Criteria for assessing accomplishment of poliomyelitis control.

The goals of control of poliomyelitis include the control of paralytic poliomyelitis, of infection by polioviruses, and of the presence and spread of polioviruses in the environment. Criteria for assessing control of paralytic poliomyelitis include required and special reporting, data from hospitals and clinics, and lameness surveys. Control of infection is evaluated by immunization histories, studies of vaccine quality and usage, and by serologic surveys for antibody prevalence. Environmental control is measured by lack of reported cases, lack of wild polioviruses in sewage, and the absence of poliovirus in the stools of healthy persons who have not received oral poliovirus vaccine. Each country must determine its own objective for control and the criteria most suited for measuring the attainment of those goals. The advantages and disadvantages of these different criteria are discussed. Developing countries will have to place primary reliance on school and household lameness surveys to evaluate control of poliomyelitis since other methods are too expensive and/or require strong health infrastructures . Developed countries can use regular and special surveillance systems for reporting cases, laboratory diagnosis for confirming suspected and vaccine-associated cases, and serologic surveys for monitoring the need and progress of immunization programs.