A dynamic model of poliomyelitis outbreaks: Learning from the past to help inform the future

Policy-makers now face important questions regarding the tradeoffs among different strategies for managing poliomyelitis risks after they succeed with polio eradication. To estimate the potential consequences of reintro-ductions of polioviruses and the resulting outbreaks, the authors developed a dynamic disease transmission model that can simulate many aspects of outbreaks for different posteradication conditions. In this paper, the authors identify the issues related to prospective modeling of future outbreaks using such a model, including the reality that accurate prediction of conditions and associated model inputs prior to future outbreaks remains challenging. The authors explored the model’s behavior in the context of three recent outbreaks resulting from importation of poliovirus into previously polio-free countries and found that the model reproduced reported data on the incidence of cases. The authors expect that this model can provide important insights into the dynamics of future potential poliomyelitis outbreaks and in this way serve as a useful tool for risk assessment. disease outbreaks; disease transmission; models, statistical; poliomyelitis; poliovirus; risk assessment; vaccination Abbreviations: IPV, inactivated polio vaccine; NID, National Immunization Day; OPV, oral polio vaccine. Efforts following the 1988 World Health Assembly reso-lution to eradicate poliomyelitis worldwide (1) reduced th