Sunday October 22, 2017

Final push against Polio begins today in 150 countries

From April 17 to May 1, 150 countries will engage in a synchronized switch to a bivalent, or two-strain, vaccine that contains no type 2 virus but targets types 1 and 3

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A girl receives polio vaccine drops at a government dispensary in a Karachi slum, Pakistan in this October 21, 2014 file photo. REUTERS/Akhtar Soomro/Files

A girl receives a polio vaccination outside her house in Yemen's capital Sanaa in this November 9, 2015 file photo. REUTERS/Khaled Abdullah/Files
A girl receives a polio vaccination outside her house in Yemen’s capital Sanaa in this November 9, 2015 file photo. REUTERS/Khaled Abdullah/Files

By Kate Kelland

LONDON, (Reuters) – In a huge immunization effort in 150 countries, health teams will on Sunday launch what they hope will be the final push against polio.

Stopping transmission of the contagious viral disease that has infected millions is possible within a year, experts say. And full, official, global eradication could be declared by the end of this decade.

First, however, the vaccine that has successfully fought polio for more than 30 years needs to be switched for one that targets the last few areas of risk.

It won’t be easy, or cheap, but the World Health Organization’s director of polio eradication, Michel Zaffran, says failure now – when there have only been 12 cases worldwide this year, in Pakistan and Afghanistan – means the virus could spread across borders again.

Success would make polio only the second human disease to be eradicated since smallpox was banished in 1980.

“Taking our foot off the pedal now could mean polio will within a few years spread straight back into large parts of the world and create 100,000 or 200,000 cases,” Zaffran told Reuters. “The job has not been done and will not be done until we have fully eradicated the virus.”

A man suffering from polio crawls outside a row of closed shops in Siliguri, India in this December 8, 2006 file photo. REUTERS/Rupak De Chowdhuri/Files
A man suffering from polio crawls outside a row of closed shops in Siliguri, India in this December 8, 2006 file photo. REUTERS/Rupak De Chowdhuri/Files

VACCINE COMPLEXITIES

For the endgame in polio to succeed, a coordinated and complex vaccine switch is crucial.

Until now, many countries have been using a shot that protects against the three types of wild polio virus – type 1, type 2 and type 3 – but type 2 polio transmission has been stopped since 1999, meaning immunizing against it now makes no sense.

In rare cases it also poses a risk that the weakened type 2 virus in the vaccine can seep into circulation and cause “vaccine-derived” polio infections.

So from April 17 to May 1, some 150 countries will engage in a synchronized switch to a bivalent, or two-strain, vaccine that contains no type 2 virus but targets types 1 and 3.

It’s a massive undertaking and a major step towards eradication, says Zaffran. “We’re entering into uncharted territory. This has never been done before. But there’s no going back now.”

That’s partly because polio vaccine manufacturers – among them France’s Sanofi Pasteur – have moved production to the bivalent shot and would find it tricky, costly, and time-consuming to reverse that move.

Anil Dutta, a vaccine expert at British drugmaker GlaxoSmithKline, which also makes polio shots, is looking beyond eradication to 2019 or 2020, when all “live” oral polio vaccines need to be discontinued.

Then the world will switch again, to “inactivated” polio vaccine, or IPV, to further reduce any risk of causing disease through immunization. Scaling up IPV production to meet the needs of the entire world takes years, he warns, and work must start now to avoid potential supply concerns.

HISTORY OF MISSES

But prediction has never been easy in the fight to wipe out polio, and health authorities have missed targets along the way.

The Global Polio Eradication Initiative, launched in 1988, originally aimed to end all transmission of the disease by 2000.

And while there has been a 99 percent reduction in cases worldwide since the GPEI launch, fighting the last 1 percent of polio has been far tougher than expected.

In 2013, the GPEI said the global fight against polio would require $5.5 billion in funding, and more will be needed beyond that to keep a lid on the disease.

The virus, which invades the nervous system and can cause irreversible paralysis within hours, spreads rapidly among children, especially in unsanitary conditions in war-torn regions, refugee camps and areas where healthcare is limited.

In Pakistan and Afghanistan, the last two countries where polio currently remains endemic, conflict and propaganda have hampered progress, and in the past posed risks to others.

The campaign to eliminate polio in Pakistan is fraught with risk, with Islamist militants attacking health teams they accuse of being Western spies. A polio worker was shot and wounded in February and in January a suicide bomber killed 15 people outside a polio eradication center in the city of Quetta.

In 2011, a polio virus from Pakistan re-infected China, which had been polio free for more than a decade.

In 2013, the disease re-emerged in Syria after a 14-year absence, prompting the need for a vast and expensive regional emergency vaccination campaign.

And last year, cases of type 2 vaccine-derived polio posed new threats in Ukraine and Mali.

David Salisbury, an immunization specialist and associate fellow at Britain’s Chatham House Centre on Global Health Security, says the last 1 percent is a “very long tail” on a stubborn epidemic.

“The original date for interruption of transmission was 2000. The next target was 2014 and it’s currently 2016,” Salisbury told Reuters, adding that even with case numbers as low as they are now, “2016 may be optimistic”.

Liam Donaldson, head of the Independent Monitoring Board of the GPEI, agrees that celebrating the expected extinction of polio virus “would not just be premature, it would be folly”.

“Polio is still out there,” he told a meeting in London. “(It) has fought back with a vengeance at every stage of the game. And it’s still fighting.”

(Reporting by Kate Kelland; editing by Giles Elgood)

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Traces of Polio Virus Found in Water Samples in Southern India

India's last case of polio was in 2011, and the country was officially declared polio-free in 2014

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FILE - A man bathes a child with a water pump beside a polio awareness campaign poster on the wall of a small shop in the village of Kosi, some 180 kilometers (113 miles) from Patna, India. Image source: AP
  • Traces of polio samples were found in South India last month in May
  • India has been declared polio-free since 2014
  • Officials said it was not a reason to panic since the strain was vaccine-inflected

After years of a deliberate fight against the deadly disease, active strain of the poliomyelitis virus was found in sewage samples in southern India collected last month, officials announced Wednesday.

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A child receiving vaccine drops. Image courtesy: Wikimedia commons

Around 300,000 children ages three to six in Hyderabad, a city of nearly 7 million, will be vaccinated in the coming week.

India’s last case of polio was in 2011, and the country was officially declared polio-free in 2014.

As the news spread, national health officials are calling on residents of Hyderabad to maintain their calm, maintaining that India is still poliovirus free.

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“This is not the first time that a strain has been found but it is a vaccine-derived strain that is found commonly in children with low levels of immunity,” CK Mishra, a Health Ministry secretary told reporters.

“They excrete it, which is why it is found in the sewage samples.”

State health officials also told residents not to panic, saying that tests to find traces of the virus in the environment have been carried out regularly since the country was declared polio free five years ago.

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India worked with the World Health Organization, UNICEF, and several volunteer organizations to fight a decades-long battle eradicating the crippling disease, which is why the public is slightly alarmed at this new development.

-prepared by Saurabh Bodas (with inputs from VOA), an intern at NewsGram. Twitter Handle: @saurabhbodas96

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Pakistan’s unending struggle with Polio

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An Afghan child looks on as a health worker administers polio vaccine .

Islamabad: On March 27, 2014, the World Health Organization announced the eradication of Polio in eleven countries in the South-East Asia Region, including India. However, Pakistan seems to face this infectious disease with never ending struggle.

The first case of Polio for 2016 was reported in Pakistan’s densely populated city of Karachi. Out of 73 cases reported globally, 54 were from Pakistan. Unfortunately, children in Pakistan suffer from malnutrition due to which immunity level hadn’t really built.

Although the country is putting continuous efforts in eradication of the disease by conducting regular vaccination campaigns, Islamic terror groups prove to be major hurdles. The militants consider polio workers as ‘western spies’ and polio drops as western conspiracy to sterilize Muslim children.

Several government initiatives to rest such rumors have been initiated. ‘Muslim Clerics’ appointed by Pakistan government have spoken up in favor of the vaccination.

Health officials, however, admit Polio still prevails in the country, paving way for resurgence of the disease worldwide.

Following video shows Pakistan’s dilemma with tackling this never ending disease.


(Image source: pakistantoday.com.pk)

One response to “Pakistan’s unending struggle with Polio”

  1. Stop giving the vaccine. The US stopped because it was causing Polio.
    In 1976, Dr Jonas Salk, creator of the killed-virus vaccine used in the 1950’s, testified that the live-virus vaccine (used almost exclusively in the U.S. from the early 1960’s to 2000) was the “principal if not sole cause” of all reported polio cases in the U.S. since 1961 (Washington Post,September 24,1976). The virus remains in the throat for one to two weeks and in the feces for up to two months. Thus, vaccine recipients are at risk, and can potentially spread the disease, as long as fecal excretion of the virus continues ( American Academy of Pediatrics, Report of the Committee on Infectious Diseases:1986(Elk Grove Village, Illinois: AAP):284–5.

    It was discovered that both versions of the vaccine cause polio or the more severe form-Non Polio Acute Flaccid Paralysis. Clinically indistinguishable from Polio but more difficult to treat.

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India achieves five polio free years

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New Delhi: This last Wednesday India completed five years of being Polio free. Polio in the 90s was the biggest disease in India affecting as many as 50000 children a year.

The last reported case in India was Howrah District in West Bengal on January 13 five years ago. While, the last case in Delhi was in June 2009.

India has achieved a remarkable result as in 2009, the country had half of the share of polio cases existing in the world.

The World Health Organisation (WHO) declared the country polio-free after it completed the mandatory period of three years without a single case being reported.

India’s neighbors like Pakistan, Afghanistan and other sub-continent countries are still fighting the battles against this disease which is why India cannot be complacent on the basis of this remarkable achievement.

The only case came close was last year when a two-year-old girl in Delhi was diagnosed with rare P2 stain virus. But doctors said there were one in million possibilities that this virus could turn into a complete polio case. Still India along with oral vaccine introduced injectable inactivated polio vaccine(IPV). The IPV vaccine makes it impossible to contract vaccine derived polio-like what happened with 2-year-old Delhi girl.

This is an example that with a set strategy and focus, any goal can be achieved. With the same intensity, India can get the favorable results in other public health sector.

India has a huge population and a breaking of any epidemic always has much bigger impact than what it can have in other nations. A large portion of this population does not even have the access to the basic medical facilities and living conditions. It means they are more likely to catch a disease and then they do not have the resources to counter that.

Take Dengue for example. Every season it affects thousands of people in the capital only and somehow there has been no way to stop this. It happens every year and then all our system does is the damage control.

If the approach followed in the eradication of polio, is used to counter other diseases as well, it will be a lot beneficial to the society.

Indian government deserves credit for the work done in making the country polio-free but more is expected in the public health sector.