The Global Polio Eradication Initiative reported 11 new cases of polio in the past week, including four in Somalia and two in Ethiopia. Currently, the highly infectious polio is endemic in only three countries — Afghanistan, Nigeria, and Pakistan — but 'exportation' to non-endemic countries can occur at any time. In fact, with six new cases appearing in non-endemic countries over this week, public health officials fear their struggle to eliminate the virus worldwide could fail.
“The successes achieved through effective and safe vaccines and immunization campaigns, a global partnership, and a global mandate to eradicate polio are continually at risk,” the Bill and Melinda Gates Foundation, a key supporter of the Global Polio Eradication Initiative, notes on its website.
The World Health Assembly established the goal of eradicating polio in 1988, when the disease was endemic in 125 countries. At that time, nearly 350,000 people, mainly children under the age of 5, were becoming paralyzed each year due to polio. Since then, global immunizations reduced the number of polio cases by more than 99 percent while also decreasing the number of endemic countries to three. In 2012, when India was declared polio-free after great struggle, many believed the end of polio was near. Now, though, the hard work accomplished over decades has been placed in jeopardy.
As long as a single case of polio exists anywhere on earth, people remain at risk all over the world. Polio is most often contracted by children under 5, and one in 200 infections leads to irreversible paralysis. Five to 10 percent of those paralyzed die. According to the World Health Organization (WHO), failure to eradicate polio in the last three remaining strongholds — Afghanistan, Nigeria, and Pakistan — could result in as many as 200,000 new cases every year, within 10 years, all over the globe.
Substantial progress has been made in Afghanistan and Nigeria, which, as of Oct. 16, reported one-third and one-half the number of cases, respectively, as compared to 2012.
The majority of cases occur in the Federally Administered Tribal Areas (FATA), a tribal region in northwestern Pakistan. Currently, the situation in North Waziristan, FATA, is the area with the largest number of children being paralyzed by poliovirus in all of Asia. The reason this area is problematic is that previously, in June 2012, the Taliban denounced vaccines as a Western plot to sterilize Muslims. At that time, leaflets distributed on behalf of Mullah Nazir, the leader of FATA, accused health workers who administer anti-polio drops of being U.S. spies, according to The Guardian. International efforts to eliminate the highly infectious disease were questioned.
"On the one hand, they are killing innocent children in drone strikes, while on the other hand they are saving their lives by vaccinating them," the leaflet said, as reported by The Guardian.
The Taliban campaign against innoculation continues to this day. Earlier this month, a Taliban bomb exploded near a polio vaccination team in Peshawar, located in FATA. Two people died in a blast many believe was meant to hit the police assigned to protect the health workers.
"The vaccination teams are still going out, but at risk to their lives," Tariq Bhutta of the Pakistan Paediatric Association told Reuters. "People can come up on motorbikes and shoot them, and they've also started attacking the police put there to protect the vaccination teams."
Spread to Israel?
A simple glance at a chart created by the Global Polio Eradication Initiative for the week of Oct. 16 tells the whole story. Put into words, there are 296 new global cases of polio reported as compared to just 171 last year. Of those, 99 occurred in endemic countries (as compared to 166 cases in endemic countries last year). Meanwhile, 197 cases — as compared to just five cases last year — occurred in non-endemic countries so far this year.
Fears of a spreading virus, then, are justified as evidenced by Israel. In response to the detection of wild poliovirus, a type of naturally occurring polio, in its sewage system, Israel began a vaccination program just last month for all children under the age of 9. This particular strain of the virus had been detected in Israel since February, and had spread, at least in sewage samples, to the West Bank and Gaza Strip. Because of the circulation of the virus over a prolonged period of time, the WHO assessed the risk of international spread from Israel to be ‘high.’
“It is important that all polio-free countries, in particular those with frequent travel and contacts with poliovirus-affected countries and areas, strengthen surveillance for cases of acute flaccid paralysis in order to rapidly detect any new virus importations and to facilitate a rapid response,” the WHO stated in a recent press release.