Polio remains a serious public health concern in a small number of countries despite global eradication efforts. Understanding where the virus is still active helps focus vaccination and surveillance resources where they are needed most.
Ongoing transmission in specific regions keeps the risk of exportation and outbreaks in vulnerable populations, making targeted interventions essential. The following sections detail current hotspots, response strategies, and common questions about the remaining areas.
| Country | Region | Status (Recent Years) | Key Challenges |
|---|---|---|---|
| Afghanistan | South Asia | Active endemic transmission | Conflict zones, difficult access |
| Pakistan | South Asia | Active endemic transmission | Population movement, weak surveillance |
| Nigeria | West Africa | Previously endemic, interrupted since 2016 | Weak health systems, rumors affecting uptake |
| Democratic Republic of the Congo | Central Africa | Circulating vaccine-derived poliovirus detected | Outbreak response, infrastructure gaps |
| Myanmar | Southeast Asia | Low-level transmission and importation risks | Displacement, cross-border spread |
Current Endemic Transmission Areas
Afghanistan and Pakistan
These two countries remain the last strongholds of wild poliovirus type 1. Factors such as insecurity, difficult terrain, and population displacement complicate immunization campaigns and routine vaccination. Continuous surveillance and tailored strategies are critical to stopping transmission.
Response in Previously Endemic Countries
Nigeria and the African Region
Nigeria has not reported wild poliovirus since 2016, but vigilance is essential to prevent resurgence. Neighboring countries and regions face challenges from cross-border movement and under-vaccinated communities, requiring synchronized campaigns and strong coordination.
Emergence of Vaccine-Derived Poliovirus
Outbreaks in Low-Vaccination Settings
Several countries, including the Democratic Republic of the Congo, have experienced outbreaks of circulating vaccine-derived poliovirus. These outbreaks occur where oral polio vaccine coverage is low and sanitation is poor, highlighting the need for stronger routine immunization and access.
Global Surveillance and Containment
Monitoring and Containment Measures
International health agencies work with national programs to monitor sewage and acute flaccid paralysis cases. Rapid response teams deploy vaccines and communication teams to address rumors and increase community trust when outbreaks are detected.
Strengthening Polio Eradication Efforts
- Maintain high routine immunization coverage in all communities
- Invest in real-time surveillance and laboratory capacity
- Ensure secure access for health workers in conflict zones
- Address vaccine hesitancy through transparent community engagement
- Coordinate cross-border strategies for mobile and refugee populations
FAQ
Reader questions
Is wild polio still present in Afghanistan and Pakistan?
Yes, Afghanistan and Pakistan are the only two countries where wild poliovirus transmission continues, primarily affecting under-immunized children in conflict-affected and remote areas.
Has Nigeria completely eliminated polio?
Nigeria has interrupted wild poliovirus transmission since 2016, but maintaining high immunity through routine vaccination is critical to prevent any return of the virus.
What is causing outbreaks in countries like the Democratic Republic of the Congo?
Outbreaks in these settings are often linked to low vaccination coverage and sanitation challenges, leading to vaccine-derived polioviruses that can spread in under-immunized populations.
How does population movement affect polio-free countries?
Movement across borders can introduce the virus into countries that have stopped transmission, making sustained surveillance and high vaccination coverage essential to prevent re-establishment.