Poliomyelitis: history, pathogenesis, global impact, prevalence in Pakistan and methods to eradicate
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By the 1950s, poliomyelitis (polio) was a major public health and medical issue as it became one of the most communicable diseases for children in the United States and globally. Following the widespread use of vaccinations in the 1950s, and an increased global effort in the late 1980s, cases of polio reduced exponentially in countries that were able to enroll widespread vaccination to their citizens. The elementary pathogenic process includes central nervous system (CNS) involvement which may lead to paralysis in extreme rare circumstances. Through mass-vaccination campaigns and global efforts led by the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and the Bill & Melinda Gates Foundation, the number of new cases has remained minimal in most of the developed world except in three countries: Pakistan, Afghanistan, and Nigeria. There are multiple reasons why this disease continues to spread in these countries including vaccine-derived disease associated with mutations, geographical logistics, and the presence of anti-vaccine terrorist groups. While this review aims to explore the history, pathogenesis, and epidemiology of polio, a focus will also be placed on why the disease is still prevalent in Pakistan and novel methods that can be taken to ensure that polio is eradicated in the country. The goal should be for poliomyelitis to join the ranks of smallpox and rinderpest, the only two diseases that have ever been completely eradicated through the use of vaccinations and global cooperation.