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Additional info for Poliomyelitis Eradication: Field Guide (Scientific and Technical Publication)

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8th ed. Washington, DC: Public Health Foundation; 2005:89–100. Cherry JD. Enteroviruses and parechoviruses. In: Feigin RD, Cherry J, Demmler GJ, Kaplan S, eds. Textbook of Pediatric Infectious Diseases. 5th ed. Philadelphia: W. B. Saunders Company; 2004:1984–2041. de Quadros CA, Andrus JA, Olivé J-M, et al. Eradication of poliomyelitis: progress in the Americas. Pediatr Infect Dis J 1991;10:222–229. de Quadros CA, Andrus JA, Olivé J-M, Macedo CG de, Henderson DA. Polio eradication from the Western Hemisphere.

Genetic sequencing revealed that the virus associated with this outbreak was atypical: it was derived from the oral polio vaccine (OPV), but it diverged genetically by 3% from the parent vaccine strain of the OPV. 5% from the parent strain. In other words, the strain had recovered the neurovirulence and transmissibility of wild poliovirus type 1. In contrast, wild polioviruses normally have < 82% genetic similarity to OPV (1). The differences found in the nucleotide sequences of the strains responsible for the outbreak indicate that the virus had been circulating in an area of low vaccination coverage for about two years, during which time the virus had accumulated genetic changes that restored the essential properties of wild poliovirus (2).

Information should also be included about the current epidemiological status of polio and other EPI target diseases. Polio update bulletins should be distributed on a weekly or monthly basis to all health care workers, other health service providers, and members of the community at large. 6 Surveillance Indicators for Acute Flaccid Paralysis The following indicators should be evaluated and reported on a routine basis: Surveillance 1. Percentages of reporting sites that submit reports every week: At least 80% of the sites should submit weekly reports, even in the absence of cases.

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