Talk:Polio eradication

Polio in Pakistan page

I'm interested in editing the Polio in Pakistan article for a class assignment so that it expands on pre-2011 factors impacting eradication. (It focuses currently essentially on the CIA-Osama bin Laden controversy.) I would appreciate any suggestions or help! Khanzar (talk) 19:31, 2 October 2015 (UTC)

polio vaccine myths europe

If you search Google for "polio vaccine myths europe" you find dozens of pages of largely the same text. They make a specific claims about what happened in the 50's and 60's in Europe with the aim of discrediting immunization. They specifically claim that:

"polio declined both in European countries that refused mass vaccination as well as in those that employed it"

"European countries that refused immunization for small pox and polio saw the epidemics end along with those countries that mandated it"

This page and the page on polio itself have clear information on what happened in the US. I think it would be very useful to add more solid information about the immunization efforts in the 50's and 60's in Europe.

A clear statement that indicates exactly and unequivocally why there is ZERO polio in all western countries would also be very useful. (Some people can't process lots of information - they need black and white statements. Here are the types of things they can understand and accept at face value - "did we ever really need vaccinations") CraigWyllie 16:50, 18 March 2007 (UTC)

In Germany, all or close to all children get vaccinated. Its being done at school, and education is compulsory in Germany, homeschooling or unschooling is illegal, i am not sure but i dont think they ask for parents consent for each vaccination, i suspect they just inform parents and get the appropriate signature at that time when parents first send their children to school. Similar policies exist in many european countries. The european union would not tolerate it and would publicly criticize member states that fail to participate in global and vital vaccination campaigns. Having universal healthcare also of course helps to reach babies and children, if it doesnt cost anything its normal to send your children to regular health checkups, you would be a bad parent if you didnt. Are you from the USA? Well, the USA is the only industrialized country that does not have something like universal healthcare, maybe thats why this question even arises. 88.64.118.221 (talk) 21:31, 10 October 2011 (UTC)

New article

I created a new article, Eradication of infectious diseases, which could use a lot of work if anyone is interested. There is a section on polio. --Ginkgo100^talk 17:59, 30 November 2007 (UTC)

I read it even before noticing it here, its awesome, thanks! Its a topic that will grow with time, or at least i very much hope so, i think humanity will soon knock out either poliomyelitis or guinea worm disease, and this will bring a boost of publicity to these eradication campaigns. I applaud you for creating this article! But i dont know what to add, its quite awesome as it is. 88.64.118.221 (talk) 21:40, 10 October 2011 (UTC)

Wrong year in table header

The table in the 2005 section is headed "Reported Polio Cases in 2012", but this can't be right. Since it's in the 2005 section and the image is for 2005, possibly it should be "Reported Polio Cases in 2005" but the total doesn't match (table total 1,911 while text and other table say 1,979 cases in 2005). Sabik (talk) 03:09, 2 April 2012 (UTC)

CIA

I recommend a separate article on the CIA's fake vax campaign, the one that greatly promoted distrust in the vaccine.--Solomonfromfinland (talk) 17:12, 22 January 2014 (UTC)

Citations? MWikidgood (talk) 19:50, 4 November 2014 (UTC)

Translate to help eradication

This article should be translated in the languages spoken in the endemic country (Somalia, Pakistan and Afghanistan). --Accurimbono (talk) 15:34, 3 December 2014 (UTC)

Could anybody make a table for year 2014?

In this article there are tables, which show polio cases for each country that had polio, for the years 2011, 2012 and 2013. But still no table for 2014, though the year has ended. Can you make it, similarly to the previous tables? It would be very useful. 89.149.102.101 (talk) 17:59, 1 March 2015 (UTC)

Done (will do image later tonight). Been meaning to do this for a while so thanks for the reminder. Tobus (talk) 23:23, 1 March 2015 (UTC)

2015 Table

The 2015 table needs to be updated when WHO posts this week's "Polio this week" update. I mean it should be updated every week, but this week especially. Brightgalrs (/braɪtˈɡæl.ərˌɛs/)^[1] 07:40, 3 September 2015 (UTC)

So what are you waiting for? Get to it! Tobus (talk) 08:19, 3 September 2015 (UTC)

Gotta wait a few more days. Also this is pretty much just a note-to-self. Brightgalrs (/braɪtˈɡæl.ərˌɛs/)^[1] 12:28, 3 September 2015 (UTC)

Polio This Week as reference

While the Polio This Week page is a great resource for keeping the current year totals up to date, it does, by definition, change every week and so is a poor choice as a reference for anything else. We need to be careful to only use it for statements that we expect to update, remove or find a new source for in the very near future. Tobus (talk) 21:16, 8 February 2016 (UTC)

External links modified

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2012 is no more the smallest year for polio cases

The article says that 2012 is the smallest year of any time by recorded cases of poliomyelitis. But 2015 has ended and it recorded only 106 cases. So 2015 may be the candidate. And 2016 had even less cases (38). Also I think there is a contradiction between table for 2015 and the main text. The table says 54 wild polio cases were in Pakistan in 2015 while the section says there were 53. I didn't want to edit it myself but decided to ask for edition by smb. else. 89.149.124.181 (talk) 12:37, 7 January 2017 (UTC)

Fixed Tobus (talk) 12:58, 7 January 2017 (UTC)

Cases per year plot

'Number of poliovirus cases by year, 1975–2015' needs to be updated to 2016, but I would suggest that, when done, an inset be made to show 2000-2016 at a more informative scale, to make recent further improvements evident. 50.37.111.195 (talk) 00:43, 21 January 2017 (UTC)

Hi, I updated the figure: https://en.wikipedia.org/wiki/File:Number_of_poliovirus_cases_by_year.svg . Let me know if there are further suggestions for improvement. Riceissa (talk) 02:25, 21 January 2017 (UTC)

2017 new suspected polio case

A new suspected polio case in a 14-month old child has been reported in major national dailies. The child lives in the Thore Valley of District Diamer, Giglit-Baltistan, which has been declared a polio-free region in the past.

The boy’s father told the local reporters that he has vaccinated his child against polio regularly. He has said that an arm and a leg of the child are not functional, and that he has taken his son to hospitals in Chilas, Gilgit and Abbottabad, where doctors have given him medicines for two months. The child’s father has claimed that his son’s condition has improved due to the medicines. The child’s father told the reporters that none of the doctors he consulted has told him about the presence of polio virus in his son.

http://pamirtimes.net/2017/03/14/suspected-polio-case-reported-from-thore-valley-diamer/

I do not see evidence that this is polio. Ruslik_Zero 20:50, 16 March 2017 (UTC)

New half-decade bracket?

It may be a little soon to do this, but as time progresses we lose the immediacy of the detailed descriptions of the early 2010s, and at some point it is probably appropriate to consider condensing these years into a 2011-2015 5-year block like with 2006-2010. The most recent years are always worth tracking, but as these events get farther in the past, the blow-by-blow of the annual reports becomes excessive and it is more useful to discuss trends and landmarks over longer periods of time than to bury these in loads of detail. (Of course, this would impact all those pretty tables and maps.) Agricolae (talk) 23:57, 30 March 2017 (UTC)

I agree that it is, as of yet, too soon to do this. I also agree that it needs to be done eventually (even if polio were eradicated next year, i.e. 2018, we'd want to condense that portion). I say wait until next year or the year after that (2018 or 2019), depending on developments in the near future. TompaDompa (talk) 12:51, 31 March 2017 (UTC)

I can agree with waiting until 2018, but just thought I would get the editors thinking about it. That being said, a good start would be to pare back 2012 and 2013 to something more akin to 2014 and 2015. Agricolae (talk) 20:46, 31 March 2017 (UTC)

Let's not do it, as that is possibly the last full half decade with cases.Jmv2009 (talk) 09:09, 14 October 2017 (UTC)

I would respond to this two different ways. First, we say that now, but they would have said the same thing five years ago. We can't base editorial decisions on wishful thinking. Second, the whole year-by-year summary is temporary. An article about an ongoing struggle has a different perspective than that of a fait accompli, and the precise details of 2012 will become trivial excessive detail. All the annual updates should be viewed as temporary, and perhaps even the five-year ones. Agricolae (talk) 10:18, 14 October 2017 (UTC)

It's 2018. Is there any particular reason to put it off until later or shall we get to it? TompaDompa (talk) 14:51, 4 January 2018 (UTC)

I would say the only reasons to put it off are technical - inertia, and the need for a consensus on how best to present the information that is now in the annual tables. At one point I experimented with a combined set of tables but couldn't come up with anything that wasn't overly 'busy'. I think a slideshow for the maps would work, but they need to have the year added to the images for that. Agricolae (talk) 16:29, 4 January 2018 (UTC)

Until we can figure out a better solution, I just collapsed the tables. TompaDompa (talk) 23:36, 4 January 2018 (UTC)

I gave it a try, but I am not in love with it if anyone wants to come up with something better. Agricolae (talk) 17:22, 5 January 2018 (UTC)

I'm really not a fan, to be honest. It clashes a lot with the other tables. I changed it back to collapsible tables, but in gallery layout. TompaDompa (talk) 18:29, 5 January 2018 (UTC)

That is what I tried first, and couldn't get it to work. Agricolae (talk) 20:32, 5 January 2018 (UTC)

I actually wanted it to be a slideshow gallery, but I'm not sure if that's possible with tables (which requires entirely different markup than images). I haven't been able to use a table as an image's caption. TompaDompa (talk) 22:55, 5 January 2018 (UTC)

Importance of Environmental Sampling

This new material seems inappropriate for the annual update. These observations apply generally, and so may have a place higher up in the article, perhaps where other challenges are discussed, but there is nothing that makes the understanding provided by environmental sampling unique to 2017. I have left it for the time being, but want to go on record as viewing its inclusion, at least in the 2017 section, disfavorably. Agricolae (talk) 19:54, 11 May 2017 (UTC)

I'm sorry. I know I said I was going to leave it, but if efforts will continue to be made to insert synthesis, then we need to talk about it.

While monitoring paralyses cases is the gold standard for tracking polio, for every paralyses case, over a hundred undetected infections occur as the paralyses rate is below a percent. Furthermore, infected people shed virus for several weeks, so for one paralyses case detected every several weeks on average one paralyses victim is actively shedding virus, and over a hundred other infected people as well. As the time between paralyses cases worldwide is currently regularly exceeding several weeks, environmental surveillance is gaining in importance to localize, and detect low-level continued infection.

References

As I see it, everything here after "shed virus for several weeks" is not found in the cited sources. Further, the first part was also true in 2016 and 2015 - it does not belong in the annual updates, but in the body of the article. Agricolae (talk) 23:02, 11 May 2017 (UTC)

The proposed section (with synthesis) is especially relevant from 2017 forward with the dwindling or even disappearance in the number of actual paralyses cases. The motivation is to give an honest impression in the article on question like "Has polio already died out?" "Why environmental surveillance if paralyses cases are the gold standard?" "Does environmental surveillance catch all infections?" I like to give explain information in terms of numbers, to which there seems to be some resistance here as well as elsewhere as "synthesis", which could result in platitudes like "no detection for a couple of years" which in turn does not take into account of e.g. the intensity of environmental surveillance in the assessment. I actually would not qualify the statements as "synthesis" but as "routine calculation" which appears permitted.Jmv2009 (talk) 04:30, 12 May 2017 (UTC)

The problem is that as editors, it is not our job to anticipate questions and answer them, that is the role of journalists, health care professionals and scientists - our role is to summarize whatever they have chosen to answer. Likewise, our preferences for the way we like to explain things should not be our guide, because we shouldn't be explaining things de novo, we should be summarizing what reliable sources have described and explained. As to it being particularly relevant to 2017, there was a scholarly paper published in 2015 that addressed the relative likelihood that polio had been eradicated in a country based on the frequency of detection of cases and environmental samples, and it correctly predicted a cVDPV case that occurred within weeks of its publication, so it was just as relevant a question then. As uncomfortable as it makes you, "there has been no case detected in X years" is a fact that can be documented - we can cite a source that says the last reported case was in 20XX. Your speculation about how many infected people might be out there can never be documented, because it is only your speculation. And yes, it is synthesis to reach a conclusion that the sources do not reach, and that is what you are doing through your calculation. Agricolae (talk) 05:47, 12 May 2017 (UTC)

Please note that per Wikipedia:No original research, performing a routine calculation is permitted. You seem to imply that I am doing more that than (without further arguments).Jmv2009 (talk) 16:27, 12 May 2017 (UTC)

You are doing more than that - a 'routine calculation' would be to take the fact that 1/200 WPV1 infections results in paralysis and rephrase it as 99.5% of cases show no paralysis. What you are doing is far from routine - combining two different frequency approximations from different sources to come up with a completely novel conclusion regarding the number of undiagnosed carriers. That is synthesis, not just routine calculation. Agricolae (talk) 16:53, 12 May 2017 (UTC)

Eradication likelyhood

Some detailed background info:

Cases in last six months: 16DEC: Bermal, Afghanistan 22DEC: Kabdulah, Pakistan 13JAN: Kandahar, Afghanistan 21JAN: Nahr-e-Sarah, Afghanistan 28JAN: Lodrhan, Pakistan 13FEB: Diamar, Pakistan 21FEB: Dasht-E-Archi, Afghanistan

Less and less of the cases occur in the typical corridors between Afghanistan and Pakistan, except near Kandahar/Quetta.

It has now been 85 days between the last reported paralyses case and the last weekly report, and 93 days since the last case in Pakistan. In 2014 in Nigeria, after 91 days 2 cases surfaced. In 2016 in Nigeria 4 cases surfaced related to strain detected only 5 years earlier. In 2012 in Chad, after 118 days 2 cases surfaced. Based on these numbers, a reasonable current estimate seems we will see 2 more WPV cases in Afghanistan as well as in Pakistan. Moveover also last year there were periods in individual countries with close to 90 days without cases as defined above, but currently the case rate is much lower in those countries. However, Pakistan and Afghanistan are seen as a single epidemiological block. This does not take into account environmental surveillance results and intensity.

In these last six month, about 8 times more environmental samples than paralyses cases have been found.

With no recent paralyses cases, in the last month there are many positive environmental samples from Sindh. Other positive samples are from Khyber Pakhtun, Bolochistan/Kandahar/Quetta, and Islamabad. Jmv2009 (talk) 18:10, 14 May 2017 (UTC)

But we need a source that draws the conclusions you want to draw. We can report that there are positive environmental samples, but the implications from these data are not for us to determine. (There is also a technical issue - we can cite PolioThisWeek for a given set of environmentals, but that citation will be invalid a week later.) Likewise, deducing what is 'a reasonable current estimate" is not something Wikipedia editors should be doing, nor should we be predicting future cases (WP:CRYSTAL). Agricolae (talk) 16:01, 18 May 2017 (UTC)

@Agricolae: Do you actually have a reference to the 2015 paper you mentioned above? I'm interested.Jmv2009 (talk) 23:04, 20 May 2017 (UTC)

Sorry, I was going from memory from when I read it, but I must have my chronology off because I can't find it on PubMed. I remember it using frequency of detection of cases and time between known cases to produce probability plots with one axis being 'months since last known case' and the other 'probability that the virus was eradicated'. I distinctly remember observing at the time that it predicted it was unlikely Nigeria had seen its last case, and that by the time the paper had gone through the drawn out review process and been published, there had already been one, as the author(s) had predicted. That being said, I may have the precise details wrong - maybe it was early 2016 instead? Back to your issue, I think the following would represent a reliable source for the problem of surveillance under diminishing viral circulation,[1] but I still think it ought to go up in the Obsticles section (where we could also discuss the difficulties of surveillance in conflict zones, for which I see several potential references, such as [2], and perhaps more soon given that there are reports filtering up, hopefully false, of cVDPV in ISIS-held Syria). Agricolae (talk) 23:40, 20 May 2017 (UTC)

This article: [3] appears to shows that when you have 130 to 200 days (depending on the circumstances) without AFP WPV1 cases, the chance that WPV1 has been eradicated exceeds 50%. Not sure whether this period takes the roughly four weeks into account between onset and reporting.Jmv2009 (talk) 09:46, 21 May 2017 (UTC)

Here is another that is trying to model elimination in Nigeria [4]. Agricolae (talk) 13:19, 21 May 2017 (UTC)

Note that in Pakistan just before July 11 2017 the last reported case was Feb 13 2017, 147 days earlier. Since then there have been 9 cases there. We are now (for the second time I believe) getting over the 100 day mark. Besides that there is a lot of positive sewage, and Afganistan is very problematic at this point. Jmv2009 (talk) 19:06, 24 August 2018 (UTC)

Eradicated? I dont think this word means what you think it means. — Preceding unsigned comment added by 2601:5CB:C080:2A20:413E:D598:46B1:376A (talk) 14:36, 23 June 2022 (UTC)

2014 China

Last month an editor added a line about a research study reporting cases of cVDPV3 in China in 2014. At the time I reverted it because it had not been formally published, being a pre-publication release. I did this in part so we could put off dealing with the conflict, as it has yet to be incorporated into the formal narrative and statistical accounting of the WHO & GPEI. Well, now it has been formally published: (paywalled). So, what do we do with it now? Put it in the text? put it in the table and map? decide that as WP:PRIMARY we can ignore it for the time being? Agricolae (talk) 23:05, 4 August 2017 (UTC)

Wait, per WP:MEDRS:  Primary sources should generally not be used for medical content. TompaDompa (talk) 10:12, 5 August 2017 (UTC)

GPEI table error

I reverted the recent edit even though the numbers given come from the GPEI website. The reason is that the tables suddenly doubled the number of cases in each location, while the accompanying text retains the original numbers (e.g. the Afghanistan text still says 10, though the table says 20, the Middle East section says Syria has 63, the table says 126). As such, we should wait to incorporate these numbers until it is clear they are real (which they certainly aren't or every number would not have precisely doubled - this is obviously some sort of data entry error). Agricolae (talk) 19:48, 18 November 2017 (UTC)

The GEPI webiste is here http://polioeradication.org/polio-today/polio-now/this-week/

The numbers are per week. If there is a difference between the text and the current numbers I would suggest that the text is now out of date.Virion123 (talk) 14:19, 21 November 2017 (UTC)

There is no reason to favor the tables over the text, since all things being equal it is just as likely someone would make an error with one as with the other - they do sometimes have a short delay when the two are updated, with the tables changing first and the text sometimes as much as several hours later, but this updating takes place [usually] on a Thursday and by the end of the day both are almost always in sync. In this case, though, they were in sync immediately after the update, but then on Saturday every number for year-to-date cases in 2017 in the table was doubled - every single one. This is not a simple difference in updating one vs the other, but a data error - just think about it, what are the chances that with four numbers for four countries, each with different regimes for monitoring and reporting, that every one of them would precisely double at the same time? Only Syria had been reporting large weekly numbers, with the other places averaging fewer than one a month, then to suddenly have 88 new cases all the same week, each one doubling the previous number? And to have this massive increase in cases happen without the GPEI taking any formal notice of it, when news of the Syria outbreak trickled out weeks before the numbers were formally reported, and a few years back the Nigeria reemergence was reported via press release immediately? It just isn't credible. That this is was an error is seemingly borne out by the fact that when I looked at it Monday and again right now the numbers have returned to their lower values. I don't know what you are looking at, maybe you need to refresh your cache, but the numbers right now that I see on the GPEI site are Afgh:10, DRC:10, Pak:5, Syr:63, not the doubled numbers from the weekend that you maintain are right.

This brings up something that has been a bit of a concern with this page. The whole approach that has been SOP here for years borders on WP:NOTNEWS - we are so enthusiastic about supplying the most up to date information that we sometimes report what turn out to be false positives (like the South Sudan situation of a few years ago) or data entry errors (which have happened before), only to have to revert a short time later when the errors are corrected. I would suggest it is more important to not report wrong information at the cost of a slight delay in updating, but that is a separate discussion. Agricolae (talk)

We have another discrepancy between the tables and the text on the GPEI site. The tables give Afghanistan 2 cases for 2018, the text gives three. Having been watching it I can confirm that the text is the correct number. With the new year transition, the tables were not created the first week and thus did not record the 1 Jan case. When the tables were created, they only reported two newer cases and not this older one. Until this discrepancy gets resolved, the text should be used as in preference to the table. Agricolae (talk) 15:54, 16 February 2018 (UTC)

And again, this time with Somalia. For the time being, I am going with the text, which provides an explicit accounting of the cases, rather than the table (which may have accidentally double-counted the 2/3 case). Agricolae (talk) 18:18, 19 July 2018 (UTC)

Just to amplify this, the cited source currently gives two different numbers for Somalia. In the table it says 5. In the text it lists 4 cases. This is not a situation of one being updated faster than the other, as the two have been in sync, with a one-case difference, since they reported 2 vs 3 cases (both numbers increasing, or both remaining constant in any given week). In our text we can be vague about the precise count, but our own table requires us to report a specific number and thus we as editors have to decide which of the two, 4 vs 5, GPEI text vs table, is the more appropriate number to use. Given that necessity, we have no context at all for the number in the table - it is just a number. However in the text, each individual case is given a specified location and viral strain typing. Likewise, there is what seems to me to be a likely explanation for the table's miscount, that one of the cases was infected with both strains, making it potentially subject to double-counting. The combination of the detailed accounting in the text and a reasonable explanation why the table might be in error makes the text number far preferable to that of the table. Agricolae (talk) 23:46, 5 August 2018 (UTC)

Thanks for explaining the revert (was about to bug you your talk page). According the "Horn Of Africa" section on the GPEI page "Somalia is reporting a total of four cases (with a total of 5 viruses) in 2018: one cVDPV type 2, two cVDPV type 3 and one case with both cVDPV type 2 & type 3". This is probably the reason for the discrepancy, at least in this case. Tobus (talk) 23:55, 5 August 2018 (UTC)

Fortunately, such discrepancies are rare. Unfortunately, when they happen they tend to persist, there apparently being different persons responsible for the tables and the text, with no comparison between the two. In both the Afghani case at the beginning of the year and this Somali case now, the disparity has rolled over for many weeks without being noticed and resolved. With the WPV cases, we have the Wild Polio case count table to serve as a tie-breaker, but with cVDPV, the Polio This Week web page is our only source (until MMWR publishes one of its periodic detailed summary reports), forcing us to divine the 'correct' situation. Agricolae (talk) 00:26, 6 August 2018 (UTC)

And the table chaos continues. Last week they seemingly corrected the Somalia problem, bringing the two into register, but this week they added another case to Somalia in the table without there being a new case reported in the text, but they also increase PNG by one, when there were two new PNG cases. I am going to continue basing our table on the GPEI text, not their table. Agricolae (talk) 19:44, 31 August 2018 (UTC)

Again, there is a disparity between table and text - GPEI formally reported a 2018 Mozambique cVDPV2 case, and their country description includes this information, but Mozambique was never added to the table and so this case is not included in the GPEI table's 2018 total which is thus one less than the actual total. That is why our cVDPV total for 2018 is currently one more than that given on the GPEI site. It is still an open question how to deal with the 2017 VDPV case, which was not reported as cVDPV at the time, but may have been reclassified following the 2018 case. Agricolae (talk) 21:26, 25 January 2019 (UTC)

Estimated vs. recorded cases

The sentence Due to the large increase in the number of vaccinators and field workers since 1998, the number of estimated cases is thought to be reasonably close to the actual reported number of cases in recent years. dates back to September 2006 (before this article was split off Poliomyelitis), and the same source was used back then. Problem is that as far as I can tell, the source doesn't actually state this, or anything even close to it.

The question of how close to the actual number of cases the reported number of cases is estimated to be is however one we should strive to provide an answer to, if at all possible. I found this by Ochmann & Roser which cites this by Tebbens et al. What do you think, could we use either of these? TompaDompa (talk) 16:21, 4 January 2018 (UTC)

The possibility of surveillance was just discuss in an essay on the Pakistan conundrum. There is more here we might want to incorporate in the 2017 summary:

https://www.sciencemag.org/news/2018/01/what-hell-going-polio-cases-are-vanishing-pakistan-yet-virus-wont-go-away

Agricolae (talk) 17:15, 13 January 2018 (UTC)

Discrepancy between 2017 figures in poliomyelitis article and poliomyelitis eradication article

Issue 1:

Poliomyelitis article has a table of "Reported polio cases in 2017" showing 20 wild cases (12 in Afghanistan) and 86 circulating vaccine-derived cases. Poliomyelitis eradication article says "There were 21 reported WPV1 polio cases with onset of paralysis in 2017" and has a table of "Reported polio cases in 2017" showing 21 wild cases (13 in Afghanistan) and 86 circulating vaccine-derived cases.

Don't know whether 20 and 12 or 21 and 13 are the correct figures. https://extranet.who.int/polis/public/CaseCount.aspx says 20 and 12. http://polioeradication.org/polio-today/polio-now/this-week/ says 21 and 13.

If possible, find out which is correct and fix the other article. If not possible to determine correct figures, then put both sets of figures ("20 or 21" for global total; "12 or 13" for Afghanistan) in both article and tag them with a note saying that there is a discrepancy between WHO and the other source.

Issue 2:

Article lead gives figures for 2016 but not for 2017. After determining correct figures to use for 2017, please update article lead to include them. 47.139.44.60 (talk) 06:25, 9 January 2018 (UTC)

Issue 1:  Done. The Poliomyelitis article has been updated.
Issue 2:  Not done yet. The figures are still subject to change because of the delay in reporting. TompaDompa (talk) 09:39, 9 January 2018 (UTC)

Seems I jumped the gun when I updated from 2016 to 2017, another case snuck in on 28th December. Chris Jefferies (talk) 15:34, 21 January 2018 (UTC)

This is pretty standard - there is always a delay in detecting and reporting cases. The recent 'new' Congo cVDPV cases are still from November. There is no need to rush this, only to create yet another line of text that will need to be updated if a new case comes in. About mid-February, when all of the new reported cases have an onset of January or later, is early enough to put a pin in 2017, particularly given that we have a whole section for the year. Agricolae (talk) 15:45, 21 January 2018 (UTC)

Virus types

I appreciate what is trying to be done here, but I am not sure the summary matches the data. For the Northern corridor, the cited source shows, in the 6 months of July 2017 to Jan 2018 that would fall roughly within the 'past year', two R4B5C5 cases, and one R4B1C1, and The Nation article suggests the new KP case is also R4B1C1. In the Southern corridor it shows two R4B5C4 and one R4B5C3. Thus it seems oversimplification to focus in on one in each corridor as 'the major' one. Agricolae (talk) 16:41, 8 September 2018 (UTC)

I feel like the information doesn't add anything on its own. To the average reader, the types just look like a random collection of letters and numbers. I think we should either cite a source that discusses the significance of this or remove it entirely. TompaDompa (talk) 16:54, 8 September 2018 (UTC)

(e/c) I tend to agree - maybe something a bit less specific. Agricolae (talk) 17:12, 8 September 2018 (UTC)

The MMWR report states that there are only two clusters in Afghanistan (with >95% match). Pretty sure its R4B5C5 in the north and R4B5C4 in the south, based on continuation of the epidemic as specified in the IMB report. But let's just leave it like it was just proposed, to be sure. My feeling is that it's good to specify strains, as it makes patently clear, despite the obscurity of the letters, that the clusters are clearly individually specified, and that there is more of a North/South cluster than an Afghanistan/Pakistan cluster.Jmv2009 (talk) 17:04, 8 September 2018 (UTC)

Anything that begins with 'Pretty sure' looks too much like WP:OR for my taste. As you were posting this I tried a version retaining the concept of different viral subtypes without getting into the alphabet soup. Agricolae (talk) 17:12, 8 September 2018 (UTC)

You are probably right with regard to Afghanistan, but both of the KP cases on the Pakistani side of the northern corridor within the past 13 months have been R4B1C1 - given we have different types on the two sides of the border, is this even a corridor any longer? In Pakistan-south, I haven't found typing for the three cases this year (this may be in the The Nation piece, but I am not familiar enough with Pakistani geography to recognize the locations he is referring to) but they all fall within a single localized cluster and may not represent the scale of what is happening with the more widespread environmental positives anyhow. That means all we have to go on really is the raw data from 2017, from which we are forced to draw our own conclusions - a no-no. Agricolae (talk) 17:23, 8 September 2018 (UTC)

Actually the weekly AFP report [5] of Pakistan as referenced shows the type as R4B5C4(D), the same strain as all the kandahar and Sindh cases at the end of last year. Only Bolochistan (in between Sindh and Kandahar) had R4B5C3 at the end of last year. From the AFP report we'll know soon what the new KP case is. I agree we need to be very careful with the phrasing here.Jmv2009 (talk) 18:26, 8 September 2018 (UTC)

I see that now regarding south Pakistan cases, but as I said, the cases themselves are really not the whole story in Pakistan given how widespread the positive environmental samples are. Certainly in the north, the Afghani ones from last year (and I assume this year) vs the two KP ones are different strains (if I am reading it right The Nation cite is telling us the new KP one is the same as last year's R4B1C1, not the R4B5C5 that was at least last year's Afghani ones). Particularly with case numbers so small, we need to be careful in drawing our own conclusions regarding what represent the 'major' strains worth relating and which represent the 'minor' strains. As Tompa says, we really need to have a WP:RS doing this analysis and summarizing what is going on on the sub-type level, rather than us drawing it from the raw data, if we are to report it with this level of detail. Agricolae (talk) 19:05, 8 September 2018 (UTC)

So the new KP case is R4B5C5(B2), indicating it is similar to the AFP cases late last year in North-East Afghanistan. Together with the statement that only two clusters have been AFP-active (MMWR report), it's pretty safe to say that North-East Afghanistan is R4B5C5 and south Afghanistan is R4B5C4 in the south, the same types as have been found as AFP cases in Pakistan. Jmv2009 (talk) 12:36, 14 September 2018 (UTC)

'Pretty safe' is not the standard of Wikipedia. We really need a WP:RS that not just reports the types, but makes the analysis and draws the conclusions you want to draw. (For that matter, 'strains causing cases' is a deceptive measure of the situation. The important factor is strains being detected, whether in cases or in environmental sampling - if it is still known to be around it is still a factor, even if it hasn't resulted in a detected case in a while, though I don't even know if they do strain-level typing of environmental positives.) At its heart, though, I just think you are pushing the envelope too far. While I have gone along with it, I am not entirely comfortable with our weekly updates, that themselves represent extraction of raw data in a manner not entirely consistent with policy, but to dig into the raw data and extract strain information, then draw big picture conclusions from it, definitely seems too far to me. Agricolae (talk) 14:53, 14 September 2018 (UTC)

I am still not comfortable with reporting strain information. I am not questioning that it is WP:V, but any time you have to dig data out of a data table in the middle of a Powerpoint presentation, rather than from an explicit statement to that effect, it suggests providing the details are out of WP:PROPORTION with the level of coverage we should be aiming at. Agricolae (talk) 15:05, 28 June 2019 (UTC)

I agree. I removed it. TompaDompa (talk) 21:53, 28 June 2019 (UTC)

References

Plots

It seems a bit odd that we give a plot of cVDPV cases in the main body of the article, but only plot the wild virus when we get down to the timeline section. I am thinking we might want to move the latter plot up (perhaps stacking the two plots at about the position the cVDPV plot now occupies), or move the cVDPV plot down. Thoughts anyone? Agricolae (talk) 19:35, 9 November 2018 (UTC)

I have no strong feelings about this one way or the other. TompaDompa (talk) 21:05, 13 November 2018 (UTC)

I juxtaposed the two plots a while back, but want to make a request for anyone who updates them in the future - make the WPV cases the same color in both plots, with the cVDPV cases being a different color. Agricolae (talk) 16:08, 21 December 2018 (UTC)

Please clean up duplicate references

For example,

Government of Nigeria reports 2 wild polio cases, first since July 2014". World Health Organization. Retrieved 2018-08-25.

is listed twice, identically, and

"WHO | WHO Removes Nigeria from Polio-Endemic List". www.who.int.

is listed twice, but with different retrieved dates.

47.139.41.39 (talk) 03:06, 31 December 2018 (UTC)

You know, you could clean them up. Agricolae (talk) 03:36, 31 December 2018 (UTC)

 Done TompaDompa (talk) 11:24, 2 January 2019 (UTC)

Pk environmental

I have several problems with this sentence. First, I don't find the standard error number given anywhere in cited source - this is not the kind of simple calculation we are allowed to do. Also, the comparisons based on this number are highly misleading for two reasons. First, they have changed their prioritization of site testing (e.g. infected Lahore is almost twice the proportion of the total tested samples in 2019 as in 2018 or 2017). Likewise, as with most viruses, polio undergoes seasonal fluctuations, and so comparing samples from one month to those from an entire previous year is sort of apples and oranges. Short-term figures are also more prone to sampling error.

Setting all that aside, though, the bigger problem is that we really have no business pulling a cell out of a single table in the middle of a 30+ page datadump. If a secondary source draws attention to this figure, fine, but it is not up to us to dig through that whole document and decide that this is the one number that we should be reporting. Agricolae (talk) 10:55, 16 February 2019 (UTC)

Why are you switching to a different argument? The original argument was that it is STATISTICALLY not significant. Do you now disagree with your statement "proportion of positive env samples based on too small a dataset to be statistically informative"? Jmv2009 (talk) 12:39, 16 February 2019 (UTC)

No switching here. 'Statistically informative' and 'statistically significant' are not the same thing. 37 datapoints drawn from a single month (when there is well-documented seasonal variation), and with sampling skewed toward sites of likely infection, do not provide an informative comparison with whole-year averages of >600 samples representing a much broader seasonal and geographic distribution. So no, I don't disagree with my original statement. That being said, now that you mention it, statistical significance is problematic too: one can't really derive an indication of statistical significance by applying a calculation of standard error explicitly predicated on random sampling to a dataset that is decidedly non-random. These are not data that lend themselves to statistical hypothesis testing. Agricolae (talk) 17:57, 16 February 2019 (UTC)

When doing a measurement, typically a "systematic" error/"bias" and a "statistical" error are distinguished. The "statistical" error is usually assigned with the noise of the measurement, and gets smaller with more data. With 37 datapoints and around 50%, the standard error is the 8% (~0.5/sqrt(37)), which I consider the "statistical" or "sampling" error. You appear to be sweeping all errors under "statistical", which may our misunderstanding. In my view, this discussion is kind of moot anyway, because this very figure is quoted in every pamphlet-style monthly polio update at [6]. and [7] and widely referred to. So this figure represents much more than just a cell in a table out of a 30+ page datadump. And yes, the sites are skewed, there is seasonal variation, which is why it said "year-to-date", which in principle may cause biased, e.g. higher results. However, I have not found any indication in reviewing all the data why it should be especially biased early year. Also late last year the year-to-date numbers increased dramatically, indicating an uncharacteristic high momentary incidence of positive sites. E.g. of the last 176 samples from last year, 28% +- 3% statistical standard error were positive.[8][9] The year before, this was not the case.[10] For comparison, last year, in early February, there were 21% +- 7% positive samples, much lower than the 51% +- 8% positve samples at the same time period this year. Moreover, there are already 4 positive Pakistan cases as of yesterday this year. Without trying to paint an unfair or alarming picture or getting into original research, one could show a very basic comparison between numbers. Jmv2009 (talk) 22:35, 22 February 2019 (UTC)

I have no interest in discussing statistical semantics: I don't think those data provide an informative comparison to full-year totals of prior years, and any attempt to compare it to individual months of previous years is clearly WP:OR. Though obviously you think it is an informative number, I don't. This difference of opinion underlies why Wikipedia prefers secondary sources, to let the broader community decide what is important and noteworthy. Last year, it was I who added the percent positive environmental samples in Pakistan, not because it was in the Pakistani government report, but because a commentary in a mainstream international media source specifically addressed the apparent disparity between no actual polio cases in Pakistan but widespread environmental presence, and which reported the precise percentage at the time. I would suggest that once the Pakistani numbers spiked to a level more consistent with environmental sampling, that figure was perhaps no longer worth reporting, but there is an inertia whereby once it gets in there, it tends to stay. Anyhow, the closer we get to the primary data reports, deciding ourselves what is important, the farther we get from what we should be doing. I have repeatedly expressed my concerns that this page is too driven by the weekly reports (that hasn't stopped me from doing updates - if it is going to have that level of data, it needs to be kept up to date), and the same applies to doing deep data dives into governmental primary reports, whether it be to mine a table for one data cell reporting fraction of positive samples three weeks into the year or to provide an analysis of specific viral strains. If someone in the mainstream media reports, OMG!, half of the environmental samples collected in Pakistan so far are positive, then yes, by all means, it should be in the article. If it is just us (or the Pakistani government) deciding that is a worthwhile number, perhaps not so much. Agricolae (talk) 23:53, 22 February 2019 (UTC)

You appear to suggest only sensationalist media is valid sourcing, which I am sure you are not meaning. By comparing months, I was just disputing your assertion that seasonal variation may be the source of the high values seen. I am not sure why the environmental sampling would give a much earlier signal than the case number; A couple of weeks at most. The other effect is that of the order of 10x more positive samples are found with environmental sampling, so the relative shot/poisson noise is about sqrt(10) times lower. Anyway, I added the pamphlet of January and 2018 to the env. data references. Jmv2009 (talk) 20:17, 23 February 2019 (UTC)

Who ever said anything about sensationalism (well, other than you)? Secondary sources are preferred. Full stop. And what I said about statistical semantics also applied to poisson noise and square roots, which clearly do not fall under the umbrella of simple calculations that Wikipedia editors are allowed to do without it being WP:OR. Agricolae (talk) 21:22, 23 February 2019 (UTC)

New 1967 Images

Maybe having three images of vaccine being delivered, but two of them from the same year and same (current) country lacks a certain diversity. Perhaps one or the other, but not both. Preferences? Agricolae (talk) 15:50, 12 March 2019 (UTC)

What would be really nice would be a free image representing one of the currently endemic countries, especially presenting a more typical local vaccinator; something like the images in [11] or [12]. Espresso Addict (talk) 03:11, 14 March 2019 (UTC)

Yes, quite. A recent image of local vaccinators delivering OPV in endemic countries (or other at-risk, e.g. Somalia, DRC, even Syria or Papua) who have been doing the critical work on the bleeding edge (sometimes literally). If we have this, it might be good to contrast with an IPV injection in the developed world, but showing the latter alone would risk giving the wrong impression. Agricolae (talk) 14:43, 14 March 2019 (UTC)

GPEI updates

It might help to remind editors again that the GPEI site is a little bit quirky in the way it updates. The text and the tables update separately, and this week is a perfect example. The text says that there were three new polio cases in Afghanistan, while the table, as of this moment, has not been changed from last week. It also describes in the text a case in Somalia which does not appear in the table. It is thus problematic to change our 'as of' date to reflect this week based on GPEI data that have yet to be fully updated. On the flip side, last week the GPEI table showed a new DRC case, while the text said there had been no cases there since last year and only added the new case in this week's revision. This is something that we are repeatedly going to have to struggle with as long as we insist on keeping this page 'up to date' the minute the date changes on the GPEI site, particularly now that the Wild Poliovirus list appears to have gone to monthly updating, leaving just the GPEI weekly report. At a minimum, we will want to make sure we are accurately reflecting what the entire update says (not just the table), preferably after the week's updating at GPEI has been completed, before doing our updates, and if that means we have last week's data for an extra day or more, so be it. Agricolae (talk) 18:40, 26 April 2019 (UTC)

The country sections are kept up to date. The main table does lag a bit. Virion123 (talk) 15:57, 28 April 2019 (UTC)

It also seems we need a new map of countries affected. Anyone able to do this? Virion123 (talk) 16:06, 28 April 2019 (UTC)

Except the country sections are not always kept up to date - just last week the table was updated for DRC but the country section was not. That is why it behooves us not to just assume either the text or the table is right, but when there is a conflict wait until it is clear which is right before making the update. And the last thing we want to do is to huddiedly replace the 'as of' date without updating all the numbers that have changed for all countries, because it signals incorrectly that the appropriate count modifications have already been made. Better to have an older date when the data was fully updated than replace it with a newer date but partially out of date data. (I have said it here before - I slower but accurate is better than faster but inaccurate/incomplete). I already prepared an updated map, and was waiting to upload it until Somalia had been added to the text. Agricolae (talk) 18:19, 28 April 2019 (UTC)

Is it still endemic in Nigeria? Article is inconsistent

Lede says "Three countries remain where the disease is endemic—Afghanistan, Pakistan and Nigeria."

But tables for individual years show 2016 as the last year when it was endemic in Nigeria and show Pakistan and Afghanistan as the only two countries where it is still endemic.

Please figure out which is wrong and fix it.47.139.42.94 (talk) 06:06, 15 August 2019 (UTC)

Three years must pass since the last case for a country not be considered endemic. Ruslik_Zero 10:03, 15 August 2019 (UTC)

Equally important, this is not for us to decide on Wikipedia - GPEI and WHO still classify it as endemic. They are taking a 'better safe than sorry' approach this time around - in 2016 they declared Nigeria no longer WPV endemic after two years without a case even though there was a region of the country where insurgency rendered monitoring impossible, only to have to announce the next week that there was a new case and they had to reverse the status change. Agricolae (talk) 21:11, 16 August 2019 (UTC)

The date of last detection is explicit in the cited source, October 2016. We can't change this to September while still citing this source that says it was October. Agricolae (talk) 07:46, 28 September 2019 (UTC)

3 years have passed now 47.139.41.188 (talk) 03:50, 29 November 2019 (UTC)

It is not about time, it is about certainty that it is no longer circulating, so it remains endemic until GPEI/WHO announce it isn't, no matter how long that takes. Nigeria is currently the epicenter of a major vaccine-derived polio outbreak, which has nothing to do with its (non-)endemici status for wild poliovirus, but they perhaps have their hands full, plus announcing that that polio is no longer endemic might be counter-productive, when it is critical the country achieves higher vaccination rates to fight the vaccine-derived epidemic. Agricolae (talk)

The GPEI and WHO no longer list T1 Polio as endemic in Nigeria Updating the article 216.180.78.11 (talk) 23:30, 17 July 2020 (UTC)

Second opinion

I am of two minds on the appropriateness of including the following, which while published in what Wikipedia would consider to be a reliable source still has the sniff of rumour mongering/conspiracy theory disguised as medical reporting.Pakistan accused of cover-up over fresh polio outbreak. Agricolae (talk) 22:12, 12 November 2019 (UTC)

That is of course a very serious accusation, not to be taken lightly. If the accusation turns out to be true, it would be the kind of content that requires WP:EXCEPTIONAL sourcing. I say wait for now, and take our cues from the sources. If the story develops, we can include it. If the accusation itself gets very widespread coverage, we can mention that there has been an accusation. If the story "fizzles out", let's leave it off the page. TompaDompa (talk) 06:09, 13 November 2019 (UTC)

Conflicting info on GPEI page

As has happened before, there is conflicting information between the table and text of the PolioThisWeek page. For Angola, the table shows 16 cases, the text 41. The table number dropped inexplicably last week after tracking with the new cases reported weekly and with the text up until that time. While this could be a case of duplicate counting giving the larger number that was discovered and reversed, it seems more likely to be a data entry error in the table, so I have gone with the text for this one. For Somalia, the text has an atypical format, adn says the last case was in 2018, but the table says there were three this year, and those appeared progressively as the cases were reported, so I think here the text is in error and have gone with the table. There are other entries that are inconsistent with prior weeks but are in agreement between text and table, so the value reported there is given. Agricolae (talk) 19:44, 15 November 2019 (UTC)

The latest GPEI update has brought Angola back into register. The Ethiopia/Somalia outbreak(s) coverage is still problematic. The text is internally inconsistent with regard to Ethiopia, first saying three cases, then two, and for Somalia the weekly updates and the table have reported 3 cases, while the text says the last case was in 2018. I have gone with the table for this and will continue to do so unless the reason for the conflict becomes clear. Agricolae (talk) 18:11, 22 November 2019 (UTC)

Relevant AfD

Wikipedia:Articles for deletion/2019 Philippines polio outbreak Agricolae (talk) 18:15, 22 November 2019 (UTC)

Graphs in Vaccine-derived poliovirus section need updating

One shows "Number of wild poliovirus cases, 1975–2017". Please add 2018 and 2019. Other shows "Number of cVDPV cases, 2000-2018". Please add 2019. 47.139.41.142 (talk) 19:06, 25 January 2020 (UTC)

It would also be good were the colors of the cVDPV plot to be switched, so that the WPV in the two plots are shown with the same color. That being said, the 2019 data are still coming in, so until that stabilizes, any change would have to be redone anyhow, so it would be better to wait another month or so before doing the updates. Agricolae (talk) 19:33, 25 January 2020 (UTC)

Just in case this is missed, the GPEI have very belatedly detected an additional 2019 cVDPV1 case in Yemen from late 2019, so when next updated these charts are updated the cVDPV number for 2019 needs to be increased by one. Agricolae (talk) 15:06, 23 August 2020 (UTC)

map update

2020 map needs updating — Preceding unsigned comment added by 88.115.204.102 (talk) 21:11, 4 February 2020 (UTC)

Verb tenses in 2019 section

Phrases in the 2019 that are written in the present tense, such as "in Pakistan the number of cases is surging" or "polio is classified as endemic" need to be changed to past tense.47.139.43.188 (talk) 18:19, 8 February 2020 (UTC)

Yes, and anyone can make those edits, even you. Agricolae (talk) 18:22, 8 February 2020 (UTC)

Tables

@Agricolae: Yes, stacking tables is an improvement, it looks better. Esszet (talk) 11:27, 27 August 2020 (UTC)

I have to side with Agricolae here. Stacking the tables messes up the alignment with the text. TompaDompa (talk) 11:38, 27 August 2020 (UTC)

In my typical half-screen view, it put the 2020 table up next to the text for 2017. Viewed full-screen it puts the 2020 table down below the See Also section. Yes, the white-space between years is awkward, but it is the only way of aligning the tables with their respective years. Agricolae (talk) 13:31, 27 August 2020 (UTC)

Making the tables collapsible could be an option. TompaDompa (talk) 13:33, 27 August 2020 (UTC)

Sorry for the late response, I didn't realize that people read Wikipedia in half-screen, it was basically fine in my (full-screen) view. I guess making them collapsible would be an option. Esszet (talk) 12:51, 4 September 2020 (UTC)

Codecruft

Is it really necessary to insert archived copies of live links given that there are bots that do routine dead-link/archive repair? To me, it bulks out the article with pointless code that makes it harder to find the text one wants to edit. Agricolae (talk) 17:50, 3 September 2020 (UTC)

A few questions to clarify the problems and dangers of polio eradication

I wonder how they determine if the polio case was a WPV or a cVDPV. Tried to ask this on a different site and all they explained is that the symptoms of WPV and cVDPV do not differ. Also, why are there so many cVDPV cases in the last few years? A very strange situation, in my opinion. First, 95% of African people are vaccinated against polio. Without it, WHO wouldn't probably certify the continent as being wil polio-free. Second, as I know, type 2 polio vaccine production was discontinued in 2016 or so. Modern vaccines must contain just types 1 and 3. Does anybody still use old oral polio vaccine? And is it good to treat all vaccine-derived polio outbreaks with more and more vaccination rounds?.. It looks like a mindgame. I understand the necessity of vaccination and I am not an anti-vaxxer; however, I think each person must be treated individually. I am not sure if a child, according to jurisdiction (laws), must be considered as parents' property (I have no children). I know some Pakistani parents are hiding their children from the vaccinators or refuse vaccination by all means. By the way, I am gravely concerned about polio situation in Pakistan. Is it true that sometimes a child receives 7+ vacine rounds but still gets wild polio?.. Again, very strange. I think scientists should work on polio vaccines every year and update them to prevent this. Otherwise, old vaccines may become pretty useless if this continues to happen. Also, does the religion of islam even allow vaccinating all the children?.. Why were was no such problem when we were eradicating smallpox in Pakistan, and why do Pakistani clerics consider that polio vaccine contains pork or alcohol? Simply ridiculous! One additional question. If a person has had polio and survived, then is he/she considered completely healthy? I guess the presence of the people who have already had polio does not affect global polio eradication. Thanks a lot. I think this thread can be useful for the encyclopedia, for the sake of free knowledge. 89.149.79.161 (talk) 21:06, 10 September 2020 (UTC)

• There are a lot of questions packed in there, but suffice to say that there is a tremendous amount of misinformation about vaccines and vaccination on the Internet. The oral polio vaccine has the advantages of being easier to transport and administer, and the disadvantage of potentially transmitting a live polio infection (the interdermal vaccine does not use a live virus). So far as I am aware, every jurisdiction in the world either gives the parents authority to have their children vaccinated, or treats the children as property of the state for this purpose. There is no principle of Islam prohibiting vaccination, and in fact most Muslim countries in the world have very robust vaccination regimes, often more so than Western countries. In general, work is constantly being done to improve elements of all vaccines, but polio is fairly stable; unlike the flu, it does not mutate quickly, so the vaccine does not need to be changed to accommodate any change in the virus. Of course, if polio were successfully eradicated, then (as with smallpox) the need for polio vaccination itself would be eliminated. With respect to survivors, it is possible to survive polio unscathed, but many survivors experience permanent disabilities as a result. A famous example is Franklin Delano Roosevelt. BD2412 T 21:23, 10 September 2020 (UTC)
  • Roosevelt's diagnosis has been called into question. It can't be conclusively proven now whether or not he had polio, but it's considered more likely that he had Guillain–Barré syndrome (GBS) and not polio. See Paralytic illness of Franklin D. Roosevelt#Retrospective diagnosis47.139.41.132 (talk) 06:29, 9 November 2020 (UTC)
• [edit conflict] :This is not really a forum for discussing general issues about a topic, but I will answer some of your questions. 1) they distinguish WPV from cVDPV by genetic sequencing of the virus. Each cVDPV will have a number of unique mutations that allow it to be identified, not only as a cVDPV and not WPV, but also which specific strain, whether it represents a newly arisen outbreak or, based on shared mutations, is the same virus as an existing outbreak (most of the cases in West Africa all come from a strain that arose in Nigeria many years ago, while most of them in Angola are novel outbreaks). 2) Why are there more recently - because they quit vaccinating with OPV2 as part of the standard vaccine. The idea was to break the catch-22, where vaccinating with OPV2 just causes additional cVDPV2 outbreaks unless you achieve very high vaccination rates (95% isn't good enough), and have no unvaccianted reservoirs (e.g. areas of unrest that cannot be accessed by vaccination campaigns). They withdrew it, then looked for cases, and went in with separate OPV2 vaccine to suppress the outbreaks. Unfortunately, they had a lot more outbreaks than they were expecting (these were cVDPV strains that were already circulating undetected before they quit OPV2 vaccination), but then when they came in with the OPV2 vaccine to try to put down the newly-discovered outbreaks, that just introduced the PV2 strain into populations that had not been vaccinated for it in a couple of years, and they had a whole lot more novel cVDPV2 strains pop up. There is a new OPV2 in development that that is much less prone to causing cVDPV cases, and it is hoped that will let them get ahead of the catch-22. 3) why are some vaccinated multiple times and still get polio? Some people have weak immune systems generally, or because of their personal genetics or some quirk of their history of virus exposure, thy just don't respond to the vaccine to build immunity. That is why you need near-100% vaccination to suppress transmission, because the vaccine is not effective in everyone and those in whom it doesn't work must be added to those who don't get the vaccine as potential spreaders (and some with weakened immune systems can be super-spreaders - they can never successfully fight off the vaccine virus, and continue to have active virus in their circulation (and potentially in their excreta) for as long as decades after being vaccinated. Changing vaccines will not solve this, as most of the people involved could not raise antibodies to any polio vaccine 4) Islam does permit vaccines, so long as they are not made with ingredients that are haram, but you can't stop conspiracy theories and viral (in the internet sense) false information from spreading. And it doesn't help that the CIA used a fake vaccine campaign as a way to collect blood samples to confirm the location of Osama bin Laden 5) what is different now than with smallpox: a) the vaccine is different - smallpox used a cowpox vaccine that could not possibly cause small pox; b) the world is a different place than it was 50 years ago. 6) is someone who recovers healthy? no. The most extremely affected people are permanently paralyzed, even their diaphragms, requiring lifelong intubation/mechanical respiration. Less extreme but more frequent is permanent paralysis of the lower body. A larger group have some symptoms but seem to recover full mobility, but even they can develop a Post-polio syndrome seen decades later that is still not well understood. Agricolae (talk) 21:54, 10 September 2020 (UTC)

Another possible answer both for how the present situation is different from smallpox eradication and for why some vaccinated children get infected anyway is HIV/AIDS. It causes significant decrease in immune system performance.47.139.47.1 (talk) 22:10, 26 December 2020 (UTC)

This sentence is unclear. AIDS is caused by a separate and distinct virus, and there is no evidence that any vaccination has any impact on developing AIDS. Are you suggesting that a pre-existing presence of AIDS in children affects the immunogenicity of the polio vaccine? BD2412 T 22:49, 26 December 2020 (UTC)

How long is cVDPV a danger?

The article doesn't seem to mention this. I see above that immune-compromised individuals can be infectious for decades, but most of the problem seems to be from cVDPV. How many months? years? is that an issue, after we stop vaccinating for a particular strain? That is, how long does the break in transmission of cVDPV need to be, to be confident it's been eradicated? (I'm assuming the contact immunity from attenuated OPV is due to a much lower rate of transmission than WPV, or else we wouldn't need to keep revaccinating.) — kwami (talk) 10:56, 11 September 2020 (UTC)

The situation with cVDPV is the same as with WPV, except that in particular with the cVDPV2 strains there tend to be a much larger proportion of asymptomatic carriers. Other than in the rare immune-compromised long-term infections, their timelines for disease progression and virus clearing in an individual are no different. How long vaccination will have to continue after the last identified case is an open subject of discussion. Some say decades, some say much shorter or complacency will set in, vaccination rates will drop, a whole bunch of new cVDPVs will arise, and we are back to square one. The fact is, nobody really has a good idea how the endgame will play out, and they are putting a lot of hope in vaccine innovation to allow less expensive, more heat-stable injections, and orals less prone to mutation. Otherwise there is no good plan for breaking the vaccine-cVDPV cycle other than just trying really hard to achieve vaccination rates sufficient to both both block transmission of existing strains and prevent new ones from arising. Agricolae (talk) 18:37, 11 September 2020 (UTC)

Thanks. I would think that every mop-up round with cVDPV2 would lead to a smaller number of new outbreaks, as a smaller population and fewer countries would have been vaccinated against it. If you mop up a country and there's no new outbreak, it's gone for good from that country, right? (Assuming it's not reintroduced from a neighbor.)

Is there a chance that we will see PV1 and cVDPV3 eradicated, so we're continuing with only monovalent PV2 vaccines?

Speaking of which, why haven't we gone to to routine monovalent PV1 vaccines, since PV3 is now only vaccine-derived? — kwami (talk) 19:13, 12 September 2020 (UTC)

Since this page is really for talking about improvements to the page and not general discussions of the topic, I have responded on your User Talk page. Agricolae (talk) 19:28, 12 September 2020 (UTC)

Numbers update / stable vs dynamic citations

Passing under my radar, GPEI has made several additions to the 2019 case counts, both for WPV and cVDPV. I have incorporated these into the narrative and tables, but these totals will need to be changed for the plot.

I have also removed all of the PolioThisWeek references from prior years, as the narratives on that page change weekly and it no longer provide the cited information. They have a new set of stable weekly tables for cVDPV, matching the stable weekly Wild Poliovirus tables, and these stable tables should be used for any case numbers that aren't expected to get stale, rather than PolioThisWeek. There are currently duplicate references for both, but I anticipate the references in the current year to be replaced by newer weekly tables, while those in previous years can retain the stable fixed-date tables I just used to replace PolioThisWeek. Agricolae (talk) 15:58, 9 November 2020 (UTC)

Pakistan or Malawi?

https://www.bbc.com/news/world-africa-60429726

Malawi finds Africa’s first wild polio case in five years

"As the case came from Pakistan, it does not affect the continent's wild poliovirus-free status, the World Health Organization (WHO) says." — Preceding unsigned comment added by 88.112.31.26 (talk) 23:05, 21 February 2022 (UTC)

Pakistan pens and fraud

https://www.theguardian.com/global-development/2022/jun/07/polio-outbreak-in-pakistan-worsens-as-eighth-child-reported-paralysed this looks relevant. — Preceding unsigned comment added by 193.1.64.8 (talk) 07:48, 7 June 2022 (UTC)

UK

VDPV2 found in sewage samples in the UK: [13] --Uhooep (talk) 14:19, 22 June 2022 (UTC)

map needs update

reported case in orthodox community in Suburbs of NYC 2600:1702:9F0:D140:B9F3:65A1:9:7E43 (talk) 09:32, 22 July 2022 (UTC)

THe map does need updated, but ntot for this reason. We base the map on the data table. We base the data table on the formal weekly announced case count from GPEI. This weekly account has yet to report the US case. It should be mentioned that it may never show up there - the GPEI has rules on what qualifies as a cVDPV case versus what qualifies simply as a vaccination contact case, that they don't count (note that the sewage hit in the UK has not been tabulated, presumably because it is being interpreted as vaccine and not cVDPV). We usually wait until GPEI records a case before we even mention it in the article, but the media freakout both in the US and UK makes it hard to wait. Agricolae (talk) 20:09, 22 July 2022 (UTC)

Someone please update 2022 map and table to include New York State (USA)

47.139.45.80 (talk) 22:30, 24 July 2022 (UTC)

See above. Agricolae (talk) 05:48, 26 July 2022 (UTC)

2023

Should a 2023 section be made yet? There is data available for which to build a page. - [14]https://polioeradication.org/wp-content/uploads/2023/01/weekly-polio-analyses-WPV-20230124.pdf Watch Atlas791 (talk) 04:54, 31 January 2023 (UTC)

The 2023 section has been created and I have added a case table to it. It needs a map (2022 map should also be updated to include Mali), and it can be expanded if there are good sources for it. Coolclawcat (talk) 22:36, 27 February 2023 (UTC)

Country statuses in case tables

@Kwamikagami: I disagree with some of the changes in this edit:

1. I don't think Mozambique should be classified as "reintroduced" in the 2023 table. My understanding of what the status "reintroduced" means, at least in how it's used in the article to interpret GPEI terminology, is "a country certified as (wild) polio-free that had WPV cases, originating in another country, detected in that table's year". It isn't a status like "endemic" or "polio-free" that remains even if new cases are/aren't detected in a given year, nor is it different from "polio-free" as the GPEI views it. It's used in the tables to differentiate from endemic countries while still recognizing that the country had WPV cases. Mozambique doesn't qualify for 2023, as there hasn't been any WPV cases detected there in 2023.
2. The "so far...only" added to the Mozambique "Types" cell is a bit redundant and inconsistent, as the "so far" is implied for all countries given the "As of [month] [day]" at the beginning of the 2023 section text, and the "only" is implied by the omission of all non-detected polio types from the country's cell in the "Types" column.
3. You appear to have inadvertently edited the Madagascar row instead of the original Mozambique row, changing it to "Mozambique" and making the above changes to it; there are now contradictory duplicate rows and no Madagascar row.
4. Afghanistan being added as a row without any cases seems strange to me. In my limited experience editing this article, countries have usually only been added to the table when a case is recorded there, even if the country is classified as endemic. Nigeria did not have any recorded cases from 2017–2019 but was/is classified as endemic during that time, yet the case tables from 2017–2019 don't list it as endemic (2018 and 2019 list it as cVDPV only, and 2017 doesn't list it at all). If Afghanistan is added as an empty entry, then that creates inconsistencies with the 2017–2019 tables. I'm not necessarily opposed to the caseless entry; I just want consistency between the 2023 table, the 2017–2019 tables, and the GPEI sources we're building the article off of.

Thanks for your time. If there is something I have overlooked or you think I am mistaken about some or all of these points, I'm willing to listen. Coolclawcat (talk) 04:52, 26 April 2023 (UTC)

Hi Coolclawcat,

Looks like I misunderstood the situation with Mozambique. Sorry about that. My understanding was that wild polio hadn't just been detected, but that it had become endemic. I thought there was a difference in the word choice of "imported" vs. "reintroduced". I must've misread something; I'm no longer as current on the situation of polio as I once was.

If Mozambique is not now an endemic country (just some imported cases last year), then I agree that we should not list it until cases are detected this year, and that it should also be blue on the map until/if that happens. [I've now made those changes.]

As for Afghanistan, I suppose we could go either way. We expect that there is ongoing transmission in Afgh. If the number of reported cases is 0, that is presumably either because cases are not being reported (conditions there are bad), or because outbreaks are seasonal, and the virus lies low until monsoon season. I think that Afghanistan should therefore be listed in the table, and marked as red on the map, until the WHO declares it polio-free. But that's just my opinion; if you feel strongly the other way, I won't argue about it. — kwami (talk) 05:05, 26 April 2023 (UTC)

Okay, I fixed the screw-up with Madagascar, and changed Mozambique to blue, as there have been no imported wild cases reported this year. Does that adequately address those concerns?

That leaves whether we should list Afghanistan. I disagree with you there, but as I said, I don't feel strongly enough to dispute it if you revert me. So, your decision. — kwami (talk) 05:26, 26 April 2023 (UTC)

Thanks for self-reverting. My main concerns have been addressed, and the Afghanistan row I'll leave as-is since the table inconsistencies I mentioned are pretty minor. Coolclawcat (talk) 01:44, 27 April 2023 (UTC)

2023

I am not so happy about this paragraph:

Cases of wild poliovirus continue to be focused in Pashto-speaking communities in the Pakistan/Afghanistan border area,...

...program efforts in Afghanistan are threatened by conflict and restrictions on eradication staff movement, while Pakistan suffers from a lack of political will and complacency with falling case numbers, particularly at the district and provincial level.

They come from one source that dates 2021 and reports on the ten years prior and so does not exactly fit into the 2023 section. Afghanistan has calmed down considerably and is no longer threatened by conflict and Pakistan's political will has probably changed as well.

Maybe it could simply be replaced by some mentioning of the last remaining provinces in Afghanistan and Pakistan where cases still occur. Gazfre (talk) 18:23, 9 August 2023 (UTC)

Unless we have RS's that the situation has improved, maybe we can just say that there has been a problem over the last decade or so, using that source, and leaving it ambiguous as to how much a problem there still is? — kwami (talk) 19:36, 9 August 2023 (UTC)

There is the source 178 in the 2021 section from October talking about improved access for vaccination workers.

More details on the situation can be found in this crisisgroup report from 2022

https://www.crisisgroup.org/asia/south-asia/afghanistan/afghanistans-security-challenges-under-taliban

The emerging picture of Afghanistan’s security landscape under Taliban rule reveals a country significantly more peaceful than a year ago, but with pockets of violence that threaten greater insecurity if not effectively managed. Gazfre (talk) 07:11, 10 August 2023 (UTC)

Here is one source regarding the changed situation in Pakistan:

from the report of the technical advisory group, May 2023_

http://polioeradication.org/wp-content/uploads/2023/05/TAG-meeting-report-Pakistan-Muscat-Oman-4-6-October-2022-FOR-PRINT.pdf

TAG noted with appreciation the strong ‘all-of-government

approach’ at all levels in Pakistan, and the programme’s close collaboration with law enforcement

agencies (LEAs). TAG saluted frontline workers who were martyred in the line of duty.

TAG noted a major shift in the epidemiology of poliovirus in Pakistan and recommended programmatic

pivots to respond to this shift. For the first time ever, endemic transmission is restricted to seven districts

in southern Khyber Pakhtunkhwa (KP) province. TAG also noted the drastic reduction in the number of

genetic clusters that continue to circulate – from 11 in 2020, to just one in 2022. Gazfre (talk) 10:29, 10 August 2023 (UTC)

good news! — kwami (talk) 15:58, 10 August 2023 (UTC)

I summarized what you've provided, but please feel free to fix. — kwami (talk) 16:30, 10 August 2023 (UTC)

Nicely summarized. Thanks Gazfre (talk) 18:24, 10 August 2023 (UTC)

Moved it up to the 2022 section. — kwami (talk) 18:43, 10 August 2023 (UTC)