Polio - still serious, for the wrong reasons

[Doc Alan]

Before vaccination was introduced in the 1950’s polio was very common in childhood worldwide – the numbers of cases have dramatically reduced, such that it’s very rare both in the UK and Philippines – only isolated cases in both countries since 2000.

There’s no cure for this viral infection which first infects the gut but then affects nerves, causing paralysis or even death. Vaccination – usually given by injection nowadays – is given to infants in both countries as part of a routine programme.

Polio can affect anyone, so if an adult has not been immunised, or not been vaccinated in the past 10 years, they may need a course or “ booster “ if travelling to “ at risk “ countries.


Especially in southern Mindanao ( with relatively low rates of vaccination ) the Philippines Government is making effort over and above the “ routine “ programme elsewhere in the country, to maintain “ polio-free “ status.

Surely polio is therefore a disease of the past, thanks to vaccination ? The World Health Organization ( WHO ) hoped to have eradicated it by the end of 2012. Only 215 cases were reported worldwide in 2012.

There are now only 3 polio-endemic countries – Pakistan, Afghanistan and Nigeria. Last month in Pakistan 9 health workers were shot dead while travelling house-house to administer vaccines to children. On January 1 this year 6 Pakistani aid workers and a doctor were shot dead. Women were the main victims ( for cultural reasons only they are allowed into houses to talk to mothers / vaccinate children ).


Why ? The Pakistani Taliban has “ banned “ polio vaccination in retaliation for use of unmanned “ drones “ by the USA. The United Nations and Pakistan Government have suspended the campaign for the time being. Many Pakistani children will have missed vaccinations as a result of this. It will affect neighbouring Afghanistan also, because they have the same type of polio virus. Nigeria had similar problems in the past decade, due to boycott led by religious and political leaders.


How I wish this could have been a success story. The only way to eradicate polio is by continuing the work that these brave health workers died for - and of course to continue vaccination elsewhere in the world, as part of a routine programme.

[Doc Alan]

Attacking health workers under any circumstances is outrageous, but to kill those trying to protect against a deadly disease – for whatever reason, and wherever in the world - is a devastating setback.


The worldwide success of polio vaccination means that most people have never seen a polio victim. The problem is that neighbouring - or more distant - countries are put at risk from those few areas where polio still exists. In 2011 polio broke out in China for the first time in over a decade after being imported from Pakistan. The campaign in the southern Philippines to augment the routine vaccination elsewhere is in recognition of the low rate of coverage and also proximity to Indonesia.


Health workers should not have to risk their lives – and deserve more protection - in attempting to improve children’s chances of never succumbing to polio. People may well have forgotten just how serious polio has been and could still be.

[raynaputi]

Thanks for the info Doc.

Sad to say that countries like Pakistan have people like Talibans living in there

[imagine]

good post Doc alan i thought polio was a thing of the past, not just in uk but all countries , obviously such as taliban are still living in the past,

heartless murderers of those who would try help with vaccinations at the risk of their own lives,helping anyone no matter what their race or beliefs, how do these killer animals still exist, pity theres not a vaccine to eradicate these murderers

[Doc Alan]

The World Health Organization has confirmed 10 cases of polio in Syria - the first outbreak in the country in 14 years. It’s highly likely more cases of paralysis will turn out to be polio.


Before Syria's civil war began in 2011, 95% of children in the country were vaccinated against the disease, but now around 500,000 children have missed out.


This is of course just part of the health crisis resulting from the conflict in Syria. Other vaccine-preventable illnesses like measles, typhoid and hepatitis A have all increased.


Polio has also re-emerged in Somalia, Kenya, Ethiopia, and South Sudan.


Not our problem ? Polio's a disease of the past, right ? Vaccination for polio isn’t needed for travellers to the Philippines !



• It’s only BECAUSE of a vaccination programme in the UK, Philippines, and most other countries that the global frequency of polio has reduced by 99% in the past 15 years. Over 10 million people are walking today who would otherwise have been paralysed !


• .Polio is highly contagious, and – bluntly – is spread by consuming food or liquid contaminated by faeces . Even though in most cases infection is not serious, 5% DO get paralysis, meningitis, and / or brain inflammation which can be fatal.


• Inactivated polio virus vaccine ( Salk ) which is injected, is now recommended, and free, in the UK, usually combined with diphtheria and other vaccines, in five doses altogether.


• In the Philippines, the “ DOH Expanded Program on Immunization “ also aims to provide free vaccines to protect infants and children from the common “ vaccine preventable diseases “, including polio, and the inactivated vaccine is preferred.


• The oral polio vaccine ( Sabin ) consisting of live “ attenuated “ ( weakened ) strains of the three virus types, is cheaper, and has its uses, containing outbreaks. It has a very small risk of “ vaccine-related polio “.


• The Global Polio Eradication Initiative aims to end all polio disease by increasing use of more affordable inactivated polio vaccines. But reaching children in the three countries where polio is endemic - Pakistan, Afghanistan, and Nigeria – is a major challenge ! Outbreaks in other countries like Syria are reminders of what may happen when vaccination is not possible. The biggest challenges to eradicating polio worldwide are conflict, political instability, public mistrust and weak health systems.



http://www.thelancet.com/journals/la...196-0/fulltext

http://www.nhs.uk/Conditions/vaccina...checklist.aspx

http://www.philvaccine.org/vaccinati...ation-schedule

[Doc Alan]

There is good news – also posted elsewhere on the Forum – about polio vaccination plans for the Philippines :-


http://sanofipasteur.com/en/Document...%206%20Oct.pdf


The last polio case in the Philippines was over 20 years ago, and in the late 1990’s in the UK. There is no cure, which is why vaccination continues in the UK, for the past decade as the inactivated injectable type now being introduced in the Philippines. There are many people living now who survived polio when they were younger ( around 120,000 in the UK ).


Of historical interest in a separate thread, there is a link about Mabini, a hero of the Philippines anti-colonial struggles, one of many who lived with lifelong disabilities due to polio ( #15, http://filipinaroses.com/showthread....-and-banknotes ).


The last countries in the world to be affected by polio are Pakistan, Afghanistan, Nigeria, with epidemics in the past year affecting Syria and Somalia.

[Michael Parnham]

Very interesting to learn about the subjects you post Alan, good reading and appreciated!