Disease eradication: poliomyelitis as a case study

Among the different strategies to fight infectious diseases, eradication is the ultimate goal. In this paper, the main differences between control, elimination and eradication programmes are first described. Then, the reasons why poliomyelitis was chosen as a priority for eradication are reviewed, and the programme detailed in terms of strategies adopted and results achieved. Because the Americas and the Eastern Pacific hove been certified polio free, and no indigenous wild poliovirus has been isolated in Europe since 1998, eradication seems imminent. Nevertheless, some issues remain challenging :insuring the absence of prolonged circulation of vaccine strains, with the fear they may revert to virulence; managing an efficient laboratory containment of polioviruses and choosing adapted strategies to allow stopping immunisation.