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Global polio eradication in sight, but new challenges emerge

The global effort to eradicate polio has achieved great success, with two of the three poliovirus strains eradicated in the last 5 years, and Africa recently declared polio-free. Australia continues to contribute to the global polio eradication effort via the Paediatric Active Enhanced Disease Surveillance Network (PAEDS) and the Australian Paediatric Surveillance Unit (APSU). These networks aim to detect cases of acute flaccid paralysis (AFP) in children, which is the key clinical feature of polio. While it now seems plausible that the world will be free of polio, non-polio enteroviruses (NPEV) causing paralytic disease that looks like polio are emerging, particularly among children.

A new review article published in the Journal of Paediatrics and Child Health highlights that the emergence of NPEV such as enterovirusesA71 (EV-A71) and enteroviruses D68 (EV-D68) in countries that are free of polio is concerning and pose a challenge to scientists, clinicians and public health authorities alike. An outbreak of EV-A71 causing some cases of AFP occurred in Sydney in 2013, and recently a cluster of possible EV-D68 AFP have been detected and further sporadic cases have occurred over the last 15 years. “Paediatric clinicians should be vigilant for these NPEV and should request stool samples in suspected cases of AFP and contact PAEDS or APSU,” says Dr Philip Britton, a co-author of this study.

“Additional testing for NPEV in respiratory samples will further improve our detection of these emerging viruses.”
The study provides a list of recommended investigations for cases of AFP that paediatricians can follow. Dubbing these enteroviruses as the “new enemies”, authors of this article say ongoing surveillance is critical as is the recognition and understanding of these diseases by clinicians to support future public health measures.

Read the full article here