Part 6 · Communicable Disease Epidemiology, Surveillance and Immunisation

55. Poliomyelitis — Eradication and AFP Surveillance

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Feature	Detail
Agent	Poliovirus (enterovirus) types 1, 2, 3; WPV2 eradicated (certified 2015), WPV3 (2019); WPV1 endemic in Pakistan and Afghanistan
Transmission	Faeco‑oral (dominant where sanitation is poor); oro‑pharyngeal
Incubation	7–14 days (range 3–35)
Communicability	7–10 days before and after onset; faecal shedding up to 3–6 weeks
Spectrum	≈ 72% inapparent; ≈ 24% abortive (minor illness); 1–5% non‑paralytic (aseptic meningitis); < 1% paralytic (≈ 1 in 200 infections)
Risk factors for paralysis	IM injections (provocation), tonsillectomy, exertion, pregnancy, older age

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Feature

Detail

Agent

Poliovirus (enterovirus) types 1, 2, 3; WPV2 eradicated (certified 2015), WPV3 (2019); WPV1 endemic in Pakistan and Afghanistan

Transmission

Faeco‑oral (dominant where sanitation is poor); oro‑pharyngeal

Incubation

7–14 days (range 3–35)

Communicability

7–10 days before and after onset; faecal shedding up to 3–6 weeks

Spectrum

≈ 72% inapparent; ≈ 24% abortive (minor illness); 1–5% non‑paralytic (aseptic meningitis); < 1% paralytic (≈ 1 in 200 infections)

Risk factors for paralysis

IM injections (provocation), tonsillectomy, exertion, pregnancy, older age