Poliomyelitis Eradication and Pandemic Influenza

This article, published in the Lancet, explains the role of poliomyelitis surveillance officers in detecting and responding to diseases of national and international importance, including avian influenza. Polio surveillance officers support countries in the implementation of their poliomyelitis vaccination campaigns, which often includes training school teachers, health workers and community volunteers, and the rapid social mobilisation and distribution of antiviral drugs and vaccines.

The surveillance officers are part of a worldwide system for surveillance of acute flaccid paralysis that identifies, investigates and collects specimens from paralysed children in more than 190 countries. The system is supported through the Global Polio Eradication Initiative (GPEI), whose partners include Rotary International, United Nations Children's Fund (UNICEF), the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO).

Surveillance is underpinned by a network of 145 laboratories in 90 countries that isolate and genetically characterise polioviruses, guiding response activities to the disease. The network has been utilised to support other diseases such as measles, yellow fever, meningitis and severe acute respiratory syndrome. Recently, the surveillance system has been broadened to include bird flu, but the authors identify the need for increased laboratory capacity to include diagnosis of H5N1 and training in influenza to polio surveillance officers as necessary to enhance surveillance and assist in the early detection of avian flu.

The authors argue that in order to increase these surveillance capacities, an increased and broadened funding base is needed, and that to ignore this need for further “international investment in poliomyelitis eradication will increase vulnerability to avian influenza in countries where health systems are weakest and least able to detect and respond.”