Brief summary of poliomyelitis The purpose of this article is to identify poliomyelitis which is a transmissible disease of fecal-oral group worldwide and discuss health interventions to control and eliminate epidemics and consider dilemmas ethical. The pathogen of polio is poliovirus, an enterovirus that is transmitted via the fecal-oral route through feces. Respiratory inhalation occurs and the virus initially replicates in the oropharynx and then invades the gastrointestinal tract. It can be transmitted via fecal-oral, airborne, waterborne processes and asymptomatic carriers. (WHO, 2009) Clinical manifestations range from self-limiting asymptomatic disease and mild symptoms such as combined fever, malaise, fatigue, nausea, headache, flu-like symptoms, neck and back stiffness and pain, to severe fetal paralytic disease which can cause death from respiratory failure. Children under five are most at risk. (WHO, 2010) Paralytic polio produces muscle pain and affects the lower body such as the legs. The poliovirus incubates for five to thirty days and becomes transmissible two days after discovery and can remain transmissible for up to six weeks. Polio can be diagnosed by clinical evaluation of viral cultures such as spinal fluids, stool samples, throat swabs, and serum antibody levels. (Webber, R., 2010). Public health interventions In the United States, polio is not endemic, so even a single case can become an epidemic. Geographically, more than 125 countries were still polio-endemic in 1988. Overall global incidents have decreased by 99% since 1988. Between 2009 and 2010, twenty-three polio-free countries were reinfected due to the imported virus. The countries of Afghanistan, India, Nigeria and Pakistan...... at the center of the document ......rol: A global perspective (3rd) Cambridge, MA: CABI publishingWorld Health Organization - Case definitions for four notifiable diseases in all circumstances under the International Health Regulations (2005). Retrieved from http://www.who.int/ihr/Case_Definitions.pdf POLIOMIElite Report Retrieved immediately from Health.utah.gov/epi/diseases/polio/plan/PolioPlan061510.pdf The Centers for Disease Control and Prevention (CDC) studied disease and mortality rates before and after widespread implementation of national vaccine recommendations (in effect before 2005) for 13 vaccine-preventable diseases; diphtheria, whooping cough, tetanus, polio, measles, mumps, rubella (including congenital rubella syndrome), invasive Haemophilus influenzae type b (Hib), acute hepatitis B, hepatitis A, chickenpox (chickenpox), Streptococcus pneumoniae and smallpox.