665:reported its first case since 2009, while 1119:Centers for Disease Control and Prevention 447:Number of wild poliovirus cases, 1975–2022 86:Centers for Disease Control and Prevention 13078:"Cocoliztli" epidemics in colonial Mexico 12419: 12409: 11816: 11435: 11375: 11365: 11077: 10906: 10797: 10581: 10529: 10463: 10401: 10399: 10239: 10216: 10129: 10023: 9970: 9879: 9815: 9559: 9159: 9060: 8828: 8726: 8414:"Polio Spreads From Nigeria After Claims" 8317: 8270: 8260: 8129:"CORE Group Polio Eradication Initiative" 7942: 7580: 7569:Bulletin of the World Health Organization 7303: 7293: 7168: 7158: 7114: 7104: 6643: 6569: 6511: 6459: 6410: 6361: 6256: 6212: 6188: 6171: 6161: 6143: 5974: 5915: 5905: 5834: 5759: 5741: 5700: 5590: 5537: 5473: 5406: 5261: 5259: 5239: 5229: 4878: 4859:Bulletin of the World Health Organization 4848: 4846: 4770: 4484: 1473:1 infection occurred in an unvaccinated, 480:2 virus, while a separate monovalent type 222:; that diagnostic tools, with sufficient 12363: 12361: 12359: 12357: 12256: 11729:(Press release). GPEI. 17 February 2022. 11685: 10902: 10900: 10740:"Polio outbreak confirmed in Mozambique" 10179: 10076: 9994:Duizer E, Ruijs WL, van der Weijden CP, 9258: 8997: 8937: 8585: 8438: 8369: 7891: 7878: 7813:Epidemiologie, Mikrobiologie, Imunologie 7748: 7597: 7519: 7486: 7039: 7006: 6539: 6537: 6535: 6533: 6531: 6481: 6479: 6433: 6335: 6023: 6021: 6019: 6017: 6015: 6013: 6011: 6009: 5346: 5167: 4901: 1897: 1861: 1806: 1782: 1651: 1643: 1383: 1235: 1044: 873: 855: 837: 819: 803: 785: 769: 751: 733: 657:Osama bin Laden's compound in Abbottabad 394: 310: 184:Factors influencing eradication of polio 46: 38: 12738:Malaria Eradication Scientific Alliance 12241: 12239: 11764: 11675:(Press release). GPEI. 11 October 2021. 11314: 10856: 10146: 9902: 9764:(WHO). 27 December 2016. Archived from 9528:"Global synchronisation and the switch" 9227: 8402: 8083: 8067:(WHO). 30 November 2001. Archived from 7326: 6943: 5941: 5939: 5937: 5935: 4852: 1709:In April 2013, a case of wild polio in 366:The inactivated polio vaccine (IPV, or 354:the eradication of wild poliovirus type 237:and cannot amplify in the environment. 14: 13922: 12376:. Global Polio Eradication Initiative. 12325:. Global Polio Eradication Initiative. 12274:. Global Polio Eradication Initiative. 12085: 11491: 11292:(Press release). GPEI. 18 March 2020. 11270:from the original on 20 September 2019 11239:from the original on 19 September 2019 11139: 10975: 10396: 9656: 9127:Sterman A, Winer Jr S (12 June 2013). 9030:"Somalia hit by severe polio outbreak" 8242: 8157:. Rotary International. Archived from 7979:from the original on 13 September 2017 7849: 7843: 7802: 7474:from the original on 12 September 2016 6808:from the original on 11 September 2013 6760: 6666: 6632:Journal of Infection and Public Health 6194: 6032:. Worldwatch Institute. Archived from 6027: 5256: 4843: 663:. 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October 2018. 10790:10.15585/mmwr.mm6724a5 10574:10.15585/mmwr.mm6829a3 10522:10.15585/mmwr.mm6833a4 10456:10.15585/mmwr.mm6744a5 10209:10.15585/mmwr.mm6809a2 10122:10.15585/mmwr.mm6710a4 9963:10.15585/mmwr.mm6708a5 9872:10.15585/mmwr.mm6646a4 9808:10.15585/mmwr.mm6632a5 8627:(GPEI). Archived from 7622:"AFP/Polio Case Count" 7503:(GPEI). 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WHO/POLIO/15.02. 4916:1961Sci...133.1050C 4910:(3458): 1050–1058. 4587:"Polio Eradication" 4529:Medicine portal 1429:Indian subcontinent 1154:In 1995, Operation 603:and the subsequent 121:weakened poliovirus 96:(GPEI). Successful 13790:Influenza pandemic 13784:Influenza pandemic 13732:Bangsamoro measles 13714:Singaporean dengue 13678:Pacific NW measles 13672:Philippine measles 13660:Madagascar measles 13642:Kerala Nipah virus 13635:Saudi Arabian MERS 13548:Singaporean dengue 13494:Zimbabwean cholera 13464:Singaporean dengue 13308:Copenhagen cholera 13290:Groningen epidemic 13084:Influenza pandemic 13066:Influenza pandemic 11881:. Voice of America 11858:. Voice of America 11544:. 25 August 2020. 11208:on 20 October 2019 10917:The New York Times 10749:. 8 January 2019. 10315:on 20 October 2018 9702:on 19 January 2017 9170:The New York Times 9071:The New York Times 9038:. 16 August 2013. 8567:on 9 December 2007 7507:on 24 October 2019 6830:. BBC. 19 May 2014 6707:. 6 October 2011. 6092:on 24 October 2016 4723:on 7 November 2019 4627:on 3 February 2011 4517:Viruses portal 4004: 3969:Khyber Pakhtunkhwa 3961:Sub-Saharan Africa 3316: 3283:Khyber Pakhtunkhwa 2604: 1944: 1904: 1868: 1813: 1789: 1658: 1650: 1414: 1336: 1055: 638:Khyber Pakhtunkhwa 401: 327:vaccine) contains 317: 55: 45: 13917: 13916: 13758: 13757: 13754: 13753: 13690:Kuala Koh measles 13604:South Korean MERS 13592:Polio declaration 13580:Madagascar plague 13512:Gujarat hepatitis 13500:Madagascar plague 13452:Midwest monkeypox 13403:Yugoslav smallpox 13373:Manchurian plague 13314:Stockholm cholera 13251: 13250: 13038:Sweating sickness 13026:Japanese smallpox 12975:Plague of Cyprian 12914:disease outbreaks 12872: 12871: 12810: 12809: 12786:Polio in Pakistan 12702: 12701: 12647: 12646: 12548:Polio eradication 12404:(34): 1129–1135. 11991:. 12 August 2022. 11803:(49): 1691–1699. 11526:. 25 August 2020. 11144:. The Telegraph. 10695:on 12 August 2018 10450:(44): 1242–1245. 10167:on 28 August 2018 10004:Euro Surveillance 9866:(46): 1276–1280. 9768:on 2 January 2017 9598:. 28 April 2017. 9368:(Press release). 8904:(21): 1981–1990. 8487:(41): 1053–1055. 8183:(Press release). 8063:(Press release). 7922:(Press release). 7858:(22): 2994–2996. 7774:978-0-9904491-1-9 7541:on 5 January 2018 7019:(Press release). 6921:. 26 April 2016. 6498:(10): 1138–1150. 6207:(25): 2346–2349. 5821:(5): 736–751.e8. 5687:(19): 3728–3744. 5070:978-92-4-159117-1 4562:Population health 4557:Polio in Pakistan 4473: 4472: 3974:Kandahar province 3952: 3951: 3272: 3271: 2557: 2556: 1911:COVID-19 pandemic 1475:immunocompromised 1333: 1332: 1188:Indo-West Pacific 1121:(CDC) passed the 1087:Sebastião Salgado 1038: 1037: 640:(KPK) and in the 570:chronic excretors 82:Rotary Foundation 80:(UNICEF) and the 58:Polio eradication 16:(Redirected from 13957: 13930:Health campaigns 13897: 13684:New York measles 13638: 13598:Indian swine flu 13586:Odisha hepatitis 13576: 13530:Pakistani dengue 13482:Pakistani dengue 13431: 13397:Wrocław smallpox 13350:Hong Kong plague 13284:Caragea's plague 13262: 13261: 13179: 13072:Mexican smallpox 13056: 13055: 13008:Plague of Sheroe 12963:Plague of Athens 12958: 12955: 12938: 12937: 12899: 12892: 12885: 12876: 12875: 12792:Every Last Child 12713: 12712: 12689:Ovine rinderpest 12658: 12657: 12501: 12500: 12481: 12474: 12467: 12458: 12457: 12453: 12433: 12423: 12413: 12378: 12377: 12375: 12365: 12352: 12351: 12349: 12347: 12341: 12333: 12327: 12326: 12324: 12314: 12308: 12307: 12300: 12294: 12293: 12282: 12276: 12275: 12273: 12265: 12254: 12253: 12251: 12243: 12234: 12233: 12226: 12220: 12219: 12217: 12215: 12200: 12194: 12193: 12191: 12189: 12174: 12168: 12167: 12165: 12163: 12143: 12137: 12136: 12134: 12132: 12117: 12108: 12107: 12105: 12103: 12083: 12077: 12076: 12074: 12072: 12057: 12051: 12050: 12027: 12021: 12020: 12018: 12016: 12007: 11999: 11993: 11992: 11985: 11979: 11978: 11972: 11964: 11958: 11957: 11955: 11953: 11942: 11936: 11935: 11933: 11931: 11920: 11914: 11913: 11911: 11909: 11897: 11891: 11890: 11888: 11886: 11874: 11868: 11867: 11865: 11863: 11851: 11845: 11844: 11837: 11831: 11830: 11820: 11788: 11779: 11778: 11776: 11774: 11762: 11753: 11752: 11750: 11748: 11737: 11731: 11730: 11723: 11717: 11716: 11714: 11706: 11700: 11699: 11697: 11695: 11683: 11677: 11676: 11669: 11663: 11662: 11660: 11658: 11643: 11618: 11617: 11615: 11613: 11598: 11589: 11588: 11586: 11584: 11564: 11558: 11557: 11555: 11553: 11534: 11528: 11527: 11516: 11510: 11509: 11507: 11505: 11489: 11483: 11482: 11480: 11478: 11456: 11450: 11449: 11439: 11407: 11398: 11397: 11379: 11369: 11345: 11339: 11338: 11336: 11334: 11312: 11306: 11305: 11303: 11301: 11286: 11280: 11279: 11277: 11275: 11255: 11249: 11248: 11246: 11244: 11224: 11218: 11217: 11215: 11213: 11194: 11188: 11187: 11185: 11183: 11164: 11158: 11157: 11155: 11153: 11137: 11131: 11130: 11128: 11126: 11106: 11100: 11099: 11097: 11095: 11075: 11069: 11068: 11066: 11064: 11042: 11036: 11035: 11033: 11031: 11025: 11014: 11006: 11000: 10999: 10997: 10995: 10973: 10967: 10966: 10964: 10962: 10940: 10934: 10933: 10931: 10929: 10904: 10895: 10894: 10892: 10890: 10854: 10848: 10847: 10845: 10843: 10837: 10826: 10818: 10812: 10811: 10801: 10769: 10763: 10762: 10760: 10758: 10736: 10730: 10729: 10727: 10725: 10719: 10711: 10705: 10704: 10702: 10700: 10681: 10675: 10674: 10672: 10670: 10664: 10653: 10645: 10622: 10621: 10619: 10617: 10602: 10596: 10595: 10585: 10553: 10544: 10543: 10533: 10501: 10495: 10494: 10492: 10484: 10478: 10477: 10467: 10435: 10429: 10428: 10426: 10424: 10418: 10411: 10403: 10394: 10393: 10391: 10389: 10370: 10364: 10363: 10361: 10359: 10353: 10339: 10331: 10325: 10324: 10322: 10320: 10301: 10292: 10291: 10289: 10287: 10278:. 20 June 2017. 10268: 10262: 10261: 10259: 10257: 10237: 10231: 10230: 10220: 10188: 10177: 10176: 10174: 10172: 10153: 10144: 10143: 10133: 10101: 10095: 10094: 10092: 10090: 10074: 10068: 10067: 10065: 10063: 10044: 10038: 10037: 10027: 9991: 9985: 9984: 9974: 9942: 9933: 9932: 9930: 9928: 9900: 9894: 9893: 9883: 9851: 9845: 9844: 9842: 9840: 9834: 9819: 9793: 9784: 9778: 9777: 9775: 9773: 9754: 9748: 9747: 9745: 9743: 9737: 9726: 9718: 9712: 9711: 9709: 9707: 9698:. Archived from 9685: 9679: 9678: 9676: 9674: 9654: 9648: 9647: 9645: 9643: 9637: 9626: 9618: 9612: 9611: 9609: 9607: 9588: 9582: 9581: 9579: 9577: 9557: 9551: 9550: 9548: 9546: 9537:. Archived from 9524: 9518: 9517: 9511: 9509: 9494: 9488: 9487: 9485: 9483: 9477: 9466: 9458: 9452: 9451: 9449: 9447: 9441: 9430: 9422: 9416: 9415: 9413: 9411: 9406:on 27 March 2014 9392: 9386: 9385: 9383: 9381: 9376:on 27 March 2014 9362: 9353: 9352: 9350: 9348: 9342: 9331: 9323: 9317: 9316: 9314: 9312: 9306: 9295: 9287: 9281: 9280: 9278: 9276: 9256: 9250: 9249: 9247: 9245: 9225: 9219: 9218: 9216: 9214: 9193: 9187: 9186: 9184: 9182: 9157: 9151: 9150: 9148: 9146: 9124: 9118: 9117: 9115: 9113: 9094: 9088: 9087: 9085: 9083: 9058: 9052: 9051: 9049: 9047: 9026: 9020: 9019: 9017: 9015: 9004:Nature News Blog 8995: 8989: 8988: 8986: 8984: 8973: 8965: 8956: 8955: 8953: 8951: 8935: 8929: 8928: 8926: 8924: 8887: 8881: 8880: 8878: 8876: 8871:. 9 October 2012 8859: 8853: 8852: 8847: 8845: 8832: 8798: 8792: 8791: 8789: 8787: 8754: 8748: 8747: 8745: 8743: 8730: 8700: 8694: 8693: 8691: 8689: 8683: 8669: 8661: 8644: 8643: 8641: 8639: 8633: 8622: 8614: 8608: 8607: 8605: 8603: 8583: 8577: 8576: 8574: 8572: 8550: 8544: 8543: 8541: 8539: 8530:. 2 March 2007. 8518: 8512: 8511: 8509: 8507: 8501: 8478: 8469: 8463: 8462: 8460: 8458: 8436: 8430: 8429: 8427: 8425: 8409: 8400: 8399: 8397: 8395: 8389: 8373: 8367: 8366: 8364: 8362: 8356: 8342: 8334: 8315: 8314: 8312: 8310: 8291: 8285: 8284: 8274: 8264: 8240: 8234: 8233: 8231: 8229: 8207: 8201: 8200: 8198: 8196: 8177: 8171: 8170: 8168: 8166: 8151: 8145: 8144: 8142: 8140: 8131:. Archived from 8125: 8119: 8118: 8095:Health Educ. Res 8090: 8081: 8080: 8078: 8076: 8057: 8051: 8050: 8048: 8046: 8027: 8021: 8020: 8018: 8016: 8010: 8003: 7995: 7989: 7988: 7986: 7984: 7978: 7955: 7946: 7940: 7939: 7937: 7935: 7916: 7910: 7909: 7907: 7905: 7889: 7876: 7875: 7847: 7841: 7840: 7838: 7836: 7810: 7800: 7794: 7793: 7791: 7789: 7783: 7766: 7755: 7746: 7745: 7743: 7741: 7726: 7697: 7696: 7694: 7692: 7686: 7675: 7667: 7642: 7641: 7639: 7637: 7618: 7595: 7594: 7584: 7566: 7557: 7551: 7550: 7548: 7546: 7526: 7517: 7516: 7514: 7512: 7493: 7484: 7483: 7481: 7479: 7457: 7446: 7445: 7443: 7441: 7435: 7428: 7420: 7414: 7413: 7411: 7409: 7393: 7387: 7386: 7384: 7382: 7363: 7357: 7356: 7354: 7352: 7324: 7318: 7317: 7307: 7297: 7265: 7259: 7258: 7256: 7254: 7232: 7226: 7225: 7220: 7218: 7212: 7198: 7192:Kinder M (ed.). 7189: 7183: 7182: 7172: 7162: 7138: 7129: 7128: 7118: 7108: 7084: 7075: 7074: 7072: 7070: 7048: 7037: 7036: 7034: 7032: 7013: 7004: 7003: 7001: 6999: 6977: 6968: 6967: 6965: 6963: 6941: 6935: 6934: 6932: 6930: 6909: 6903: 6902: 6900: 6898: 6879: 6873: 6872: 6870: 6868: 6846: 6840: 6839: 6837: 6835: 6824: 6818: 6817: 6815: 6813: 6791: 6785: 6784: 6782: 6780: 6758: 6752: 6751: 6749: 6747: 6727: 6721: 6720: 6718: 6716: 6697: 6691: 6690: 6688: 6686: 6664: 6658: 6657: 6647: 6623: 6617: 6616: 6614: 6612: 6590: 6584: 6583: 6573: 6541: 6526: 6525: 6515: 6483: 6474: 6473: 6463: 6431: 6425: 6424: 6414: 6397:(2–3): 183–188. 6382: 6376: 6375: 6365: 6333: 6322: 6321: 6319: 6317: 6297: 6286: 6285: 6283: 6281: 6275: 6260: 6242: 6233: 6227: 6226: 6216: 6192: 6186: 6185: 6175: 6165: 6141: 6135: 6134: 6132: 6130: 6121:. Archived from 6108: 6102: 6101: 6099: 6097: 6078: 6072: 6071: 6069: 6067: 6058:. Archived from 6052: 6046: 6045: 6043: 6041: 6025: 6004: 6003: 6001: 5999: 5993: 5978: 5952: 5943: 5930: 5929: 5919: 5909: 5885: 5879: 5878: 5876: 5874: 5855: 5849: 5848: 5838: 5806: 5800: 5799: 5797: 5795: 5780: 5774: 5773: 5763: 5745: 5721: 5715: 5714: 5704: 5672: 5666: 5665: 5663: 5661: 5655: 5624: 5618:Fine PE (1993). 5615: 5609: 5608: 5606: 5604: 5588: 5582: 5581: 5579: 5577: 5558: 5552: 5551: 5541: 5524:(8): 1113–1123. 5509: 5503: 5502: 5500: 5498: 5492: 5477: 5451: 5442: 5436: 5435: 5433: 5431: 5425: 5410: 5392: 5383: 5377: 5376: 5374: 5372: 5353: 5344: 5343: 5341: 5339: 5324: 5318: 5317: 5315: 5313: 5298: 5292: 5291: 5263: 5254: 5253: 5243: 5233: 5209: 5203: 5202: 5200: 5198: 5184: 5165: 5164: 5162: 5160: 5154: 5135: 5126: 5120: 5119: 5117: 5115: 5096: 5090: 5089: 5087: 5085: 5079: 5050: 5039: 5033: 5032: 5030: 5028: 5022: 5002:MMWR Supplements 4999: 4990: 4984: 4983: 4981: 4979: 4973: 4950: 4942: 4936: 4935: 4899: 4893: 4892: 4882: 4850: 4841: 4840: 4838: 4836: 4817: 4811: 4810: 4808: 4806: 4791: 4785: 4784: 4774: 4742: 4733: 4732: 4730: 4728: 4719:. 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Archived from 4583: 4527: 4526: 4525: 4515: 4514: 4452: 4447: 4429: 4424: 4406: 4401: 4383: 4378: 4360: 4355: 4337: 4332: 4314: 4309: 4291: 4286: 4268: 4263: 4245: 4240: 4222: 4217: 4199: 4194: 4176: 4171: 4153: 4149: 4144: 4124: 4119: 4101: 4096: 4078: 4073: 4055: 4050: 3991: 3990: 3931: 3926: 3908: 3903: 3885: 3880: 3862: 3857: 3839: 3834: 3816: 3811: 3793: 3788: 3770: 3765: 3747: 3742: 3724: 3719: 3701: 3697: 3692: 3672: 3667: 3649: 3644: 3626: 3621: 3603: 3598: 3580: 3575: 3557: 3552: 3534: 3529: 3511: 3506: 3488: 3483: 3465: 3460: 3442: 3437: 3419: 3415: 3410: 3390: 3385: 3367: 3362: 3303: 3302: 3291:Russian invasion 3251: 3246: 3228: 3223: 3205: 3200: 3182: 3177: 3159: 3154: 3136: 3131: 3113: 3108: 3090: 3085: 3067: 3062: 3044: 3039: 3021: 3016: 2998: 2993: 2975: 2970: 2952: 2947: 2929: 2924: 2906: 2901: 2883: 2878: 2860: 2855: 2837: 2832: 2814: 2809: 2791: 2786: 2768: 2763: 2745: 2741: 2736: 2716: 2711: 2693: 2689: 2685: 2680: 2655: 2650: 2591: 2590: 2568: 2536: 2531: 2513: 2508: 2490: 2485: 2467: 2462: 2444: 2439: 2421: 2416: 2398: 2393: 2375: 2370: 2352: 2347: 2329: 2324: 2306: 2301: 2283: 2278: 2260: 2255: 2237: 2232: 2214: 2209: 2191: 2186: 2168: 2163: 2145: 2140: 2122: 2117: 2099: 2095: 2090: 2072: 2067: 2049: 2045: 2040: 2022: 2017: 1999: 1995: 1990: 1931: 1930: 1877:Papua New Guinea 1850:Syrian Civil War 1730: 1688: 1635: 1472: 1410: 1404: 1398: 1392: 1372: 1341: 1326: 1320: 1314: 1308: 1302: 1296: 1288: 1282: 1276: 1270: 1264: 1258: 1252: 1246: 1200: 1132: 700: 699: 691: 687: 542: 487: 483: 479: 474: 460: 444: 361: 357: 352: 334: 333:US$ 0.15 to 0.20 164: 160: 156: 129:contact immunity 21: 13965: 13964: 13960: 13959: 13958: 13956: 13955: 13954: 13920: 13919: 13918: 13913: 13750: 13633: 13571: 13554:Swansea measles 13506:Bolivian dengue 13434: 13426: 13415:Indian smallpox 13385:Croydon typhoid 13355: 13247: 13188: 13174: 13109: 13050: 13043: 13014:Plague of Amwas 12987: 12980: 12969:Antonine Plague 12956: 12929: 12916: 12903: 12873: 12868: 12806: 12742: 12708: 12698: 12677: 12653: 12643: 12579: 12573: 12526: 12520: 12496: 12490: 12485: 12444: 12441: 12436: 12387: 12385:Further reading 12382: 12381: 12373: 12367: 12366: 12355: 12345: 12343: 12339: 12335: 12334: 12330: 12322: 12316: 12315: 12311: 12302: 12301: 12297: 12284: 12283: 12279: 12271: 12267: 12266: 12257: 12249: 12245: 12244: 12237: 12228: 12227: 12223: 12213: 12211: 12202: 12201: 12197: 12187: 12185: 12175: 12171: 12161: 12159: 12144: 12140: 12130: 12128: 12119: 12118: 12111: 12101: 12099: 12084: 12080: 12070: 12068: 12059: 12058: 12054: 12029: 12028: 12024: 12014: 12012: 12000: 11996: 11987: 11986: 11982: 11970: 11966: 11965: 11961: 11951: 11949: 11944: 11943: 11939: 11929: 11927: 11922: 11921: 11917: 11907: 11905: 11898: 11894: 11884: 11882: 11875: 11871: 11861: 11859: 11852: 11848: 11839: 11838: 11834: 11789: 11782: 11772: 11770: 11763: 11756: 11746: 11744: 11739: 11738: 11734: 11725: 11724: 11720: 11712: 11708: 11707: 11703: 11693: 11691: 11684: 11680: 11671: 11670: 11666: 11656: 11654: 11653:. 23 April 2024 11645: 11644: 11621: 11611: 11609: 11600: 11599: 11592: 11582: 11580: 11565: 11561: 11551: 11549: 11536: 11535: 11531: 11518: 11517: 11513: 11503: 11501: 11490: 11486: 11476: 11474: 11457: 11453: 11422:(15): 538–544. 11408: 11401: 11346: 11342: 11332: 11330: 11313: 11309: 11299: 11297: 11288: 11287: 11283: 11273: 11271: 11256: 11252: 11242: 11240: 11225: 11221: 11211: 11209: 11196: 11195: 11191: 11181: 11179: 11166: 11165: 11161: 11151: 11149: 11138: 11134: 11124: 11122: 11107: 11103: 11093: 11091: 11076: 11072: 11062: 11060: 11043: 11039: 11029: 11027: 11023: 11012: 11008: 11007: 11003: 10993: 10991: 10974: 10970: 10960: 10958: 10942: 10941: 10937: 10927: 10925: 10910:(24 May 2019). 10905: 10898: 10888: 10886: 10855: 10851: 10841: 10839: 10835: 10824: 10820: 10819: 10815: 10784:(24): 690–694. 10770: 10766: 10756: 10754: 10738: 10737: 10733: 10723: 10721: 10717: 10713: 10712: 10708: 10698: 10696: 10683: 10682: 10678: 10668: 10666: 10662: 10651: 10647: 10646: 10625: 10615: 10613: 10604: 10603: 10599: 10568:(29): 642–646. 10554: 10547: 10516:(33): 729–733. 10502: 10498: 10490: 10486: 10485: 10481: 10436: 10432: 10422: 10420: 10416: 10409: 10405: 10404: 10397: 10387: 10385: 10372: 10371: 10367: 10357: 10355: 10351: 10337: 10333: 10332: 10328: 10318: 10316: 10303: 10302: 10295: 10285: 10283: 10270: 10269: 10265: 10255: 10253: 10238: 10234: 10189: 10180: 10170: 10168: 10155: 10154: 10147: 10116:(10): 300–305. 10102: 10098: 10088: 10086: 10075: 10071: 10061: 10059: 10046: 10045: 10041: 9992: 9988: 9943: 9936: 9926: 9924: 9901: 9897: 9852: 9848: 9838: 9836: 9832: 9802:(32): 854–858. 9791: 9785: 9781: 9771: 9769: 9756: 9755: 9751: 9741: 9739: 9735: 9724: 9720: 9719: 9715: 9705: 9703: 9687: 9686: 9682: 9672: 9670: 9655: 9651: 9641: 9639: 9635: 9624: 9620: 9619: 9615: 9605: 9603: 9590: 9589: 9585: 9575: 9573: 9558: 9554: 9544: 9542: 9526: 9525: 9521: 9507: 9505: 9496: 9495: 9491: 9481: 9479: 9475: 9464: 9460: 9459: 9455: 9445: 9443: 9439: 9428: 9424: 9423: 9419: 9409: 9407: 9394: 9393: 9389: 9379: 9377: 9364: 9363: 9356: 9346: 9344: 9340: 9329: 9325: 9324: 9320: 9310: 9308: 9304: 9293: 9289: 9288: 9284: 9274: 9272: 9257: 9253: 9243: 9241: 9226: 9222: 9212: 9210: 9202:BBC News Online 9195: 9194: 9190: 9180: 9178: 9163:(7 June 2013). 9158: 9154: 9144: 9142: 9134:Times of Israel 9125: 9121: 9111: 9109: 9096: 9095: 9091: 9081: 9079: 9059: 9055: 9045: 9043: 9035:BBC News Online 9028: 9027: 9023: 9013: 9011: 8996: 8992: 8982: 8980: 8971: 8967: 8966: 8959: 8949: 8947: 8936: 8932: 8922: 8920: 8888: 8884: 8874: 8872: 8861: 8860: 8856: 8843: 8841: 8799: 8795: 8785: 8783: 8755: 8751: 8741: 8739: 8701: 8697: 8687: 8685: 8681: 8667: 8663: 8662: 8647: 8637: 8635: 8631: 8620: 8616: 8615: 8611: 8601: 8599: 8592:BBC News Online 8584: 8580: 8570: 8568: 8552: 8551: 8547: 8537: 8535: 8527:BBC News Online 8520: 8519: 8515: 8505: 8503: 8499: 8476: 8470: 8466: 8456: 8454: 8437: 8433: 8423: 8421: 8410: 8403: 8393: 8391: 8387: 8375: 8374: 8370: 8360: 8358: 8357:on 4 March 2016 8354: 8340: 8336: 8335: 8318: 8308: 8306: 8301:. 11 May 2005. 8293: 8292: 8288: 8241: 8237: 8227: 8225: 8224:on 19 June 2007 8209: 8208: 8204: 8194: 8192: 8179: 8178: 8174: 8164: 8162: 8153: 8152: 8148: 8138: 8136: 8127: 8126: 8122: 8091: 8084: 8074: 8072: 8059: 8058: 8054: 8044: 8042: 8041:on 29 July 2007 8029: 8028: 8024: 8014: 8012: 8008: 8001: 7997: 7996: 7992: 7982: 7980: 7976: 7964:(39): 720–722. 7953: 7947: 7943: 7933: 7931: 7918: 7917: 7913: 7903: 7901: 7890: 7879: 7848: 7844: 7834: 7832: 7808: 7801: 7797: 7787: 7785: 7781: 7775: 7764: 7756: 7749: 7739: 7737: 7736:. 23 April 2024 7728: 7727: 7700: 7690: 7688: 7684: 7673: 7669: 7668: 7645: 7635: 7633: 7620: 7619: 7598: 7564: 7558: 7554: 7544: 7542: 7529:Lee JW (1995). 7527: 7520: 7510: 7508: 7495: 7494: 7487: 7477: 7475: 7459: 7458: 7449: 7439: 7437: 7433: 7426: 7422: 7421: 7417: 7407: 7405: 7394: 7390: 7380: 7378: 7365: 7364: 7360: 7350: 7348: 7325: 7321: 7280:(7): e0180608. 7266: 7262: 7252: 7250: 7234: 7233: 7229: 7216: 7214: 7210: 7196: 7190: 7186: 7139: 7132: 7085: 7078: 7068: 7066: 7050: 7049: 7040: 7030: 7028: 7015: 7014: 7007: 6997: 6995: 6979: 6978: 6971: 6961: 6959: 6942: 6938: 6928: 6926: 6911: 6910: 6906: 6896: 6894: 6881: 6880: 6876: 6866: 6864: 6847: 6843: 6833: 6831: 6826: 6825: 6821: 6811: 6809: 6792: 6788: 6778: 6776: 6768:BBC News Online 6759: 6755: 6745: 6743: 6728: 6724: 6714: 6712: 6705:BBC News Online 6699: 6698: 6694: 6684: 6682: 6665: 6661: 6624: 6620: 6610: 6608: 6591: 6587: 6542: 6529: 6484: 6477: 6432: 6428: 6383: 6379: 6348:(6): 978a–978. 6334: 6325: 6315: 6313: 6298: 6289: 6279: 6277: 6273: 6251:(23): 640–646. 6240: 6234: 6230: 6193: 6189: 6142: 6138: 6128: 6126: 6110: 6109: 6105: 6095: 6093: 6082:"Poliomyelitis" 6080: 6079: 6075: 6065: 6063: 6054: 6053: 6049: 6039: 6037: 6026: 6007: 5997: 5995: 5991: 5961:(13): 312–318. 5950: 5944: 5933: 5886: 5882: 5872: 5870: 5857: 5856: 5852: 5807: 5803: 5793: 5791: 5781: 5777: 5722: 5718: 5673: 5669: 5659: 5657: 5653: 5622: 5616: 5612: 5602: 5600: 5589: 5585: 5575: 5573: 5572:on 24 June 2018 5560: 5559: 5555: 5510: 5506: 5496: 5494: 5490: 5449: 5443: 5439: 5429: 5427: 5423: 5401:(33): 859–863. 5390: 5384: 5380: 5370: 5368: 5355: 5354: 5347: 5337: 5335: 5325: 5321: 5311: 5309: 5308:. 12 April 2024 5300: 5299: 5295: 5264: 5257: 5210: 5206: 5196: 5194: 5186: 5185: 5168: 5158: 5156: 5152: 5133: 5127: 5123: 5113: 5111: 5098: 5097: 5093: 5083: 5081: 5077: 5071: 5048: 5040: 5036: 5026: 5024: 5020: 4997: 4991: 4987: 4977: 4975: 4971: 4948: 4944: 4943: 4939: 4900: 4896: 4851: 4844: 4834: 4832: 4819: 4818: 4814: 4804: 4802: 4793: 4792: 4788: 4757:(19): 441–446. 4743: 4736: 4726: 4724: 4715: 4714: 4707: 4697: 4695: 4680: 4671: 4661: 4659: 4652:BBC News Online 4644: 4640: 4630: 4628: 4615: 4614: 4610: 4600: 4598: 4597:on 8 March 2016 4585: 4584: 4580: 4575: 4523: 4521: 4509: 4506: 4487: 4475: 4474: 4450: 4445: 4427: 4422: 4404: 4399: 4381: 4376: 4358: 4353: 4335: 4330: 4312: 4307: 4289: 4284: 4266: 4261: 4243: 4238: 4220: 4215: 4197: 4192: 4174: 4169: 4151: 4150: 4147: 4142: 4138: 4122: 4117: 4099: 4094: 4076: 4071: 4053: 4048: 4028: 4023: 4021: 4019: 4014: 4005: 3987: 3954: 3953: 3929: 3924: 3906: 3901: 3883: 3878: 3860: 3855: 3837: 3832: 3814: 3809: 3791: 3786: 3768: 3763: 3745: 3740: 3722: 3717: 3699: 3698: 3695: 3690: 3686: 3670: 3665: 3647: 3642: 3624: 3619: 3601: 3596: 3578: 3573: 3555: 3550: 3532: 3527: 3509: 3504: 3486: 3481: 3463: 3458: 3440: 3435: 3417: 3416: 3413: 3408: 3404: 3388: 3383: 3365: 3360: 3340: 3335: 3333: 3331: 3326: 3317: 3299: 3274: 3273: 3249: 3244: 3226: 3221: 3203: 3198: 3180: 3175: 3157: 3152: 3134: 3129: 3111: 3106: 3088: 3083: 3065: 3060: 3042: 3037: 3019: 3014: 2996: 2991: 2973: 2968: 2950: 2945: 2927: 2922: 2904: 2899: 2881: 2876: 2858: 2853: 2835: 2830: 2812: 2807: 2789: 2784: 2766: 2761: 2743: 2742: 2739: 2734: 2730: 2722:Dem. Rep. Congo 2714: 2709: 2691: 2690: 2687: 2686: 2683: 2679: 2678: 2676: 2672: 2670: 2667: 2666: 2653: 2648: 2628: 2623: 2621: 2619: 2614: 2605: 2587: 2566: 2559: 2558: 2534: 2529: 2511: 2506: 2488: 2483: 2465: 2460: 2442: 2437: 2419: 2414: 2396: 2391: 2373: 2368: 2350: 2345: 2327: 2322: 2304: 2299: 2281: 2276: 2258: 2253: 2235: 2230: 2212: 2207: 2189: 2184: 2166: 2161: 2143: 2138: 2128:Dem. Rep. Congo 2120: 2115: 2097: 2096: 2093: 2088: 2070: 2065: 2047: 2046: 2043: 2038: 2020: 2015: 1997: 1996: 1993: 1988: 1968: 1963: 1961: 1959: 1954: 1945: 1927: 1805: 1728: 1686: 1642: 1633: 1552:42, Angola 29, 1487: 1470: 1412: 1408: 1406: 1402: 1400: 1396: 1394: 1390: 1370: 1339: 1334: 1328: 1324: 1322: 1318: 1316: 1312: 1310: 1306: 1304: 1300: 1298: 1294: 1290: 1286: 1284: 1280: 1278: 1274: 1272: 1268: 1266: 1262: 1260: 1256: 1254: 1250: 1234: 1198: 1141:, August 1991. 1130: 1117:, and the U.S. 1103: 1076:Ciro de Quadros 1043: 698: 689: 685: 681: 593: 591:Antivaccination 587: 540: 516: 499: 491:clinical trials 485: 481: 477: 472: 468: 467: 466: 465: 464: 461: 452: 451: 450: 448: 445: 434: 393: 380:fractional-dose 359: 355: 350: 332: 309: 243: 186: 162: 158: 154: 141:immunodeficient 35: 28: 23: 22: 15: 12: 11: 5: 13963: 13953: 13952: 13947: 13942: 13937: 13932: 13915: 13914: 13912: 13911: 13905: 13899: 13889: 13883: 13882:(1981–present) 13877: 13871: 13865: 13859: 13853: 13847: 13841: 13835: 13829: 13823: 13817: 13811: 13805: 13799: 13793: 13787: 13781: 13775: 13768: 13766: 13760: 13759: 13756: 13755: 13752: 13751: 13749: 13748: 13747: 13746: 13735: 13734:(2023–present) 13729: 13726:Jamaica dengue 13723: 13717: 13711: 13705: 13699: 13693: 13687: 13681: 13675: 13669: 13663: 13657: 13651: 13645: 13639: 13631: 13625: 13622:Yemeni cholera 13619: 13613: 13607: 13601: 13595: 13589: 13583: 13577: 13573:DR Congo Ebola 13569: 13563: 13557: 13551: 13545: 13539: 13533: 13527: 13521: 13515: 13509: 13503: 13497: 13491: 13485: 13479: 13473: 13467: 13461: 13455: 13449: 13442: 13440: 13436: 13435: 13433: 13432: 13424: 13418: 13412: 13406: 13400: 13394: 13388: 13382: 13376: 13370: 13363: 13361: 13357: 13356: 13354: 13353: 13347: 13341: 13335: 13329: 13323: 13317: 13311: 13305: 13299: 13293: 13287: 13281: 13278:Maltese plague 13275: 13272:Ottoman plague 13268: 13266: 13259: 13253: 13252: 13249: 13248: 13246: 13245: 13239: 13233: 13230:Persian Plague 13227: 13224:Russian plague 13221: 13215: 13209: 13203: 13196: 13194: 13190: 13189: 13187: 13186: 13180: 13176:Maltese plague 13172: 13166: 13160: 13157:Maltese plague 13154: 13148: 13142: 13136: 13133:Italian plague 13130: 13127:Maltese plague 13124: 13117: 13115: 13111: 13110: 13108: 13107: 13105: 13099: 13096:Maltese plague 13093: 13087: 13081: 13075: 13069: 13062: 13060: 13053: 13045: 13044: 13042: 13041: 13035: 13029: 13023: 13017: 13011: 13005: 12999: 12992: 12990: 12982: 12981: 12979: 12978: 12972: 12966: 12960: 12950:Hittite plague 12946: 12944: 12935: 12931: 12930: 12928: 12927: 12921: 12918: 12917: 12902: 12901: 12894: 12887: 12879: 12870: 12869: 12867: 12866: 12861: 12856: 12851: 12850: 12849: 12844: 12834: 12829: 12824: 12818: 12816: 12815:Related topics 12812: 12811: 12808: 12807: 12805: 12804: 12803: 12802: 12799:The Final Inch 12795: 12783: 12782: 12781: 12776: 12768: 12767: 12766: 12761: 12750: 12748: 12744: 12743: 12741: 12740: 12735: 12730: 12725: 12719: 12717: 12710: 12704: 12703: 12700: 12699: 12697: 12696: 12691: 12685: 12683: 12679: 12678: 12676: 12675: 12664: 12662: 12655: 12652:Eradication of 12649: 12648: 12645: 12644: 12642: 12641: 12636: 12631: 12626: 12624:Onchocerciasis 12621: 12616: 12611: 12610: 12609: 12604: 12594: 12589: 12583: 12581: 12575: 12574: 12572: 12571: 12561: 12551: 12541: 12534:Dracunculiasis 12530: 12528: 12522: 12521: 12519: 12518: 12507: 12505: 12498: 12497:human diseases 12495:Eradication of 12492: 12491: 12484: 12483: 12476: 12469: 12461: 12455: 12454: 12440: 12439:External links 12437: 12435: 12434: 12388: 12386: 12383: 12380: 12379: 12353: 12328: 12309: 12295: 12277: 12255: 12235: 12221: 12195: 12169: 12138: 12109: 12078: 12052: 12022: 11994: 11980: 11959: 11937: 11915: 11892: 11869: 11846: 11832: 11780: 11754: 11732: 11718: 11701: 11678: 11664: 11619: 11590: 11559: 11529: 11511: 11484: 11451: 11399: 11340: 11307: 11281: 11250: 11219: 11189: 11159: 11132: 11101: 11070: 11037: 11001: 10968: 10935: 10896: 10849: 10813: 10764: 10731: 10706: 10676: 10623: 10597: 10545: 10496: 10479: 10430: 10395: 10365: 10326: 10293: 10263: 10232: 10203:(9): 225–230. 10178: 10145: 10096: 10085:on 25 May 2017 10069: 10039: 9986: 9957:(8): 253–256. 9934: 9895: 9846: 9779: 9749: 9713: 9680: 9649: 9613: 9583: 9552: 9541:on 15 May 2016 9519: 9489: 9453: 9417: 9387: 9354: 9318: 9282: 9251: 9220: 9188: 9152: 9119: 9089: 9053: 9021: 8990: 8957: 8930: 8882: 8854: 8793: 8749: 8695: 8645: 8634:on 18 May 2013 8609: 8578: 8545: 8513: 8464: 8431: 8401: 8390:on 11 May 2007 8368: 8316: 8286: 8235: 8202: 8191:on 16 May 2010 8172: 8146: 8120: 8101:(1): 110–111. 8082: 8052: 8022: 7990: 7941: 7911: 7877: 7842: 7795: 7773: 7747: 7698: 7643: 7596: 7575:(4): 268–273. 7552: 7518: 7485: 7447: 7415: 7388: 7358: 7319: 7260: 7227: 7184: 7130: 7076: 7038: 7005: 6969: 6936: 6904: 6874: 6841: 6819: 6786: 6753: 6722: 6692: 6659: 6638:(2): 153–155. 6618: 6585: 6527: 6475: 6426: 6377: 6323: 6287: 6228: 6187: 6156:(9): 801–803. 6136: 6103: 6073: 6062:on 6 July 2010 6047: 6036:on 8 June 2006 6005: 5931: 5880: 5850: 5801: 5775: 5716: 5667: 5633:(2): 265–302. 5610: 5583: 5553: 5504: 5437: 5378: 5345: 5319: 5293: 5274:(6): 672–692. 5255: 5204: 5166: 5121: 5091: 5069: 5034: 4985: 4937: 4894: 4865:(9): 683–688. 4842: 4812: 4786: 4734: 4705: 4669: 4638: 4608: 4577: 4576: 4574: 4571: 4570: 4569: 4564: 4559: 4554: 4549: 4544: 4540:The Final Inch 4536: 4531: 4519: 4505: 4502: 4486: 4483: 4471: 4470: 4468: 4466: 4463: 4460: 4454: 4453: 4448: 4443: 4440: 4437: 4431: 4430: 4425: 4420: 4417: 4414: 4408: 4407: 4402: 4397: 4394: 4391: 4385: 4384: 4379: 4374: 4371: 4368: 4362: 4361: 4356: 4351: 4348: 4345: 4339: 4338: 4333: 4328: 4325: 4322: 4316: 4315: 4310: 4305: 4302: 4299: 4293: 4292: 4287: 4282: 4279: 4276: 4270: 4269: 4264: 4259: 4256: 4253: 4247: 4246: 4241: 4236: 4233: 4230: 4224: 4223: 4218: 4213: 4210: 4207: 4201: 4200: 4195: 4190: 4187: 4184: 4178: 4177: 4172: 4167: 4164: 4161: 4155: 4154: 4145: 4140: 4135: 4132: 4126: 4125: 4120: 4115: 4112: 4109: 4103: 4102: 4097: 4092: 4089: 4086: 4080: 4079: 4074: 4069: 4066: 4063: 4057: 4056: 4051: 4046: 4043: 4040: 4034: 4033: 4030: 4025: 4016: 4011: 4007: 4006: 3994: 3989: 3988: 3986: 3983: 3950: 3949: 3947: 3945: 3942: 3939: 3933: 3932: 3927: 3922: 3919: 3916: 3910: 3909: 3904: 3899: 3896: 3893: 3887: 3886: 3881: 3876: 3873: 3870: 3864: 3863: 3858: 3853: 3850: 3847: 3841: 3840: 3835: 3830: 3827: 3824: 3818: 3817: 3812: 3807: 3804: 3801: 3795: 3794: 3789: 3784: 3781: 3778: 3772: 3771: 3766: 3761: 3758: 3755: 3749: 3748: 3743: 3738: 3735: 3732: 3726: 3725: 3720: 3715: 3712: 3709: 3703: 3702: 3693: 3688: 3683: 3680: 3674: 3673: 3668: 3663: 3660: 3657: 3651: 3650: 3645: 3640: 3637: 3634: 3628: 3627: 3622: 3617: 3614: 3611: 3605: 3604: 3599: 3594: 3591: 3588: 3582: 3581: 3576: 3571: 3568: 3565: 3559: 3558: 3553: 3548: 3545: 3542: 3536: 3535: 3530: 3525: 3522: 3519: 3513: 3512: 3507: 3502: 3499: 3496: 3490: 3489: 3484: 3479: 3476: 3473: 3467: 3466: 3461: 3456: 3453: 3450: 3444: 3443: 3438: 3433: 3430: 3427: 3421: 3420: 3411: 3406: 3401: 3398: 3392: 3391: 3386: 3381: 3378: 3375: 3369: 3368: 3363: 3358: 3355: 3352: 3346: 3345: 3342: 3337: 3328: 3323: 3319: 3318: 3306: 3301: 3300: 3298: 3295: 3270: 3269: 3267: 3265: 3262: 3259: 3253: 3252: 3247: 3242: 3239: 3236: 3230: 3229: 3224: 3219: 3216: 3213: 3207: 3206: 3201: 3196: 3193: 3190: 3184: 3183: 3178: 3173: 3170: 3167: 3161: 3160: 3155: 3150: 3147: 3144: 3138: 3137: 3132: 3127: 3124: 3121: 3115: 3114: 3109: 3104: 3101: 3098: 3092: 3091: 3086: 3081: 3078: 3075: 3069: 3068: 3063: 3058: 3055: 3052: 3046: 3045: 3040: 3035: 3032: 3029: 3023: 3022: 3017: 3012: 3009: 3006: 3000: 2999: 2994: 2989: 2986: 2983: 2977: 2976: 2971: 2966: 2963: 2960: 2954: 2953: 2948: 2943: 2940: 2937: 2931: 2930: 2925: 2920: 2917: 2914: 2908: 2907: 2902: 2897: 2894: 2891: 2885: 2884: 2879: 2874: 2871: 2868: 2862: 2861: 2856: 2851: 2848: 2845: 2839: 2838: 2833: 2828: 2825: 2822: 2816: 2815: 2810: 2805: 2802: 2799: 2793: 2792: 2787: 2782: 2779: 2776: 2770: 2769: 2764: 2759: 2756: 2753: 2747: 2746: 2737: 2732: 2727: 2724: 2718: 2717: 2712: 2707: 2704: 2701: 2695: 2694: 2681: 2674: 2668: 2663: 2657: 2656: 2651: 2646: 2643: 2640: 2634: 2633: 2630: 2625: 2616: 2611: 2607: 2606: 2594: 2589: 2588: 2586: 2583: 2555: 2554: 2552: 2550: 2547: 2544: 2538: 2537: 2532: 2527: 2524: 2521: 2515: 2514: 2509: 2504: 2501: 2498: 2492: 2491: 2486: 2481: 2478: 2475: 2469: 2468: 2463: 2458: 2455: 2452: 2446: 2445: 2440: 2435: 2432: 2429: 2423: 2422: 2417: 2412: 2409: 2406: 2400: 2399: 2394: 2389: 2386: 2383: 2377: 2376: 2371: 2366: 2363: 2360: 2354: 2353: 2348: 2343: 2340: 2337: 2331: 2330: 2325: 2320: 2317: 2314: 2308: 2307: 2302: 2297: 2294: 2291: 2285: 2284: 2279: 2274: 2271: 2268: 2262: 2261: 2256: 2251: 2248: 2245: 2239: 2238: 2233: 2228: 2225: 2222: 2216: 2215: 2210: 2205: 2202: 2199: 2193: 2192: 2187: 2182: 2179: 2176: 2170: 2169: 2164: 2159: 2156: 2153: 2147: 2146: 2141: 2136: 2133: 2130: 2124: 2123: 2118: 2113: 2110: 2107: 2101: 2100: 2091: 2086: 2083: 2080: 2074: 2073: 2068: 2063: 2060: 2057: 2051: 2050: 2041: 2036: 2033: 2030: 2024: 2023: 2018: 2013: 2010: 2007: 2001: 2000: 1991: 1986: 1983: 1980: 1974: 1973: 1970: 1965: 1956: 1951: 1947: 1946: 1934: 1929: 1928: 1926: 1923: 1804: 1801: 1700:Horn of Africa 1692:Central Africa 1641: 1638: 1592:with 8 cases, 1548:64, Sudan 45, 1515:Umaru Yar'Adua 1511:Turai Yar'Adua 1486: 1483: 1407: 1401: 1395: 1389: 1331: 1330: 1323: 1317: 1311: 1305: 1299: 1293: 1291: 1289: 2.1–2.55 1285: 1283: 1.65–2.1 1279: 1277: 1.2–1.65 1273: 1271: 0.75–1.2 1267: 1265: 0.3–0.75 1261: 1255: 1249: 1244: 1233: 1230: 1102: 1099: 1093:, in the book 1059:Czechoslovakia 1042: 1039: 1036: 1035: 1032: 1029: 1025: 1024: 1021: 1018: 1014: 1013: 1010: 1007: 1003: 1002: 999: 996: 990: 989: 986: 983: 979: 978: 975: 972: 968: 967: 964: 961: 957: 956: 953: 950: 946: 945: 942: 939: 933: 932: 929: 926: 922: 921: 918: 915: 911: 910: 907: 904: 900: 899: 896: 893: 889: 888: 885: 882: 876: 875: 871: 870: 867: 864: 858: 857: 853: 852: 849: 846: 840: 839: 835: 834: 831: 828: 822: 821: 817: 816: 813: 810: 806: 805: 801: 800: 797: 794: 788: 787: 783: 782: 779: 776: 772: 771: 767: 766: 763: 760: 754: 753: 749: 748: 745: 742: 736: 735: 731: 730: 727: 724: 718: 717: 714: 711: 707: 706: 697: 694: 680: 677: 586: 583: 545:seroconversion 515: 512: 498: 495: 462: 455: 454: 453: 446: 439: 438: 437: 436: 435: 433: 430: 392: 389: 308: 305: 304: 303: 300: 296: 268: 265: 242: 239: 215: 214: 211: 204: 193: 185: 182: 108:in ruminants. 104:in humans and 26: 9: 6: 4: 3: 2: 13962: 13951: 13948: 13946: 13943: 13941: 13938: 13936: 13933: 13931: 13928: 13927: 13925: 13909: 13906: 13903: 13900: 13894:(2019–present 13893: 13890: 13887: 13884: 13881: 13878: 13875: 13872: 13869: 13868:Hong Kong flu 13866: 13863: 13860: 13857: 13854: 13851: 13848: 13845: 13842: 13839: 13836: 13833: 13830: 13827: 13824: 13821: 13818: 13815: 13812: 13809: 13806: 13803: 13800: 13797: 13794: 13791: 13788: 13785: 13782: 13779: 13776: 13773: 13770: 13769: 13767: 13765: 13761: 13744: 13741: 13740: 13739: 13736: 13733: 13730: 13727: 13724: 13721: 13718: 13715: 13712: 13709: 13706: 13703: 13700: 13697: 13696:Tonga measles 13694: 13691: 13688: 13685: 13682: 13679: 13676: 13673: 13670: 13667: 13666:Samoa measles 13664: 13661: 13658: 13655: 13652: 13649: 13646: 13643: 13640: 13636: 13632: 13629: 13626: 13623: 13620: 13617: 13614: 13611: 13608: 13605: 13602: 13599: 13596: 13593: 13590: 13587: 13584: 13581: 13578: 13574: 13570: 13567: 13564: 13561: 13558: 13555: 13552: 13549: 13546: 13543: 13540: 13537: 13534: 13531: 13528: 13525: 13524:Haiti cholera 13522: 13519: 13516: 13513: 13510: 13507: 13504: 13501: 13498: 13495: 13492: 13489: 13488:Iraqi cholera 13486: 13483: 13480: 13477: 13474: 13471: 13470:Indian dengue 13468: 13465: 13462: 13459: 13456: 13453: 13450: 13447: 13444: 13443: 13441: 13437: 13429: 13425: 13422: 13419: 13416: 13413: 13410: 13407: 13404: 13401: 13398: 13395: 13392: 13389: 13386: 13383: 13380: 13377: 13374: 13371: 13368: 13365: 13364: 13362: 13358: 13351: 13348: 13345: 13342: 13339: 13336: 13333: 13330: 13327: 13326:Guam smallpox 13324: 13321: 13318: 13315: 13312: 13309: 13306: 13303: 13300: 13297: 13294: 13291: 13288: 13285: 13282: 13279: 13276: 13273: 13270: 13269: 13267: 13263: 13260: 13258: 13254: 13243: 13240: 13237: 13234: 13231: 13228: 13225: 13222: 13219: 13216: 13213: 13210: 13207: 13204: 13201: 13198: 13197: 13195: 13191: 13184: 13181: 13177: 13173: 13170: 13167: 13164: 13163:Naples Plague 13161: 13158: 13155: 13152: 13149: 13146: 13143: 13140: 13137: 13134: 13131: 13128: 13125: 13122: 13121:London plague 13119: 13118: 13116: 13112: 13106: 13103: 13102:London plague 13100: 13097: 13094: 13091: 13090:London plague 13088: 13085: 13082: 13079: 13076: 13073: 13070: 13067: 13064: 13063: 13061: 13057: 13054: 13052: 13046: 13039: 13036: 13033: 13030: 13027: 13024: 13021: 13020:Plague of 664 13018: 13015: 13012: 13009: 13006: 13003: 13000: 12997: 12994: 12993: 12991: 12989: 12983: 12976: 12973: 12970: 12967: 12964: 12961: 12951: 12948: 12947: 12945: 12943: 12939: 12936: 12932: 12926: 12923: 12922: 12919: 12915: 12911: 12907: 12900: 12895: 12893: 12888: 12886: 12881: 12880: 12877: 12865: 12862: 12860: 12857: 12855: 12852: 12848: 12845: 12843: 12840: 12839: 12838: 12835: 12833: 12830: 12828: 12825: 12823: 12820: 12819: 12817: 12813: 12801: 12800: 12796: 12794: 12793: 12789: 12788: 12787: 12784: 12780: 12777: 12775: 12772: 12771: 12769: 12765: 12762: 12760: 12757: 12756: 12755: 12754:United States 12752: 12751: 12749: 12745: 12739: 12736: 12734: 12731: 12729: 12726: 12724: 12721: 12720: 12718: 12714: 12711: 12705: 12695: 12692: 12690: 12687: 12686: 12684: 12680: 12673: 12669: 12666: 12665: 12663: 12659: 12656: 12650: 12640: 12637: 12635: 12632: 12630: 12627: 12625: 12622: 12620: 12617: 12615: 12612: 12608: 12605: 12603: 12600: 12599: 12598: 12595: 12593: 12590: 12588: 12585: 12584: 12582: 12576: 12569: 12565: 12562: 12559: 12555: 12552: 12549: 12545: 12542: 12539: 12535: 12532: 12531: 12529: 12523: 12516: 12512: 12509: 12508: 12506: 12502: 12499: 12493: 12489: 12482: 12477: 12475: 12470: 12468: 12463: 12462: 12459: 12451: 12447: 12446:"Polio today" 12443: 12442: 12431: 12427: 12422: 12417: 12412: 12407: 12403: 12399: 12395: 12390: 12389: 12372: 12371: 12364: 12362: 12360: 12358: 12338: 12332: 12321: 12320: 12313: 12305: 12299: 12291: 12287: 12281: 12270: 12264: 12262: 12260: 12248: 12242: 12240: 12231: 12225: 12209: 12208:National Post 12205: 12199: 12184: 12180: 12173: 12157: 12153: 12149: 12142: 12126: 12122: 12116: 12114: 12097: 12093: 12089: 12082: 12066: 12062: 12056: 12048: 12044: 12040: 12036: 12032: 12026: 12011: 12006: 11998: 11990: 11984: 11976: 11969: 11963: 11947: 11941: 11925: 11919: 11903: 11896: 11880: 11873: 11857: 11850: 11842: 11836: 11828: 11824: 11819: 11814: 11810: 11806: 11802: 11798: 11794: 11787: 11785: 11768: 11761: 11759: 11742: 11736: 11728: 11722: 11711: 11705: 11689: 11682: 11674: 11668: 11652: 11648: 11642: 11640: 11638: 11636: 11634: 11632: 11630: 11628: 11626: 11624: 11607: 11603: 11597: 11595: 11578: 11574: 11570: 11563: 11547: 11543: 11539: 11533: 11525: 11521: 11515: 11499: 11495: 11488: 11472: 11468: 11467: 11462: 11455: 11447: 11443: 11438: 11433: 11429: 11425: 11421: 11417: 11413: 11406: 11404: 11395: 11391: 11387: 11383: 11378: 11373: 11368: 11363: 11359: 11355: 11351: 11344: 11328: 11324: 11323: 11318: 11311: 11295: 11291: 11285: 11269: 11265: 11261: 11254: 11238: 11234: 11230: 11223: 11207: 11203: 11199: 11193: 11177: 11173: 11169: 11163: 11147: 11143: 11136: 11120: 11116: 11112: 11105: 11089: 11085: 11081: 11074: 11058: 11054: 11053: 11048: 11041: 11022: 11018: 11011: 11005: 10989: 10985: 10984: 10979: 10972: 10956: 10952: 10950: 10945: 10939: 10923: 10919: 10918: 10913: 10909: 10903: 10901: 10884: 10880: 10876: 10872: 10868: 10864: 10860: 10853: 10834: 10831:(WHO). 2019. 10830: 10823: 10817: 10809: 10805: 10800: 10795: 10791: 10787: 10783: 10779: 10775: 10768: 10752: 10748: 10746: 10741: 10735: 10716: 10710: 10694: 10690: 10686: 10680: 10661: 10657: 10650: 10644: 10642: 10640: 10638: 10636: 10634: 10632: 10630: 10628: 10611: 10607: 10601: 10593: 10589: 10584: 10579: 10575: 10571: 10567: 10563: 10559: 10552: 10550: 10541: 10537: 10532: 10527: 10523: 10519: 10515: 10511: 10507: 10500: 10489: 10483: 10475: 10471: 10466: 10461: 10457: 10453: 10449: 10445: 10441: 10434: 10415: 10408: 10402: 10400: 10383: 10379: 10375: 10369: 10350: 10346: 10344: 10336: 10330: 10314: 10310: 10306: 10300: 10298: 10281: 10277: 10273: 10267: 10251: 10247: 10243: 10236: 10228: 10224: 10219: 10214: 10210: 10206: 10202: 10198: 10194: 10187: 10185: 10183: 10166: 10162: 10158: 10152: 10150: 10141: 10137: 10132: 10127: 10123: 10119: 10115: 10111: 10107: 10100: 10084: 10080: 10073: 10057: 10053: 10049: 10043: 10035: 10031: 10026: 10021: 10017: 10013: 10010:(21): 30542. 10009: 10005: 10001: 9997: 9990: 9982: 9978: 9973: 9968: 9964: 9960: 9956: 9952: 9948: 9941: 9939: 9922: 9918: 9914: 9910: 9906: 9899: 9891: 9887: 9882: 9877: 9873: 9869: 9865: 9861: 9857: 9850: 9831: 9827: 9823: 9818: 9813: 9809: 9805: 9801: 9797: 9790: 9783: 9767: 9763: 9759: 9753: 9734: 9730: 9723: 9717: 9701: 9697: 9695: 9690: 9684: 9668: 9664: 9660: 9653: 9634: 9630: 9623: 9617: 9601: 9597: 9593: 9587: 9571: 9567: 9563: 9556: 9540: 9536: 9534: 9529: 9523: 9516: 9503: 9499: 9493: 9474: 9470: 9463: 9457: 9438: 9434: 9427: 9421: 9405: 9401: 9397: 9391: 9375: 9371: 9367: 9361: 9359: 9339: 9335: 9328: 9322: 9303: 9299: 9292: 9286: 9270: 9266: 9262: 9255: 9239: 9235: 9231: 9224: 9208: 9204: 9203: 9198: 9192: 9176: 9172: 9171: 9166: 9162: 9156: 9140: 9136: 9135: 9130: 9123: 9107: 9103: 9099: 9093: 9077: 9073: 9072: 9067: 9063: 9057: 9041: 9037: 9036: 9031: 9025: 9009: 9005: 9001: 8994: 8979: 8978: 8970: 8964: 8962: 8945: 8941: 8934: 8919: 8915: 8911: 8907: 8903: 8899: 8898: 8893: 8886: 8870: 8869: 8864: 8858: 8851: 8840: 8836: 8831: 8826: 8822: 8818: 8814: 8810: 8809: 8804: 8797: 8782: 8778: 8774: 8770: 8766: 8765: 8760: 8753: 8738: 8734: 8729: 8724: 8720: 8716: 8712: 8711: 8706: 8699: 8680: 8676: 8674: 8666: 8660: 8658: 8656: 8654: 8652: 8650: 8630: 8626: 8619: 8613: 8597: 8593: 8589: 8582: 8566: 8562: 8560: 8555: 8549: 8533: 8529: 8528: 8523: 8517: 8498: 8494: 8490: 8486: 8482: 8475: 8468: 8452: 8448: 8447: 8442: 8435: 8419: 8415: 8408: 8406: 8386: 8382: 8378: 8372: 8353: 8349: 8347: 8339: 8333: 8331: 8329: 8327: 8325: 8323: 8321: 8304: 8300: 8296: 8290: 8282: 8278: 8273: 8268: 8263: 8258: 8254: 8250: 8249:PLOS Medicine 8246: 8239: 8223: 8219: 8217: 8212: 8206: 8190: 8186: 8182: 8176: 8160: 8156: 8150: 8134: 8130: 8124: 8116: 8112: 8108: 8104: 8100: 8096: 8089: 8087: 8070: 8066: 8062: 8056: 8040: 8036: 8032: 8026: 8007: 8000: 7994: 7975: 7971: 7967: 7963: 7959: 7952: 7945: 7929: 7925: 7921: 7915: 7899: 7895: 7888: 7886: 7884: 7882: 7873: 7869: 7865: 7861: 7857: 7853: 7846: 7830: 7826: 7822: 7819:(3): 99–108. 7818: 7814: 7806: 7799: 7780: 7776: 7770: 7763: 7762: 7754: 7752: 7735: 7731: 7725: 7723: 7721: 7719: 7717: 7715: 7713: 7711: 7709: 7707: 7705: 7703: 7683: 7679: 7672: 7666: 7664: 7662: 7660: 7658: 7656: 7654: 7652: 7650: 7648: 7631: 7627: 7623: 7617: 7615: 7613: 7611: 7609: 7607: 7605: 7603: 7601: 7592: 7588: 7583: 7578: 7574: 7570: 7563: 7556: 7540: 7536: 7532: 7525: 7523: 7506: 7502: 7498: 7492: 7490: 7473: 7469: 7467: 7462: 7456: 7454: 7452: 7432: 7425: 7419: 7403: 7399: 7392: 7376: 7372: 7368: 7362: 7346: 7342: 7338: 7334: 7330: 7323: 7315: 7311: 7306: 7301: 7296: 7291: 7287: 7283: 7279: 7275: 7271: 7264: 7248: 7244: 7242: 7237: 7231: 7224: 7209: 7205: 7203: 7195: 7188: 7180: 7176: 7171: 7166: 7161: 7156: 7152: 7148: 7144: 7137: 7135: 7126: 7122: 7117: 7112: 7107: 7102: 7098: 7094: 7090: 7083: 7081: 7064: 7060: 7058: 7053: 7047: 7045: 7043: 7026: 7022: 7018: 7012: 7010: 6993: 6989: 6987: 6982: 6976: 6974: 6957: 6953: 6952: 6947: 6940: 6924: 6920: 6919: 6914: 6908: 6892: 6888: 6884: 6878: 6862: 6858: 6857: 6852: 6845: 6829: 6823: 6807: 6803: 6802: 6797: 6790: 6774: 6770: 6769: 6764: 6757: 6741: 6737: 6733: 6726: 6710: 6706: 6702: 6696: 6680: 6676: 6675: 6670: 6663: 6655: 6651: 6646: 6641: 6637: 6633: 6629: 6622: 6606: 6602: 6601: 6596: 6589: 6581: 6577: 6572: 6567: 6563: 6559: 6555: 6551: 6547: 6540: 6538: 6536: 6534: 6532: 6523: 6519: 6514: 6509: 6505: 6501: 6497: 6493: 6489: 6482: 6480: 6471: 6467: 6462: 6457: 6453: 6449: 6445: 6441: 6437: 6430: 6422: 6418: 6413: 6408: 6404: 6400: 6396: 6392: 6388: 6381: 6373: 6369: 6364: 6359: 6355: 6351: 6347: 6343: 6339: 6332: 6330: 6328: 6311: 6307: 6303: 6296: 6294: 6292: 6272: 6268: 6264: 6259: 6254: 6250: 6246: 6239: 6232: 6224: 6220: 6215: 6210: 6206: 6202: 6198: 6191: 6183: 6179: 6174: 6169: 6164: 6159: 6155: 6151: 6147: 6140: 6124: 6120: 6118: 6113: 6107: 6091: 6087: 6083: 6077: 6061: 6057: 6051: 6035: 6031: 6024: 6022: 6020: 6018: 6016: 6014: 6012: 6010: 5990: 5986: 5982: 5977: 5972: 5968: 5964: 5960: 5956: 5949: 5942: 5940: 5938: 5936: 5927: 5923: 5918: 5913: 5908: 5903: 5899: 5895: 5891: 5884: 5868: 5864: 5860: 5854: 5846: 5842: 5837: 5832: 5828: 5824: 5820: 5816: 5812: 5805: 5790: 5786: 5779: 5771: 5767: 5762: 5757: 5753: 5749: 5744: 5739: 5735: 5731: 5727: 5720: 5712: 5708: 5703: 5698: 5694: 5690: 5686: 5682: 5678: 5671: 5652: 5648: 5644: 5640: 5636: 5632: 5628: 5621: 5614: 5598: 5594: 5587: 5571: 5567: 5563: 5557: 5549: 5545: 5540: 5535: 5531: 5527: 5523: 5519: 5515: 5508: 5489: 5485: 5481: 5476: 5471: 5467: 5463: 5459: 5455: 5448: 5441: 5422: 5418: 5414: 5409: 5404: 5400: 5396: 5389: 5382: 5366: 5362: 5358: 5352: 5350: 5334: 5330: 5323: 5307: 5303: 5297: 5289: 5285: 5281: 5277: 5273: 5269: 5262: 5260: 5251: 5247: 5242: 5237: 5232: 5227: 5223: 5219: 5215: 5208: 5193: 5189: 5183: 5181: 5179: 5177: 5175: 5173: 5171: 5151: 5147: 5143: 5139: 5132: 5125: 5109: 5105: 5101: 5095: 5076: 5072: 5066: 5062: 5058: 5054: 5047: 5046: 5038: 5019: 5015: 5011: 5007: 5003: 4996: 4989: 4970: 4966: 4962: 4958: 4954: 4947: 4941: 4933: 4929: 4925: 4921: 4917: 4913: 4909: 4905: 4898: 4890: 4886: 4881: 4876: 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4173: 4168: 4165: 4162: 4160: 4157: 4156: 4146: 4141: 4136: 4133: 4131: 4128: 4127: 4121: 4116: 4113: 4110: 4108: 4105: 4104: 4098: 4093: 4090: 4087: 4085: 4082: 4081: 4075: 4070: 4067: 4064: 4062: 4059: 4058: 4052: 4047: 4044: 4041: 4039: 4036: 4035: 4031: 4026: 4017: 4012: 4009: 4008: 4001: 3997: 3992: 3982: 3980: 3975: 3970: 3964: 3962: 3957: 3948: 3946: 3943: 3940: 3938: 3935: 3934: 3928: 3923: 3920: 3917: 3915: 3912: 3911: 3905: 3900: 3897: 3894: 3892: 3889: 3888: 3882: 3877: 3874: 3871: 3869: 3866: 3865: 3859: 3854: 3851: 3848: 3846: 3843: 3842: 3836: 3831: 3828: 3825: 3823: 3820: 3819: 3813: 3808: 3805: 3802: 3800: 3797: 3796: 3790: 3785: 3782: 3779: 3777: 3774: 3773: 3767: 3762: 3759: 3756: 3754: 3751: 3750: 3744: 3739: 3736: 3733: 3731: 3728: 3727: 3721: 3716: 3713: 3710: 3708: 3705: 3704: 3694: 3689: 3684: 3681: 3679: 3676: 3675: 3669: 3664: 3661: 3658: 3656: 3653: 3652: 3646: 3641: 3638: 3635: 3633: 3630: 3629: 3623: 3618: 3615: 3612: 3610: 3607: 3606: 3600: 3595: 3592: 3589: 3587: 3584: 3583: 3577: 3572: 3569: 3566: 3564: 3561: 3560: 3554: 3549: 3546: 3543: 3541: 3538: 3537: 3531: 3526: 3523: 3520: 3518: 3515: 3514: 3508: 3503: 3500: 3497: 3495: 3492: 3491: 3485: 3480: 3477: 3474: 3472: 3469: 3468: 3462: 3457: 3454: 3451: 3449: 3446: 3445: 3439: 3434: 3431: 3428: 3426: 3423: 3422: 3412: 3407: 3402: 3399: 3397: 3394: 3393: 3387: 3382: 3379: 3376: 3374: 3371: 3370: 3364: 3359: 3356: 3353: 3351: 3348: 3347: 3343: 3338: 3329: 3324: 3321: 3320: 3313: 3309: 3304: 3294: 3292: 3286: 3284: 3278: 3268: 3266: 3263: 3260: 3258: 3255: 3254: 3248: 3243: 3240: 3237: 3235: 3234:United States 3232: 3231: 3225: 3220: 3217: 3214: 3212: 3209: 3208: 3202: 3197: 3194: 3191: 3189: 3186: 3185: 3179: 3174: 3171: 3168: 3166: 3163: 3162: 3156: 3151: 3148: 3145: 3143: 3140: 3139: 3133: 3128: 3125: 3122: 3120: 3117: 3116: 3110: 3105: 3102: 3099: 3097: 3094: 3093: 3087: 3082: 3079: 3076: 3074: 3071: 3070: 3064: 3059: 3056: 3053: 3051: 3048: 3047: 3041: 3036: 3033: 3030: 3028: 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2430: 2428: 2425: 2424: 2418: 2413: 2410: 2407: 2405: 2402: 2401: 2395: 2390: 2387: 2384: 2382: 2379: 2378: 2372: 2367: 2364: 2361: 2359: 2358:Guinea-Bissau 2356: 2355: 2349: 2344: 2341: 2338: 2336: 2333: 2332: 2326: 2321: 2318: 2315: 2313: 2310: 2309: 2303: 2298: 2295: 2292: 2290: 2287: 2286: 2280: 2275: 2272: 2269: 2267: 2264: 2263: 2257: 2252: 2249: 2246: 2244: 2241: 2240: 2234: 2229: 2226: 2223: 2221: 2218: 2217: 2211: 2206: 2203: 2200: 2198: 2195: 2194: 2188: 2183: 2180: 2177: 2175: 2172: 2171: 2165: 2160: 2157: 2154: 2152: 2149: 2148: 2142: 2137: 2134: 2131: 2129: 2126: 2125: 2119: 2114: 2111: 2108: 2106: 2103: 2102: 2092: 2087: 2084: 2081: 2079: 2076: 2075: 2069: 2064: 2061: 2058: 2056: 2053: 2052: 2042: 2037: 2034: 2031: 2029: 2026: 2025: 2019: 2014: 2011: 2008: 2006: 2003: 2002: 1992: 1987: 1984: 1981: 1979: 1976: 1975: 1971: 1966: 1957: 1952: 1949: 1948: 1941: 1937: 1932: 1922: 1918: 1914: 1912: 1907: 1900: 1896: 1892: 1888: 1884: 1882: 1878: 1874: 1864: 1860: 1856: 1853: 1851: 1847: 1843: 1837: 1833: 1831: 1825: 1823: 1822:intramuscular 1819: 1809: 1800: 1796: 1792: 1785: 1781: 1779: 1775: 1771: 1767: 1763: 1759: 1755: 1751: 1747: 1743: 1739: 1733: 1725: 1723: 1718: 1717:of Ethiopia. 1716: 1715:Somali Region 1712: 1707: 1705: 1701: 1697: 1693: 1682: 1680: 1676: 1672: 1668: 1664: 1654: 1646: 1637: 1631: 1627: 1623: 1619: 1613: 1611: 1607: 1603: 1599: 1595: 1591: 1587: 1583: 1579: 1575: 1571: 1567: 1563: 1559: 1555: 1554:Côte d'Ivoire 1551: 1547: 1541: 1537: 1535: 1531: 1527: 1522: 1520: 1516: 1512: 1506: 1504: 1500: 1496: 1492: 1482: 1480: 1476: 1466: 1464: 1460: 1456: 1452: 1448: 1444: 1442: 1438: 1434: 1430: 1426: 1421: 1419: 1386: 1382: 1380: 1379:Côte d'Ivoire 1376: 1368: 1363: 1361: 1357: 1356:Uttar Pradesh 1351: 1349: 1346: 1292: 1259: <0.3 1253: no data 1248: 1247: 1242: 1238: 1229: 1227: 1223: 1219: 1215: 1212:, India, and 1211: 1207: 1202: 1195: 1193: 1189: 1185: 1181: 1177: 1176:Mediterranean 1173: 1169: 1165: 1161: 1160:Mediterranean 1157: 1152: 1150: 1145: 1142: 1140: 1136: 1128: 1124: 1120: 1116: 1112: 1108: 1105:In 1988, the 1098: 1096: 1092: 1088: 1083: 1081: 1077: 1073: 1068: 1064: 1060: 1052: 1047: 1033: 1030: 1027: 1026: 1022: 1019: 1016: 1015: 1011: 1008: 1005: 1004: 1000: 997: 995: 992: 991: 987: 984: 981: 980: 976: 973: 970: 969: 965: 962: 959: 958: 954: 951: 948: 947: 943: 940: 938: 935: 934: 930: 927: 924: 923: 919: 916: 913: 912: 908: 905: 902: 901: 897: 894: 891: 890: 886: 883: 881: 878: 877: 872: 868: 865: 863: 860: 859: 854: 850: 847: 845: 842: 841: 836: 832: 829: 827: 824: 823: 818: 814: 811: 808: 807: 802: 798: 795: 793: 790: 789: 784: 780: 777: 774: 773: 768: 764: 761: 759: 756: 755: 750: 746: 743: 741: 738: 737: 732: 728: 725: 723: 720: 719: 715: 712: 709: 708: 705: 701: 693: 676: 672: 670: 666: 662: 658: 654: 650: 645: 643: 639: 635: 634: 628: 625: 624: 619: 614: 610: 606: 602: 597: 592: 582: 580: 579: 573: 571: 565: 563: 559: 555: 551: 546: 538: 537:Uttar Pradesh 534: 530: 524: 522: 511: 507: 503: 494: 492: 459: 443: 429: 425: 423: 418: 414: 410: 406: 405:herd immunity 397: 391:Herd immunity 388: 384: 381: 377: 373: 369: 364: 346: 343: 338: 330: 326: 322: 321:polio vaccine 313: 301: 297: 294: 290: 286: 285:enteroviruses 282: 278: 274: 269: 266: 263: 262:polio vaccine 259: 258: 257: 255: 251: 248: 238: 236: 233: 229: 225: 221: 212: 209: 205: 202: 198: 194: 191: 190: 189: 181: 179: 175: 171: 166: 152: 148: 144: 142: 138: 134: 130: 126: 122: 118: 117:polio vaccine 114: 109: 107: 103: 99: 95: 91: 87: 83: 79: 75: 71: 70:public health 67: 66:poliomyelitis 63: 59: 53: 49: 41: 37: 33: 32:Polio vaccine 19: 13720:Uganda Ebola 13439:21st century 13421:Surat plague 13391:NYC smallpox 13360:20th century 13265:19th century 13193:18th century 13114:17th century 13080:(1545, 1576) 13059:16th century 13002:Roman Plague 12971:(165–180 AD) 12965:(429–426 BC) 12912:and notable 12837:Transmission 12797: 12790: 12607:epidemiology 12547: 12449: 12401: 12397: 12369: 12344:. 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Peshawar. 6600:The Guardian 6598: 6588: 6553: 6549: 6495: 6491: 6443: 6439: 6429: 6394: 6390: 6380: 6345: 6341: 6314:. Retrieved 6305: 6278:. Retrieved 6248: 6244: 6231: 6204: 6200: 6190: 6153: 6149: 6139: 6129:13 September 6127:. Retrieved 6123:the original 6115: 6106: 6094:. Retrieved 6090:the original 6076: 6064:. Retrieved 6060:the original 6050: 6038:. Retrieved 6034:the original 5996:. Retrieved 5958: 5954: 5897: 5893: 5883: 5871:. Retrieved 5853: 5818: 5814: 5804: 5792:. Retrieved 5788: 5778: 5733: 5729: 5719: 5684: 5680: 5670: 5658:. Retrieved 5630: 5626: 5613: 5601:. Retrieved 5586: 5574:. Retrieved 5570:the original 5556: 5521: 5517: 5507: 5495:. Retrieved 5457: 5453: 5440: 5428:. Retrieved 5398: 5394: 5381: 5369:. Retrieved 5336:. Retrieved 5332: 5322: 5310:. Retrieved 5305: 5296: 5271: 5267: 5221: 5217: 5207: 5195:. Retrieved 5191: 5157:. Retrieved 5146:10665/276245 5124: 5112:. Retrieved 5103: 5094: 5082:. Retrieved 5044: 5037: 5025:. Retrieved 5005: 5001: 4988: 4976:. 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Retrieved 4595:the original 4590: 4581: 4538: 4499: 4495: 4491: 4488: 4480: 4476: 4457: 4027:Transmission 3995: 3965: 3958: 3955: 3936: 3753:Burkina Faso 3339:Transmission 3307: 3287: 3279: 3275: 3256: 2627:Transmission 2595: 2579: 2571: 2563: 2560: 2541: 2404:Burkina Faso 2289:Sierra Leone 2016:reintroduced 1967:Transmission 1935: 1919: 1915: 1908: 1905: 1893: 1889: 1885: 1869: 1857: 1854: 1838: 1834: 1826: 1814: 1797: 1793: 1790: 1734: 1726: 1719: 1708: 1694:(focused in 1683: 1677:prefecture, 1659: 1626:Turkmenistan 1614: 1586:Sierra Leone 1566:Burkina Faso 1542: 1538: 1523: 1519:Birnin Kebbi 1507: 1488: 1467: 1445: 1422: 1415: 1364: 1352: 1338:By 2001, 575 1337: 1327: >10 1321: 7.5–10 1297: 2.55–3 1203: 1196: 1153: 1146: 1143: 1104: 1094: 1084: 1056: 1051:East Germany 993: 936: 879: 861: 843: 825: 791: 757: 739: 721: 703: 682: 673: 669:John Brennan 665:Leon Panetta 646: 631: 629: 621: 598: 594: 577: 574: 566: 525: 517: 508: 504: 500: 497:Surveillance 469: 426: 413:transmission 402: 385: 365: 347: 318: 293:adenoviruses 275:and reduced 254:immunization 250:transmission 244: 216: 208:transmission 187: 167: 145: 137:asymptomatic 110: 57: 56: 36: 13950:Vaccination 13910:(2023–2024) 13904:(2022–2023) 13888:(2009–2010) 13876:(1977–1979) 13870:(1968–1970) 13864:(1961–1975) 13858:(1957–1958) 13852:(1919–1930) 13846:(1918–1920) 13844:Spanish flu 13840:(1899–1923) 13834:(1889–1890) 13832:Russian flu 13828:(1881–1896) 13822:(1863–1879) 13816:(1855–1860) 13810:(1852–1860) 13804:(1829–1851) 13798:(1816–1826) 13792:(1557–1559) 13722:(2022–2023) 13710:(2019–2020) 13704:(2019–2020) 13702:DRC measles 13656:(2018–2020) 13624:(2016–2022) 13612:(2015–2016) 13568:(2013–2016) 13562:(2013–2014) 13560:Chikungunya 13526:(2010–2019) 13520:(2009–2010) 13502:(2008–2017) 13496:(2008–2009) 13460:(2003–2005) 13448:(2002–2004) 13430:(1998–1999) 13411:(1972–1973) 13375:(1910–1911) 13369:(1900–1904) 13334:(1862–1863) 13304:(1847–1848) 13298:(1837–1838) 13280:(1813–1814) 13274:(1812–1819) 13244:(1793–1798) 13238:(1780–1782) 13226:(1770–1772) 13214:(1720–1722) 13208:(1710–1712) 13202:(1707–1708) 13178:(1675–1676) 13171:(1665–1666) 13153:(1647–1652) 13147:(1633–1644) 13135:(1629–1631) 13104:(1592–1593) 13098:(1592–1593) 13092:(1563–1564) 13086:(1557–1559) 13040:(1485–1551) 13034:(1346–1353) 13032:Black Death 12957: 1330 12859:Vaccination 12779:Pulse Polio 12707:Eradication 11773:18 February 11747:18 February 11152:21 November 10994:20 February 10669:29 November 10616:22 November 10423:22 November 9663:Daily Trust 9244:12 November 8775:: 190–194. 8721:: 270–274. 7788:8 September 7400:. Reuters. 6446:(9): E302. 6066:19 February 5224:(8): 1329. 5061:10665/42850 4825:www.who.int 4601:11 February 4205:South Sudan 4038:Afghanistan 4018:Circulating 3776:South Sudan 3609:Ivory Coast 3350:Afghanistan 3330:Circulating 2699:Afghanistan 2618:Circulating 2243:South Sudan 1978:Afghanistan 1958:Circulating 1778:Timor-Leste 1746:North Korea 1630:Brazzaville 1495:Afghanistan 1437:Pulse Polio 1315: 5–7.5 1228:in Africa. 1149:Pulse Polio 661:his killing 653:hepatitis B 620:in issuing 613:colonialism 562:South Sudan 422:vaccination 307:Vaccination 289:echoviruses 277:muscle tone 228:specificity 224:sensitivity 170:Afghanistan 125:inactivated 113:vaccination 76:(WHO), the 13924:Categories 13654:Kivu Ebola 13409:London flu 12842:horizontal 12668:Rinderpest 12661:Successful 12580:(regional) 12504:Successful 11904:. Politico 11885:28 January 11694:19 October 11200:(Report). 11182:2 November 11117:(CIDRAP). 10827:(Report). 10757:27 October 10388:24 January 10319:21 October 9927:19 January 9839:27 October 9706:9 February 9627:(Report). 9606:28 October 9467:(Report). 9431:(Report). 9332:(Report). 9296:(Report). 9213:27 October 9046:27 October 8638:3 February 8571:24 January 8506:27 October 8457:7 February 8424:19 January 8394:21 October 8309:7 February 8255:(3): e73. 8195:2 February 8045:2 February 7983:27 October 7904:2 February 7636:10 January 7545:2 February 7511:24 October 7440:10 October 7408:10 October 7371:IFLScience 7217:10 October 7099:(1): 521. 6998:10 October 6280:27 October 6096:28 October 6040:2 February 5998:27 October 5736:(3): 183. 5430:27 October 5136:(Report). 5114:28 October 5084:26 October 5051:. Geneva: 5027:27 October 4978:27 October 4727:2 November 4662:14 October 4631:9 November 4573:References 4446:cVDPV only 4423:cVDPV only 4412:Mozambique 4400:cVDPV only 4377:cVDPV only 4354:cVDPV only 4331:cVDPV only 4308:cVDPV only 4285:cVDPV only 4262:cVDPV only 4239:cVDPV only 4216:cVDPV only 4193:cVDPV only 4170:cVDPV only 4143:cVDPV only 4118:cVDPV only 4095:cVDPV only 3925:cVDPV only 3902:cVDPV only 3879:cVDPV only 3856:cVDPV only 3845:Mauritania 3833:cVDPV only 3810:cVDPV only 3787:cVDPV only 3764:cVDPV only 3741:cVDPV only 3718:cVDPV only 3691:cVDPV only 3678:Mozambique 3666:cVDPV only 3643:cVDPV only 3620:cVDPV only 3597:cVDPV only 3574:cVDPV only 3551:cVDPV only 3528:cVDPV only 3505:cVDPV only 3494:Madagascar 3482:cVDPV only 3459:cVDPV only 3436:cVDPV only 3409:cVDPV only 3245:cVDPV only 3222:cVDPV only 3199:cVDPV only 3188:Rep. Congo 3176:cVDPV only 3153:cVDPV only 3130:cVDPV only 3107:cVDPV only 3084:cVDPV only 3061:cVDPV only 3038:cVDPV only 3015:cVDPV only 2992:cVDPV only 2969:cVDPV only 2946:cVDPV only 2923:cVDPV only 2900:cVDPV only 2877:cVDPV only 2854:cVDPV only 2831:cVDPV only 2820:Madagascar 2808:cVDPV only 2785:cVDPV only 2762:cVDPV only 2735:cVDPV only 2661:Mozambique 2530:cVDPV only 2507:cVDPV only 2484:cVDPV only 2461:cVDPV only 2450:Rep. Congo 2438:cVDPV only 2427:Mozambique 2415:cVDPV only 2392:cVDPV only 2369:cVDPV only 2346:cVDPV only 2323:cVDPV only 2300:cVDPV only 2277:cVDPV only 2254:cVDPV only 2231:cVDPV only 2208:cVDPV only 2197:Madagascar 2185:cVDPV only 2162:cVDPV only 2139:cVDPV only 2116:cVDPV only 2105:Tajikistan 2089:cVDPV only 2066:cVDPV only 1830:Boko Haram 1824:delivery. 1738:Bangladesh 1622:Kazakhstan 1618:Tajikistan 1578:Mauritania 1499:Bangladesh 1345:Copenhagen 1210:Bangladesh 1041:1950s–1987 589:See also: 550:cold chain 409:poliovirus 329:attenuated 232:vertebrate 201:poliovirus 197:extinction 165:1 (WPV1). 106:rinderpest 88:(CDC) and 62:poliovirus 52:Poliovirus 13886:Swine flu 13856:Asian flu 13774:(541–767) 13743:Argentina 13028:(735–737) 13022:(664–689) 13016:(638–639) 13010:(627–628) 12998:(541–542) 12988:classical 12977:(250–266) 12910:epidemics 12906:Pandemics 12346:9 January 12188:21 August 11769:. 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