Poliomyelitis surveillance in the Czech Republic from the start of vaccination to the certification of eradication in the European Region

Poliomyelitis anterior acuta is an acute infectious disease caused by polioviruses of three antigenic types. First epidemics of poliomyelitis emerged at the end of the 19th century. The World Health Organization launched the poliomyelitis eradication program in 1988. The incidence of poliomyelitis in the world decreased from 350,000 cases in 1988 to 1918 cases in 2002 when poliomyelitis eradication was certified in three WHO regions, the European Region (2002), American Region (1994) and West Pacific Region (2000). Systematic clinico-virological surveillance of poliomyelitis has been carried in the Czech Republic since 1961, including annual vaccination campaigns with living OPV vaccine, clinical screening, virological screening of clinical specimens and sewage water (environmental) samples and sera screening within serological surveys mapping the vaccination immunological efficacy. From 1961 to 2003, 21,423 stool specimens of vaccinated healthy children, 62,440 stool specimens of patients, 6250 cerebrospinal fluid specimens and 2100 throat swab specimens were screened. Within the outdoor environment surveillance, 15,460 sewage water samples were analysed. From 1995 to 2003 129 cases of acute flaccid paresis were investigated in children under 15 years of age and 28 stool samples from their contacts were screened. Over the same period, 1280 sewage water samples from refugee camps were analysed. For serological surveys, about 60,000 sera from healthy individuals of all age categories were investigated. No case of paralytic poliomyelitis has been reported and no wild virus has been isolated in the Czech Republic since 1961.