Eradication of poliomyelitis: progress in the People's Republic of China.

China and the other countries of the Western Pacific Region have a goal of eradication of wild poliovirus by the end of 1995. In this report we examine the progress made toward eradication through the end of 1993. We examined the information about poliomyelitis and wild poliovirus based on the acute flaccid paralysis surveillance system. The number of reported poliomyelitis cases decreased from 4623 cases in 1989 and 5065 cases in 1990, which occurred during a large nationwide poliomyelitis epidemic, to 538 cases in 1993. Mass supplemental immunization sessions were conducted during the 1991 to 1992 and 1992 to 1993 winters. After the two rounds of supplemental immunizations in the 1992 to 1993 winter, wild poliovirus was not detected for the subsequent 21 months in 22 contiguous provinces in central and northern China, in which 980 million persons reside. In 1993 wild poliovirus was detected in only 5 provinces in southern China and in 2 provinces in the remote Western region; these provinces have only 14% of the total population in China. China is close to achieving its 1995 poliomyelitis elimination goal. Mass supplemental immunizations in children 0 to 3 years old can rapidly eliminate wild poliovirus from large, very densely populated areas, low income rural areas and remote mountainous areas. There appears to be no technical obstacle, even in the most difficult areas, to achieving global eradication of wild poliovirus by the year 2000.