title: [Polio, the long walk to the endgame].
abstract: Although the WHO original target date for the global eradication of poliomyelitis was the year 2000 -thanks to vaccination and institutional, public and private, resources for that purpose-, in 2013 the disease remained endemic in three countries, Afghanistan, Pakistan and Nigeria, and some cases were described in five others. The circulation of wild type 1 poliovirus in Israel, Gaza and the West Bank and the cases in Syria were a wakeup call, as at that time there were polioviruses derived from the oral vaccine that are still circulating among the human population and can cause the development of the disease. Travelling "from" and "to" endemic areas are factors to consider in poliovirus exportation and in its spread when it reaches areas with poor immunogenicity. Wars, terrorism, intolerance, lack of culture and proliferation of anti-vaccine groups and the rise of the anti-vaccination movement are important factors in the maintenance and expansion of the virus and in the "non-vaccination" against it. Based on the international situation to date, the Emergency Committee of WHO met in May 2014 to address the problem. It is still necessary to enhance the knowledge of the disease and its agent. In the first case to perform a differential diagnosis of flaccid paralysis and to continue vaccination programs, and in the second case to keep studying and looking for the poliovirus in environmental samples, which is a model for the study of many other viruses.
authors.affiliation: Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica, Facultad de Medicina, Universidad de Salamanca, Salamanca, España. Electronic address: joegas@usal.es.
authors.forename: José Elías
authors.initials: JE
authors.lastname: García-Sánchez
authors.affiliation: Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica, Facultad de Medicina, Universidad de Salamanca, Salamanca, España.
authors.forename: Enrique
authors.initials: E
authors.lastname: García-Sánchez
authors.affiliation: Departamento de Sanidad, IES Martínez Uribarri, Salamanca, Salamanca, España.
authors.forename: Enrique
authors.initials: E
authors.lastname: García-Merino
authors.affiliation: Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica, Facultad de Medicina, Universidad de Salamanca, Salamanca, España.
authors.forename: María José
authors.initials: MJ
authors.lastname: Fresnadillo-Martínez
mesh_terms: D000346:Afghanistan / Q000453:epidemiology; D060740:Disease Eradication / Q000379:methods / Q000458:organization & administration / Q000639:trends; D019353:Endemic Diseases; D014943:Global Health; D006801:Humans; D017589:Immunization Programs; D008877:Middle East / Q000453:epidemiology; D009549:Nigeria / Q000453:epidemiology; D010154:Pakistan / Q000453:epidemiology; D011051:Poliomyelitis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D017955:Poliovirus / Q000302:isolation & purification / Q000502:physiology; D023321:Poliovirus Vaccines; D011159:Population Surveillance; D011634:Public Health; D064890:Social Determinants of Health; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data; D014944:World Health Organization
chemical_list: D023321:Poliovirus Vaccines
keywords: Disease eradication; Erradicación; Poliomielitis; Poliomyelitis; Poliovirus; Public health; Salud pública; Vaccination; Vacunación