摘要：What is already known about this topic? Since 2016, Afghanistan and Pakistan have been the only countries reporting ongoing transmission of indigenous wild poliovirus type 1 (WPV1). What is added by this report? During January 2018–September 2019, the number of WPV1 cases in Pakistan increased, compared with the number during the previous 4 years. Sewage samples indicated wide WPV1 transmission, not only in the three major reservoir areas in three provinces, but also among other districts and provinces. Vaccine refusals, chronically missed children, community campaign fatigue, and poor vaccination management and implementation have exacerbated the situation. What are the implications for public health practice? Stopping WPV1 transmission will require continuing cross-border coordination with Afghanistan, gaining community trust, conducting high-quality campaigns, improving oversight of field activities, and improving managerial processes to unify eradication efforts.
