ABSTRACT
Establishing a sensitive and specific system for polio diagnosis was complicated as the majority of wild poliovirus infections (>99%) are subclinical (15) and evenwhen there is paralysis, polio cannot be definitively confirmed clinically (16,17). Serologic testing is inadequate because it cannot distinguish antibodies due to wild polioviruses from those produced by vaccine. Consequently, the GPEI has relied on poliovirus culture from stool specimens for diagnosis (18), which although resource intensive has high specificity, sensitivity, and predictive value.
