1. IPV IPV Rapidly produces high level of protective antibodies No risk of vaccine associated illness No interference from other enteroviruses. I.P.V. produces only limited intestinal immunity. I.P.V. protects vaccinees, not their contacts, directly or indirectly through the environment

2. Strategies for Polio Eradication  Strong routine immunization program  National Immunization Days (NID)  Acute flaccid paralysis surveillance  Mopping – up immunization  Outbreak response

3. Immunization Strategies for Polio Eradication Appropriate setting for NIDs:  Areas of high endemicity reduce transmission.  Areas of low endemicity interrupt transmission.  Polio – Free areas : prevent spread of Wild Virus if Importation occurs

4. Technical Features of Effective NIDs  Wide geographic area  High coverage.  All children in target age group(0-5 years) regardless of prior.  Low season for Wild Polio Virus transmission.  Rapid ( days to 1 week).  2 rounds 4 – 6 weeks apart.

5. Polio Eradication - Analysis Performances indicators:  Completeness & timeliness of monthly reports objective: 90% & 80% respectively.  AFP rate in children < 15v years of age Objective: ≥ 1/100 000  Investigation ≤ 48 hours of report Objective: ≥ 80%

6.  2 stool specimens collected 24-48 apart & ≤14 days after onset Objective : ≥ 80%  Stool specimens arriving at the lab within 3 days of being sent Objective : ≥ 80%  Stool specimens arriving at the lab in good condition Objective : ≥ 90%  Result from the laboratory in ≤28 days Objective : ≥ 80%

7. Stopping NIDs: Key Issue  Presence of Wild Polio Virus circulation.  Status of AFP surveillance & laboratory.  Risk of importation.  Population immunity (routine OPV)

8. Clinical classification scheme Clinical classification scheme Died or lost follow up confirmed AFP residual confirmed Paralysis Paralysis Follow up at Positive For wild Confirmed 60 days poliovirus Follow up at Positive For wild Confirmed 60 days poliovirus No residual Discard No residual Discard Paralysis Paralysis

9. Virologic Classification scheme Virologic Classification scheme Wild poliovirus Confirmed Residual Compatible Residual Compatible weakness, weakness, AFP died, lost to follow up expert Inadequate or review Inadequate or review no specimen no specimen Discard Discard No wild No wild virus No residual weakness Discard virus No residual weakness Discard Adequate specimens Discard Adequate specimens Discard