ACVPM Infectious Diseases Practice Exam

Wild-type poliovirus circulation is now limited to only a couple of places, reflecting where transmission has not yet been interrupted. In this question, the two countries where wild poliovirus is still circulating are Afghanistan and Pakistan. Ongoing transmission in these neighboring nations has persisted due to challenges in achieving complete vaccination coverage, access issues in conflict-affected areas, and cross-border movement that helps spread the virus despite global eradication efforts. The other options refer to regions that have interrupted wild poliovirus transmission or have only experienced outbreaks from importations, not sustained endemic circulation. India cleared wild poliovirus years ago, and broader Africa is now polio-free for wild-type strains, with Nigeria also no longer sustaining wild-type transmission. Egypt and Somalia have faced outbreaks from imports but do not have ongoing endemic wild poliovirus circulation.