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
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.