And by that we would encourage that the countries of the world who don't have Polio to try to help finish the job so that all can stop immunizing for Polio. The other major challenge is to adequate disease surveillance in diagnostic laboratory support which will be critical to being sure that we don't have Polio. We still have a ways to go. Several issues related to measles control have come up. One is that the America's region has embarked on the measles elimination following on the strategy of Polio eradication in that they have conducted national immunization days in nearly all of the countries of Latin America covering all children under the age of 15 and building on the Polio surveillance system whereby they have begun surveillance for fever and rash.
Transmission continues especially in urban areas.
We're intensifying now a strategy which includes improving coverage generally added with special campaigns in urban areas and trying to improve disease surveillance. Over 80 countries report reaching 1 per 1000 live births Neonatal tetanus elimination has been defined as less than one case per thousand live births in every district of a country. Now more than 80 countries have reported reaching less than one per thousand live births many less countries can report less than one per thousand live births in every district. We find though epidemiologically neonatal tetanus occurring in countries occurs in clusters. We also find that most of the neonatal tetanus occurring in the world is centered in 12 countries in Asia and Africa.