Abstract
The detection of people with paralytic cases of wild poliovirus 1 (WPV1) in two African countries (ie, Malawi in February, 2022, and Mozambique in May, 2022) outside endemic areas of WPV1 transmission (ie, Pakistan and Afghanistan) will become a serious setback if low vaccination coverage and decreased surveillance of acute flaccid paralysis are not addressed with alacrity.1–3 Detection of vaccine-derived poliovirus (VDPV) outbreaks in new settings, including circulating vaccine-derived type 2 poliovirus (cVDPV2) in Ukraine in October, 2021, circulating vaccine-derived type 3 poliovirus (cVDPV3) in Israel in March, 2022, and cVDPV2 in the USA in July, 2022, and the environmental detection of VDPV in sewage systems in London, UK, in June, 2022, show the serious threat of polio re-emergence in settings that had previously interrupted polio transmission.
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