Polio or Poliomyelitis was recognized as a condition in the
1840 and the causative agent of the disease was identified in 1908.
The disease well known for its paralysing condition for
limbs had affected populations from Asia, Africa, the Americas, and Europe.
Efforts to control and eradicate the disease resulted in the
development of the polio vaccine in the 1950’s. Since then vaccinations have
been administered to vulnerable populations worldwide.
By the year 2000, the continents of America were declared
polio free, and in 2002, Europe was declared Polio free.
What causes polio?
Polio is caused by three virus types/strains, these are wild
polio virus 1 (WPV1), WPV2 and WPV3.
Wild polio virus type 2 (WPV2) was eradicated worldwide in
1999 while WPV1 and WPV3 still remain in circulation.
Until March this year, polio was endemic in four
countries, Afghanistan, India, Pakistan,
and Nigeria but India was removed from the list by the Global Polio Eradication
Initiative being free of any polio cases for 1 year. If there will be no other
polio cases in India for another year, that is 2 continuous years then India
will be declared free of polio.
Despite this milestone for India, there are still outbreaks
of polio in Afghanistan, Pakistan and Nigeria. Re- established transmission and
imported transmission cases of polio have been observed in neighboring
countries of the endemic areas as well as surrounding countries. For example in
Angola, Chad and DRC there has been re-established transmission of the disease
while the virus has been imported to Central African republic, China, Congo,
Cote d’Ivoire, Gabon, Guinea, Kenya, Liberia, Mali, Niger and Uganda.
What is the difference between re-established transmission
and imported transmission?
Re-established transmission is when an outbreak to
the virus re-emerges within the population due to either missed booster
vaccinations within a population which was previously free of the virus while
imported transmission of the virus is usually outbreaks from a virus brought in
from endemic countries to other areas through migration of infected
individuals.
Advances in science have allowed for easier identification
as well as tracking the origin of the virus during outbreaks. This has been
made possible through genome sequencing of polio virus from patients in
outbreak areas, by comparing the results with previously sequenced polio
viruses from other regions, one is able to track where the virus could have
originated from.
Is it possible to eliminate polio globally?
This is the question that was posed many years ago and since
the onset of the disease people have been working hard to eradicate the
disease. The development of the polio vaccine helped accelerate the efforts of
control and eradication of the disease. Despite the milestones in polio
eradication in Europe and the Americas there are still challenges to the
eradication of the disease in parts of Africa and Asia.
Re-emergence of polio in countries and areas where the
disease was eliminated has raised fears especially in the continents where
there are still countries where the disease is endemic.
Porous borders have contributed to some of the outbreaks in
areas which were declared polio free. Free movement of people from endemic
areas who have not been vaccinated against the disease into disease free areas
increase the risk of infection or re-infection, hence countries have to be
aware of this risk.
Responses to outbreaks and administration of the polio
vaccine are crucial in controlling the spread and elimination of the disease. In
India door to door vaccination helped to vaccinate at least 1 million people
per month and was proved to be a great success. Even though this method worked
for India, vaccination campaigns have been challenged in parts of Pakistan and
Afghanistan due to political unrest which present a security risk to both
health workers and the people living in the region. Misconceptions such as
those that the polio vaccine is meant to sterilize people have also contributed
to non-compliance in certain communities. It has been reported that people in the
regions where there is war and political unrests many children have missed out
on their polio vaccine and booster vaccine putting the population at risk of
contracting the disease.
In Africa, the west Africa region has experienced
re-established transmission of polio (Angola, Chad and Democratic Republic of
Congo) as well as cases of the virus being imported into neighboring countries
(Central African Republic, Congo, Cote d’Ivoire, Gabon, Guinea, Kenya, Liberia,
Mali, Niger and Uganda). With Nigeria being the only remaining country in
Africa where Polio is endemic, migration and cross border trade with
neighboring countries offers a high risk of transmission of the disease.
Political unrests in some of the African countries mentioned above have also
hampered vaccination campaigns leaving populations at high risk of the
disease. There are still many areas
where health works cannot reach to administer the vaccine due to security
risks. Non- compliance by certain groups of people also increases the danger of
re-infection and affecting the eradication process.
So what should be done to eradicate this disease?
It is crucial for governments and organizations working
towards eradication of polio to provide resources and set up measures for
surveillance to monitor and administer the polio vaccine. Most important is the
involvement of the community through civic education on the dangers of polio
and the importance of vaccination. In
several communities it has been observed that people listen more to their local
authorities than their health workers especially when there is some negative
myths associated with the Polio vaccine.
Village chiefs, religious leaders, tribal leaders, business leaders and
other people with authority in the communities are crucial in disseminating
information to the communities.
In refugee and natural disaster camps, the UN and their
partner Rotary international are working hard to vaccinate children against
Polio , an example is that of Somalia, despite all the hardships the country is
going through, there are no reported polio cases.
There is still hope that polio will be eradicated, but joint
efforts between governments, non -governmental organizations and the population
at large is crucial for this to happen. It is our responsibility, each and
every one of us to ensure that polio is eradicated globally. Each one of us has
to make sure that the people around them, the people they know, friends and
family have been vaccinated against polio. Together we can fight polio.
To read more on what is going on around the world regarding polio eradication, visit the Global Polio Eradication Initiative website on http://www.polioeradication.org/
