POLIO ERADICATION - SURVEILLANCE IMPLICATIONS FOR THE UNITED-KINGDOM

The requirements for certification of elimination of wild virus poliom yelitis will pose particular problems for some industrialized countrie s, such as the United Kingdom, where there has been no case detected f or at least a decade. Systems of surveillance of poliomyelitis have be en reviewed and potential weaknesses identified. When oral polio vacci ne is routinely used, the rate of vaccine-associated cases provides an indication of the likelihood that if they occurred, wild virus cases would be detected. Acute flaccid paralysis surveillance was done for 3 years, but rates were lower than reported elsewhere and were accepted for certification purposes. Alternative techniques, such as surveilla nce of polioviruses, either in clinical samples or from the environmen t, may be developed in such countries. The ability to identify enterov iruses and to distinguish between wild and vaccine strains of poliovir uses will give assurance that silent transmission of wild viruses is u nlikely.