Response to poliomyelitis in Peru.

In 1991, confirmed polio cases were reported in the Americas only from Peru (1 wild-type 1 poliovirus) and Colombia (6 wild-type 1 poliovirus) [see front page of this issue]. 1 other wild-type 1 poliovirus was isolated from a case of acute flaccid paralysis in Peru with onset of paralysis in December 1990. The response to the confirmed cases in Colombia was to target more that 1 million households in the risk area for mop-up vaccination campaigns. Approximately 80% of the children under 5 years of age were vaccinated in 2 rounds of campaigns. A 3rd round is scheduled for February 1992. The last confirmed polio case in Peru (date of paralysis onset August 1991) was reported from the department of Junin. The initial immunization response was directed to essentially all the communities in the Department. Over 90% of the children of Junin were vaccinated with OPV in 2 rounds of mop-up campaigns held in 1991. However, vaccination activities have been greatly affected by civil disturbance, health strikes, and work slowdowns. The great majority of vaccine delivered in Peru in 1991 could only be delivered by way of house-to-house mop-up activities. In followup campaigns, 587,557 (96%) of the targeted children under 5 years of age were vaccinated. Of the 615,070 children targeted, 63% were also vaccinated 1 month later during the 2nd round of activities. Of the 22 million inhabitants in Peru, approximately 3 million are under 5 years of age. For 1992, the Peruvian Government has established that 66% of these children are under very high risk conditions and in critical need of special vaccination programs. The Ministry is mounting a house-to-house mop-up campaign that will be carried out from 29 February to 8 March and will include health education for cholera prevention. As of the 3rd week of 1992, the cholera epidemic continues to scourge Peru. Over 320,000 cases were reported in 1991, representing 75% of all cholera cases reported for all countries in the Americas in 1991 and 60% of the world's reported cases during 1991. The cholera epidemic in the Americas is the single largest cholera epidemic that has occurred in the world during this century. In response to the initial cases, Peru set up a cholera surveillance system patterned after the system established for acute flaccid paralysis. PAHO strongly believes that special attention to integrate mass vaccination campaigns with cholera prevention activities should help consolidated efforts toward achieving polio eradication in Peru. During the mop-up campaign that will take place--the largest ever carried out in the Americas--, approximately 2 million households will be visited in order to vaccinate the children and disseminate cholera information.