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To the Editor: In their JAMA Classics commentary, Drs Cochi and Kew¹ stated that poliovirus type 2 was eradicated in 1999. However, vaccine-derived type 2 poliovirus has been circulating in Nigeria from 2006 to the present, resulting in 103 cases during the period January 1, 2007, to August 12, 2008.² The re-emergence and continued circulation of this type of poliovirus is not consistent with eradication.

Those who worked on smallpox eradication, myself included, labored under the assumption that eradication is forever, not a one-time achievement necessitating an open-ended, long-term strategy for its maintenance. The formidable and resource-intensive challenges facing polio eradication have recently been discussed at a symposium at the US National Institutes of Health in September 2007.³ These epidemiological, immunological, and virological barriers were not addressed by Cochi and Kew. The global community needs clear communication about the remaining challenges and sizable investments for field operations and research, not . . . [Full Text of this Article]

Robert Steinglass, MPH
rsteinglass@jsi.com
IMMUNIZATIONbasics
JSI Research & Training Institute
Arlington, Virginia

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