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Hunting Down the Polio Virus

Published: June 5, 2009

Infant being administered a dose of polio vaccine
The number of new cases of polio in the world has plummeted to fewer than 500

Earlier this year, the Centers for Disease Control and Prevention's (CDC) Stop Transmission of Polio (STOP) program celebrated its 10-year anniversary as part of the largest public health initiative in history – the eradication of polio. When the initiative was launched in 1988 to fight one of the most dreaded childhood diseases of the 20th century, more than 125 countries were polio-endemic and an estimated 350,000 children were paralyzed by the disease each year – nearly 1,000 each day.

Today, only four countries—Afghanistan, India, Nigeria, and Pakistan—remain endemic for polio. Last year, 1,652 children were paralyzed by polio worldwide, a reduction of more than 99 percent since 1988. So far this year, just over 500 cases of polio have been reported worldwide.

Over the past 10 years the STOP program has been supported by more than 1,000 volunteers who have traveled to 60 countries around the world to "hunt down the polio virus in the last reservoirs on earth." This mission was later expanded to support the global measles initiative," said Yinka Kerr, MSPH, STOP Program Team Lead, Global Immunization Division. "This effort has dramatically reduced childhood mortality and provided valuable assistance to strengthen immunization systems globally."

Volunteers provide a range of technical support: conducting field surveillance for polio, training local health care providers in surveillance, and planning and monitoring polio and measles vaccination campaigns. "In addition, volunteers have helped establish and enhance data management systems for disease surveillance in selected countries," added Kerr. "And since 2006, volunteers with expertise in communications have also supported UNICEF in social mobilization, advocacy, and communications for immunization in Africa and Asia."

Polio eradication poster

Memories and Milestones

To mark the anniversary, the STOP program joined with partners from Rotary International and the World Health Organization (WHO), as well as current and former CDC staff from the Global Immunization Division and the Coordinating Office for Global Health, to reflect on accomplishments over the past 10 years and to focus on the vision for the future.

"In 1998 it was clear that additional skilled public health staff were needed in the field in many countries if we were really going to be successful in the battle against the disease," said Steve Cochi, MD, Special Advisor to the division director, Global Immunization Division, and director of the Global Immunization Division when STOP was initiated. "The STOP program was CDC's idea, and we met with several of the agency's 'smallpox warriors' to hear their thoughts on training and deploying staff for three-month assignments. Based on their experience eradicating smallpox in the 1970s, they recognized the value of such a program and provided great input as we got started."

The first STOP team was nearly all CDC staff—EIS officers, epidemiologists, and public health advisors—who were trained and sent to Burkina Faso, Nigeria, Yemen, Nepal, and Bangladesh. Since then, STOP has become the largest global health training program ever at CDC.

"Ten years ago, a sense of urgency and opportunity resulted in the creative decision to establish the STOP Program," said Stephen B. Blount, MD, director of CDC's Coordinating Office for Global Health. "Over the years, the program's contribution to polio eradication has been significant. More children today are leading healthy, active lives and hundreds of public health workers from around the world have learned—and lived—the the lessons of hope and teamwork that predict the success soon of the eradication effort. In the years to come, I'm sure we will apply what we've learned from STOP to take on and complete the unfinished business of making routine immunizations a part of the life of every child."

Polio vaccine billboard from the mid-20th Century
This historical image, which depicts workers creating a billboard in downtown Atlanta, Georgia, shows one of the communication modes, the billboard, used to promote public health awareness, in this case, polio vaccinations within a community. The billboard, as well as television, magazines, and pamphlets, are only some of the myriad of modalities implemented when information of this kind is disseminated throughout society, and across cultural barriers.

These contributions were recently recognized with the induction of the spearheading organizations of the Global Polio Eradication Initiative—CDC, the World Health Organization, Rotary International, and UNICEF—into the Polio Hall of Fame. The organizations were honored for their work at a ceremony in Warm Springs, Georgia, home of former President Franklin Delano Roosevelt. Roosevelt's grandson was among the speakers on hand to celebrate the near eradication of polio and the hard work of CDC and other organizations fighting this tenacious disease.

"The work toward polio eradication is so impactful," said Anne Schuchat, MD, (RADM, USPHS), assistant surgeon general and Director of the National Center for Immunization and Respiratory Diseases. "STOP teams volunteer in some of the most challenging places in the world, trying to make things better, making a difference every day. We're down to a very few cases in difficult places. It takes so many people to do great things. And we are all part of this together."

The eradication of polio is now a truly global effort, with STOP Team members reflecting the international commitment to polio eradication. International bridges are being built and global connections made among public health professionals through the STOP Team initiative that will continue long after the polio virus is gone.

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