Polio ● Endemic before widespread of vaccines ● 1916 outbreak in North America ○ 6000 died ○ 27,000 paralyzed ● Outbreak in hot climates ○ Most devastating in tropical nations ■ May be related to usage of water ■ Oral-Oral ■ Fecal Oral infection ● Highly infectious ○ 7-10 days needed before symptoms ■ Infectious for 6 weeks ■ Due to hideout, extremely difficult to eradicate ● Transmission is only from human to human ○ Vaccination may be the key ■ After vaccination in the 90s the incident rate has dropped exponentially ■ In 2013 only 416 incident cases ● In Western nations polio is eradicated ○ Pakistan,Afghanistan and Nigeria is still in Endemic ■ In relatively small scale ■ They are all Tropical region ■ Still global concern ● These patients can move to any country at any time ■ We have still monitored the Polio trait in waste water in Canada even though it was eradicated. ● Still needs to be aware ● Constant monitoring is essential ● Planes to prevent ○ Vaccinations ■ Human-human infection only ■ If there's no host human no more spread ○ Surveillance/monitoring ○ Improving sanitation ■ Most are from untreated water source ○ Impoverished environment have hardness to access childrens