Independent Monitoring Board - Global Polio Eradication Initiative

AT A GLANCEThe International Health Regulations provide a mechanism through which the risk ofinternational polio spread could be lessened. The time is drawing near when peopletravelling from countries in which polio circulates should be required to show acertificate proving they have received a course of vaccination before they travel.We recommend that contingency plans are drawn up to make use of theInternational Health Regulations to require that people travelling from a polioaffectedcountry have a complete and documented course of vaccinationbefore they are allowed to travel. These plans should be developed with anintention that they be implemented when just two countries with endemic orre-established transmission remain.The Programme must boldly usethe tools that it has available– the time to employ theInternational Health Regulationsis drawing closeThere is also the question of what defines an outbreak. Currently, an outbreakresponse is triggered when a case is detected. But drawing samples from sewageoffers a more sensitive way to detect low-level transmission. The wider use ofenvironmental surveillance, coupled with an appropriate response, could detect andclose down outbreaks more rapidly.Environmental surveillanceoffers a means to bolsteroutbreak detection, and shouldbe far more widely usedWe recommend that environmental surveillance should be much expanded inits use and that, if feasible, a positive environmental sample should trigger afull outbreak response. We recognize that the feasibility and logistics of thisneed to be looked into but this should be done rapidly.22Independent Monitoring Board of the Global Polio Eradication Initiative Every Missed Child