PAHO warns of polio’s return despite 35 years without wild poliovirus in the Americas

According to PAHO, vaccination coverage in the Region of the Americas still remains below the recommended threshold of 95 percent. Although vaccination rates are gradually recovering from the decline during the COVID-19 pandemic, not all children are yet sufficiently protected against the infectious disease.

In 2025, 91 percent of children received the first dose of the inactivated polio vaccine (IPV), compared with 86 percent in 2024. Vaccination coverage for the second dose rose from 87 to 89 percent, while the percentage of children receiving the third dose increased from 85 to 87 percent. In 2021, the latter percentage was still 80 percent.

PAHO Director Jarbas Barbosa emphasises that the eradication of the wild poliovirus in the region is an important milestone, but that continued vigilance remains necessary. “The eradication of wild poliovirus in the Americas is one of the greatest public health achievements in our region. But we must not take this success for granted,” Barbosa states.

According to him, the risk of importing the virus remains as long as polio occurs elsewhere in the world. High vaccination coverage and effective disease surveillance are therefore essential to prevent new infections and outbreaks.

From thousands of infections to a polio-free region

In 1975, nearly 6,000 polio cases were still recorded in the Region of the Americas. The last case caused by the wild poliovirus was identified in Peru on August 23, 1991. It involved an unvaccinated two-year-old child who suffered permanent paralysis. Three years later, in 1994, the Region of the Americas became the first in the world to be officially declared free of wild poliovirus transmission. This achievement was reached through large-scale vaccination campaigns, the expansion of routine vaccination programmes and intensive cooperation between countries and health authorities.

Poliovirus still circulates in Afghanistan and Pakistan

Despite progress, polio has not yet been fully eradicated worldwide. Afghanistan and Pakistan are currently the only two countries where the wild poliovirus remains endemic.

According to figures from the Global Polio Eradication Initiative (GPEI), 48 cases of infection with the wild poliovirus had been registered worldwide as of October 20, 2026. Of these, 42 cases were identified in Afghanistan and six in Pakistan.

PAHO warns that the virus can be reintroduced through international travel into countries where the disease has not occurred for many years. Communities with low vaccination coverage are particularly at risk of transmission.

There are also concerns about countries’ capacity to detect possible polio cases in time.

Health authorities closely monitor cases of acute flaccid paralysis. This is a sudden loss of muscle strength that can have various causes, but also constitutes an important warning sign of polio.

Over the past year, countries in the Region of the Americas recorded an average of 0.85 cases of acute flaccid paralysis per 100,000 children under the age of fifteen. The region therefore remains below the recommended surveillance standard of at least one case per 100,000 children. According to PAHO, this points to the need to further improve the detection and registration of possible infections.

Polio can cause permanent paralysis

Polio is a highly infectious viral disease that mainly affects children under the age of five. The virus can affect the nervous system and cause irreversible paralysis within a few days. Of patients who become paralysed, an estimated 5 to 10 percent die because the respiratory muscles are also affected. There is no curative treatment for polio. Vaccination, however, provides effective protection against the disease.

The global fight against polio began in 1988 with the establishment of the Global Polio Eradication Initiative. At that time, an estimated 350,000 children were paralysed by polio each year in more than 125 countries. Since then, the number of polio cases worldwide has declined by 99.9 percent. An estimated 20 million people have been spared paralysis thanks to international vaccination efforts. In addition, more than 1.5 million lives have been saved.

The World Health Organization (WHO) warns that failure to achieve full eradication could lead to a global resurgence. In that scenario, up to 200,000 polio cases per year could occur again within ten years.

Call to check children’s vaccinations

On the occasion of World Polio Day, PAHO stresses that countries must strengthen their routine vaccination programmes and ensure that all children have access to the recommended vaccines.

Suriname is also part of the Region of the Americas to which the warning applies. Maintaining polio-free status depends on continued vaccination efforts and a well-functioning system for the early detection of possible infections.

PAHO calls on parents and caregivers to check whether their children have received all recommended polio vaccinations. Any missed doses should be caught up as soon as possible, according to the organisation.

According to the health organisation, the Region of the Americas can retain its historic achievement only if countries continue to invest in vaccination, disease surveillance and international cooperation.