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The certification of smallpox eradication and implications for guinea worm, poliomyelitis, and other diseases: confirming and maintaining a negative.
[dracunculiasis]
Rigorous
,
independent
,
confirmation
of
disease
eradication
is
necessary
to
assure
credibility
of
the
claimed
accomplishment
.
The
criteria
and
procedures
for
formal
certification
of
global
disease
freedom
are
based
on
the
biological
and
epidemiological
features
of
the
pathogen
and
its
manifestations
.
Certification
activities
by
previously
endemic
and
at
-risk
countries
include
comprehensive
documentation
focusing
on
surveillance
,
reports
of
national
independent
review
groups
,
and
special
field
surveys
.
National
and
regional
results
are
reviewed
by
authoritative
International
Commissions
(
ICs
)
which
verify
the
findings
by
field
visits
.
The
ICs
present
their
results
to
an
independent
WHO-convened
group
(
"
Global
Commission
"
for
smallpox
)
,
members
of
which
participate
in
field
visits
.
When
fully
satisfied
,
the
Global
Commission
makes
conclusions
and
recommendations
to
the
World
Health
Assembly
(
WHA
)
.
Smallpox
was
confirmed
eradicated
in
1980
by
the
WHA
less
than
three
years
after
the
last
naturally
occurring
case
was
detected
.
Dracunculiasis
(
guinea
worm
)
freedom
has
been
certified
in
187
countries
.
Regional
commissions
have
certified
the
Americas
,
Asia
,
and
Europe
polio-free
;
however
,
re
-establishment
of
endemic
foci
in
countries
previously
declared
disease-free
has
created
special
challenges
for
completing
this
program
.
Post-eradication
activities
require
attention
to
surveillance
,
maximum
security
of
the
microbial
agent
,
and
essential
research
to
assure
maintenance
of
disease
freedom
.
Diseases
Validation
Diseases presenting
"national independent review groups"
symptom
dracunculiasis
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