Polio is back

Friday, November 8, 2013

Good morning:

Polio is back.

On October 25th, the New York Times reported,

The World Health Organization has spent 25 years trying to eradicate polio. In recent years, the disease’s presence had narrowed to just three countries — Nigeria, Pakistan and Afghanistan — from more than 125 when the campaign began in 1988. The virus is highly infectious and mainly affects children younger than 5. Within hours, it can cause irreversible paralysis or even death if breathing muscles are immobilized. The only effective treatment is prevention, the World Health Organization says on its Web site, through multiple doses of a vaccine.

While the source of the Syrian polio strain remained unclear, public health experts said the jihadists who had entered Syria to fight the government of President Bashar al-Assad may have been carriers. Dr. Aylward said there were some indications that the strain had originated in Pakistan. He cited the recent discovery of the Pakistani strain in sewage in Egypt, Israel, the West Bank and Gaza.

The strain has now been confirmed to have originated in Pakistan and it’s spreading.

The New York Times is reporting today,

Escalating its emergency battle to stop the spread of a polio revival in Syria, the World Health Organization has doubled the number of children it says should be urgently vaccinated to more than 20 million throughout the Middle East, the organization’s top official in charge of eradicating the highly contagious and crippling disease said Wednesday.

The official, Dr. Bruce Aylward, also said the organization’s projection of a two-month vaccination campaign — envisaged just a few weeks ago for 10 million Middle East children — would now take six to eight months, require at least 50 million doses of vaccine for repeated treatments and might require the diversion of vaccine originally intended to be used elsewhere.

The disease is difficult to contain because only 1 out of 200 people infected with the virus will experience any symptoms. The virus is passed in human waste. Unsanitary conditions in refugee camps are an ideal environment in which the virus can spread rapidly.

It only takes one person infected without symptoms who gets on a plane and travels to a destination somewhere on the planet . . .

Charlie Cooper, the Health Reporter for The Independent, reports today,

Writing in The Lancet, Professor Martin Eichner of the University of Tubingen in Germany and Stefan Brockmann, of Reutlingen Regional Public Health Office, warn that, because only one in 200 infected individuals are severely affected by the disease, there is a risk that unvaccinated refugees from Syria or travellers from neighbouring countries could introduce the virus “unrecognised”.

Countries in Europe with relatively poor vaccine coverage – including Austria, Ukraine and Bosnia Herzegovina – may be at particular risk of “sustained transmission” if the disease was carried into the region, they said.

At a meeting on Wednesday, the World Health Organization doubled the number of people who urgently need to be vaccinated to 20 million. An eight-month campaign will target children both within Syria and in Turkey, Lebanon, Iraq, Jordan, Israel and the Palestinian territories.

Although the risk of infection at this time in the U.S. is probably pretty low and there is an urgent need for the vaccine in the Middle East that must take precedence, I recommend you contact your doctor or nearest public health office to get vaccinated, if you have not been vaccinated, and especially if your children have not been vaccinated.

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11 Responses to Polio is back

  1. ay2z says:

    I grew up knowing someone who had been crippled by polio, it came on quickly as a young mother with small children and someone in my family was at her bedside, putting aside any fears of the deease as she was already exposed and determined to not leave her side. The account of the pain the mother endured was terrible but she survived and I knew her as a womderful person who became as part of the family.

    Polio vaccines were given for many years after that time as part of the health regulations and dosed by a small amount of liquid in a tiny paper cup.

    Saw this story when it came out but why is it only fear for ourselves, that we take up the concern for others as it may affect ourselves? The cost will be great, to people and their families, not temporarily until help arrives, but forever. (How does a young mother care for her baby in arms when she is fighting for life through the disease and then how does she help the child when the polio takes her ability to walk to the child, pick them up, away? Wasn’t the iron lung invented for just this disease originally?

    • ay2z says:

      Thanks, Lyn, missed your comment that answered my question of the iron lung. (the lungs from that era are now museum pieces)

  2. fauxmccoy says:

    horrifying.

  3. Folks are pleading with an outcry because they think that polio (and other ills like racism) has been eradicated! Nope!

  4. Lyn says:

    Thanks Fred for writing this public service. Back in the 50s when I was in nurses training, we still had wards and wards of poor people living in Iron Lungs. I got my first Polio Vaccine in 1955 and it was then and still a miracle.

  5. Two sides to a story says:

    How sad. In the US, I believe that kids are still immunized for polio. However, smallpox is thought to be eradicated and I believe only my eldest child of 4 (long an adult) is immunized. What a mess it will be if smallpox rears it’s ugly head somewhere – there are vast numbers of people who are not immunized for it.

  6. Professor Martin Eichner, from the Institute of Clinical Epidemiology and Applied Biometry, University of Tübingen, and Stefan Brockmann, from the Department for Infection Control, Reutlingen Regional Public Health Office, Germany have expressed this concern:

    “Moreover, hundreds of thousands of people are fleeing Syria and seek refuge in neighbouring countries and Europe,” they continue. During the Hajj in Saudi Arabia last month, visitors from countries with known polio transmission were vaccinated, but Syria was not included with those countries.

    This situation, combined with the vaccination approach used in Europe, is concerning, according to the authors. Most European Union (EU) countries currently use inactivated polio vaccine (IPV) rather than oral polio vaccination (OPV). Similar to many other regions, most EU states discontinued use of OPV because of rare reports that it caused acute flaccid paralysis (AFP), even though OPV offers high protection against acquiring and transmitting the infection. Only some EU member states still permit OPV use, and none has a stockpile of it.

    In contrast, the more widely used IPV is highly effective in preventing AFP and active polio disease, but is only partially effective in preventing infection with polio virus. For decades, Europe has been free of circulating polio viruses and, therefore, IPV has been sufficient.

    However, IPV will only continue to be effective in preventing transmission if vaccination coverage continues to be very high, if hygienic standards are good throughout the population, and if there is low crowding. These conditions could easily be disrupted by the present situation of large numbers of refugees fleeing from Syria to Europe and other neighboring countries.

  7. Medscape is reporting:

    For every 200 WPV1 infections, only 1 results in symptomatic polio. Therefore, hundreds of individuals could be infected and the virus could circulate for nearly a year before an outbreak could be identified from a single case of AFP.

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