We are People of Action, Would you like to be?

Polio Eradication – Encouraging News, Challenges Remain

–July 2018, Delane Wycoff, D5630 Polio Plus Chair

WHO Disproves Claims of Polio Return in Venezuela

Major news outlets got it wrong—Case was not polio

In the previous newsletter, it was erroneously reported that Polio had returned to the Western Hemisphere.  This was based upon widespread news reports from British news outlets including The Guardian and The Telegraph and also USA’s CNN network.

“Tests carried out by the specialized global laboratory for genetic sequencing have ruled out the presence of both wild poliovirus and vaccine-derived poliovirus (VDPV),” clarified a press release the WHO and their regional body, the Pan American Health Organization (PAHO).

Rumors of a return of polio to Venezuela began after the PAHO diagnosed acute flaccid paralysis (AFP) in a 34-month-old boy in the Orinoco Delta (Northeast) region of Venezuela earlier in June. The paralysis had begun on April 29.

As the WHO statement points out, polio is just one of many possible causes of AFP.  AFP allegedly affects more than 100,000 people across the globe every year.  

Polio has been reported in Papua, New Guinea

This time it’s confirmed

The report that came from Papua New Guinea on June 22nd, though, is no fiction. It was issued by the World Health Organization and concerns not one, but three children who have tested positive for a threatening polio virus.

Papua New Guinea is already ranked by the WHO as having the worst health status in the Pacific region. The polio outbreak comes at a time when the country is also facing huge challenges from diseases such as malaria, tuberculosis (TB), cancer, diarrheal diseases, pneumonia, and HIV/AIDS. By landmass, population and economy, PNG is the largest nation among Pacific island countries, yet the country’s health indicators have either stalled or gone backwards over the past 30 years.  Low immunization rates in Papua New Guinea, where 39% of the target population fails to be vaccinated, are not adequate to prevent spread.  Immediate bolstering of vaccinations will be critical to limiting the disease transmission.

These cases in Morobe province have galvanized health authorities into a focused response of intense surveillance and stepped-up vaccinations in the region surrounding this pocket of active polio transmission. More than 2900 health workers, vaccinators and volunteers have been mobilized to vaccinate almost 300 000 children under 5 years of age in Morobe.   Similar measures have been successful in containing past outbreaks in other countries. 

Circulating vaccine-derived polio spreads in Congo

There’s a worrisome polio outbreak in the Democratic Republic of the Congo (DRC) that you have probably never heard of. Part of the reason is that it is overshadowed by Ebola. But part is because it is caused not by the wild virus that is hanging on by a thread in Afghanistan, Pakistan, and perhaps Nigeria, but by a rare mutant derived from the weakened live virus in the oral polio vaccine, which has regained its neurovirulence and ability to spread. Public health experts have worked for months to stamp out the virus, but it keeps spreading. It has already paralyzed 29 children, and on 21 June a case was reported on the border with Uganda, far outside the known outbreak zone, heightening concerns the virus could be spreading across Africa. The DRC is “absolutely” the most worrisome polio outbreak today, says Michel Zaffran, who heads the Global Polio Eradication Initiative in Geneva at the World Health Organization.

This is a Type 2 polio virus mutated from live vaccine.  Similar outbreaks in Myanmar and other countries have been successfully contained, but so far, the spread of this virus in Africa has not yet been curtailed.  If the number of cases continues to grow and/or spread geographically, the vaccination strategy may need to be revised to meet the observed circumstances.

 Polio endemic countries show variable progress toward becoming polio free

As of July 17, 2018:

  • Nigeria – No wild type polio cases in 2018 or 2017. Two circulating vaccine-derived cases in 2018.
  • Afghanistan – Nine wild type polio cases in 2018, compared to five cases by this date in 2017. These are both low numbers, but the trend demands better vaccination coverage.
  • Pakistan – Three wild type polio cases in 2018, exactly the same as at this time in 2017. Similar to Afghanistan, these numbers are low but demand better vaccination coverage.

Nigeria appears to be progressing toward becoming polio free.  The progress in Pakistan and Afghanistan seems to have stalled in the last year and may require new strategies to reach previously missed families during past vaccination campaigns.  Migrant families have been identified as a concern, but current border-crossing vaccination efforts may only be a partial solution.

Time Now to Plan Polio Plus Fundraising

If you haven’t yet started, your club should consider planning for Polio plus Fundraising now.  World Polio Day is Wednesday, October 24, 2018.  This offers a perfect opportunity to boost community interest in educational or fundraising activities on or near that date.

Polio Eradication will not be complete until we achieve zero cases and find no residual in the environment.  We are close, but like putting out a fire, we need to watch for burning embers to prevent flare ups.