MMWR: Flu recommendations and polio eradication update

Several interesting items related to vaccination appear in today's issue of MMWR. Among them:

-- A revision to the ACIP document "Prevention and Control of Influenza," an expansive review of all aspects of seasonal flu vaccination guidance and related data. Notable in this updated version is additional encouragement aimed at promoting influenza vaccination of health care workers as well as information on the composition of the 2007-08 vaccine.

-- A report on worldwide progress toward polio eradication, as of May 2007. The number of polio-endemic countries remains at four (Pakistan, Afghanistan, Nigeria, and India) with the vast majority of the 1,997 cases reported in 2006 occurring in Nigeria (1,123) and India (676). Global vaccination coverage stands at 78%, a number that is well over 90% in the Americas but far lower in Nigeria (39%) and India (58%). Those interested in polio eradication should visit our previous posts about polio, which include several items discussing the merits and challenges associated with pursuing eradication.

Debate on continuing polio eradication efforts

That's what is being reported in this AP story from last week: "Experts reconsider goal of ending polio." The debate centers on whether efforts should be centered on containment -- polio is endemic in four countries and affects roughly 2,000 people a year -- or a continuation of the quite costly eradication program now entering its 19th year. Eliminating these remaining cases has proven to be far more difficult than smallpox eradication, which was accomplished in half as much time.

The story highlights an interesting and important debate among experts within the WHO, the infectious disease community overall, and leaders from the countries still affected by the disease.

Of note is the nearly-4,000 word feature published nearly a year ago in the New York Times on the challenges of polio eradiation, which we wrote about here.