The World Health Organization (WHO) has announced the goal for global eradication of poliomyelitis by the year 2000. This entails the prevention of cases of wild-type induced paralytic poliomyelitis and the elimination of transmission of the virus throughout the world. In industrialized nations, high levels of immunization and good sanitation would appear to meet these goals. In developing countries, however, individual protection is compromised, even with three doses of oral polio vaccine (OPV), and four or five doses of OPV are recommended for routine immunization. In developing countries two strategies for interruption of transmission are being used. The WHO recommends high levels of coverage of infants with four doses of OPV administered in routine vaccination. In the Americas, transmission has been interrupted by the bi-annual immunization of all children under the age of 5 years. For the rapid eradication of poliomyelitis, either dramatic improvements in sanitation need to be made or massive immunization programs need to be undertaken. Non-polio enterovirus infections of neonates may produce multisystem disease, including sepsis, meningoencephalitis, hepatitis, myocarditis, and pneumonitis. Markers for severe illness include maternal viral symptoms at delivery, early onset of illness, and viremia. Enteroviruses also cause congenital infections; sequelae include stillbirth and, possibly, congenital anomalies. Specific antiviral therapy for perinatal enterovirus infections is not currently available.
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