4-P-2

 

POLIOMYELITIS ERADICATION INITIATIVE AND EXPANDED PROGRAM ON IMMUNIZATION IN CHINA

Wang Kean1, Zhang Xinglu1, Zhu Xu1, Wang Zhao2, Shao Ruitai2, Zhou Jun2, Alan Shnur3, Lisa Lee3

1 Chinese Academy of Preventive Medicine, China

2 Ministry of Health, China

3 WHO Beijing, China

 

On October 29, 2001, the People’s Republic of China was declared polio-free by the Regional Commission for the Certification of Poliomyelitis Eradication in the Western Pacific.  China is the world’s most populous country, and as recently as the 1960s, as many as 20,000-43,000 reported cases of poliomyelitis were reported each year.  Achievement of polio-free status caps a more than decade-long nationwide effort that we summarize in this article.

Since 1978, OPV has been one of four routine vaccines given to all children.  Expansion of the cold chain and achievement of universal childhood immunization goals resulted in dramatic decline in cases through the 1970s and 1980s.  In the winter of 1993-1994, China conducted the first of three coordinated National Immunization Days (NIDS) with over 74 million children immunized.  The campaign was highly successful with the last indigenous case of poliomyelitis in China occurring the following year on September 28, 1994.  To keep China polio-free, routine coverage has been maintained at high levels and approximately 800 million doses of OPV have been administered during 14 rounds of NIDS or Sub-National Immunization Days (SNIDS).  Since 1994, poliomyelitis specific surveillance has exceeded WHO recommended performance criteria and nearly 90,000 stool specimens have been tested and were negative for wild poliovirus.  Importations of wild poliovirus occurred in 1995, 1996 and 1999 and were quickly detected and contained.

Eradication of indigenous poliomyelitis in China is a historic achievement and demonstrates the ability of the country’s public health system to reach ambitious goals given high levels of political support and sufficient resources.  China shares borders with several polio-endemic countries and must meet the challenge of sustaining interest in, and support for, activities to keep the country polio-free until global eradication.