1. Why has Poliovirus not been eradicated to date?
Several reasons have historically led to that poliovirus not being eradicated. Some of them are listed as follows:
1) People’s misconception about Poliovirus.
2) Insecurity within the country, especially, in the countries in which wild polioviruses have been transmitting endemic.
3) Poor health system. Also, the poliovirus vaccine is more complicated to administer compared to some other vaccines such as the smallpox vaccine. For instance, the oral poliovirus vaccine needs to be kept refrigerated and administrated multiple times.
4) Mistrust of the West and their vaccination programs in afflicted areas. For instance, 8 poliovirus vaccinators were killed in northern Afghanistan in February 2022 which forced the United Nations to stop the vaccination in two provinces. The following month, another vaccination worker was killed in northwestern Pakistan. Since 2012, more than 70 vaccinators have been targeted in Pakistan as well.
5) Underscoring the poliovirus dangers. This resulted in reemerging of the virus in southern Africa in 2021. Also, several vaccine-derived cases appeared in the United States and Israel in 2022. Furthermore, the war in Ukraine disrupted the government's efforts to prevent the virus outbreak in the west side of the country.
6) Undermining poliovirus vaccination campaigns by misinformation. For instance, a mob in Khyber Pakhtunkhwa province of Pakistan burned a healthcare facility in 2019 after a rumor that vaccinated children had fallen ill due to the expiration of their vaccine doses.
7) a Million children missed routine vaccinations due to the COVID-19 pandemic. The spread of the new coronavirus in early 2020 deteriorated the situation as poliovirus vaccination was halted around the world. The countries such as Afghanistan and Pakistan observed spikes in poliovirus-afflicted children in 2020.
Where do pockets of Poliovirus infections caused by wild-type polioviruses occur?
Pakistan and Afghanistan are the countries in which wild-type polioviruses are transmitted endemic. Among the 110 cases of wild poliovirus throughout the world in 2020, two-thirds were in Pakistan and the remaining one-third were in Afghanistan. In 2014, Pakistan reported 300 cases of paralytic poliovirus; however, it decreased to only one case in 2021. Moreover, health experts are warning about the reemergent of poliovirus in Ukraine amid Russia’s invasion in early 2022. Upon the appearance of several poliovirus vaccine-derived cases in late 2021, the WHO and the health ministry of Ukraine set up a vaccination campaign, but it has been disrupted by war. The resurgence of poliovirus often occurs in unstable areas where health systems are disrupted by war as well as in areas where refugees have resettled. For instance, Syria observed a reemergence of the disease between 2013 to 2014 during the civil war.
2. Where do pockets of Poliovirus infections caused by wildtype polioviruses occur?
There are still isolated pockets of wildtype poliovirus infections in a few nations, mostly in portions of Asia and Africa. Afghanistan, Pakistan, and Nigeria are the three nations where the wildtype poliovirus is still endemic, according to the World Health Organization (WHO), which means that the virus is still actively spreading and resulting in new cases.
There have occasionally been wild type poliovirus outbreaks outside of these nations, frequently as a result of the importation of the virus from endemic nations. For instance, a poliovirus outbreak in the Philippines in 2019 was associated with a strain of the virus that had its origins in Pakistan.
Rare instances of poliovirus infections have also occurred in regions that have been deemed polio-free, frequently as a result of inadequate immunization rates or other flaws in immunization protocols. For instance, Papua New Guinea, which had been polio-free for 18 years, reported a case of the wildtype poliovirus in 2018. In response, the government started a widespread vaccination program to stop the virus from spreading.
The global incidence of wildtype poliovirus has been significantly reduced, and efforts to eradicate it are still underway. Even so, there is a chance of importation and outbreaks in other locations as long as the virus is still present in a few nations. To stop the poliovirus from reemerging, it is crucial to maintain high vaccination rates and surveillance.
3. Why has Poliovirus has not been eradicated to date?
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