MMWR Morb Mortal Wkly Rep. 2019 Apr 5;68(13):312-318. doi: 10.15585/mmwr.mm6813a4.
When the Global Polio Eradication Initiative (GPEI) began in 1988, cases of poliomyelitis were reported from 125 countries. Since then, only Afghanistan, Nigeria, and Pakistan have experienced uninterrupted transmission of wild poliovirus (WPV). The primary means of detecting poliovirus is through surveillance for acute flaccid paralysis (AFP) among children aged <15 years with testing of stool specimens for WPV and vaccine-derived polioviruses (VDPVs) in World Health Organization (WHO)-accredited laboratories of the Global Polio Laboratory Network (GPLN) (1,2). AFP surveillance is supplemented by environmental surveillance for polioviruses in sewage at selected locations. Analysis of genomic sequences of isolated polioviruses enables assessment of transmission by time and place, potential gaps in surveillance, and emergence of VDPVs (3). This report presents 2017-2018 poliovirus surveillance data, focusing on 31 countries* identified as high-priority countries because of a "high risk of poliovirus transmission and limited capacity to adequately address those risks" (4). Some of these countries are located within WHO regions with endemic polio, and others are in regions that are polio-free. In 2018, 26 (84%) of the 31 countries met AFP surveillance indicators nationally; however, subnational variation in surveillance performance was substantial. Surveillance systems need continued strengthening through monitoring, supervision, and improvements in specimen collection and transport to provide sufficient evidence for interruption of poliovirus circulation.
当全球根除脊髓灰质炎行动(GPEI)于 1988 年启动时,有 125 个国家报告了脊髓灰质炎病例。自那时以来,只有阿富汗、尼日利亚和巴基斯坦经历了野生脊髓灰质炎病毒(WPV)的持续传播。检测脊髓灰质炎病毒的主要方法是通过对年龄<15 岁的儿童进行急性弛缓性麻痹(AFP)监测,在世界卫生组织(WHO)认可的全球脊髓灰质炎实验室网络(GPLN)的实验室中检测粪便标本中的 WPV 和疫苗衍生脊髓灰质炎病毒(VDPV)(1,2)。AFP 监测通过在选定地点对污水中的脊髓灰质炎病毒进行环境监测来补充。分离的脊髓灰质炎病毒基因组序列分析可评估按时间和地点的传播情况、监测中的潜在差距以及 VDPV 的出现(3)。本报告介绍了 2017-2018 年脊髓灰质炎病毒监测数据,重点介绍了 31 个被确定为高优先级国家的国家*,因为它们“存在脊髓灰质炎病毒传播的高风险和有限的能力来充分应对这些风险”(4)。其中一些国家位于有脊髓灰质炎流行的世卫组织区域内,其他国家则位于无脊髓灰质炎区域。2018 年,31 个国家中有 26 个(84%)在国家层面上符合 AFP 监测指标;然而,监测绩效的次国家级差异很大。监测系统需要通过监测、监督以及改进标本采集和运输来继续加强,以提供充分的证据来中断脊髓灰质炎病毒的传播。