Polio! Let’s Stop It
Dr.Zeeshan Khan
Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988
the global incidence of poliomyelitis has fallen by nearly 99 %.From a
situation where wild type poliovirus was endemic in 125 countries across
five continents, transmission is now limited to regions of just three
countries – Pakistan, Afghanistan and Nigeria.A sharp increase in Pakistan’s
poliomyelitis cases in 2014 prompted the International Health Regulations
Emergency Committee to declare the situation a ‘public health emergency of
international concern’.Global polio eradication hinges on Pakistan’s ability
to address the religious, political and socioeconomic barriers to
immunisation; including discrepancies in vaccine coverage, a poor health
infrastructure, and conflict in polio-endemic regions of the country.This
comprises focusing on the historical and contemporary challenges facing
Pakistan’s polio eradication programme and the impact of conflict and
insecurity, and sheds light on strategies to combat vaccine hesitancy,
engage local communities and build on recent progress towards polio
eradication in Pakistan.
Pakistan’s polio eradication programme has come under international scrutiny
due to its position as the main driver of global wild poliovirus spread in
recent years. This is rooted in financial and organisational deficits, as
well as active conflict and insecurity, which has resulted in the persistent
failure of effective immunisation campaigns and SIAs to reach all areas of
the country.
Two types of vaccine protect against polio:oral poliovirus vaccine (OPV) and
inactivated poliovirus vaccine (IPV).Poliomyelitisis a crippling and
potentially deadly infectious disease. It is caused by the poliovirus. The
virus spreads from person to person and can invade an infected person’s
brain and spinal cord, causing paralysis (can’t move parts of the body).
Most people who get infected with poliovirus (about 72 out of 100) will not
have any visible symptoms.About 1 out of 4 people with poliovirus infection
will have flu-like symptoms that may include—Sore
throat,Fever,Tiredness,Nausea,Headache,Stomach pain.These symptoms usually
last 2 to 5 days then go away on their own.
A smaller proportion of people with poliovirus infection will develop other
more serious symptoms that affect the brain and spinal
cord:Paresthesia,Meningitis,Paralysis or weakness in the arms, legs, or
both, occurs in about 1 out of 200 people with poliovirus infection
Paralysis is the most severe symptom associated with polio because it can
lead to permanent disability and death. Between 2 and 10 out of 100 people
who have paralysis from poliovirus infection die because the virus affects
the muscles that help them breathe.
Even children who seem to fully recover can develop new muscle pain,
weakness, or paralysis as adults, 15 to 40 years later. This is called
post-polio syndrome.People with the paralytic infection are considered to
have Polio only.
Poliovirus only infects humans. It is very contagious and spreads through
person-to-person contact.The virus lives in an infected person’s throat and
intestines. It enters the body through the mouth and spreads through contact
with the feces (poop) of an infected person and, though less common, through
droplets from a sneeze or cough. You can get infected with poliovirus if you
have feces on your hands and you touch your mouth. Also, you can get
infected if you put in your mouth objects like toys that are contaminated
with feces (poop).
An infected person may spread the virus to others immediately before and
about 1 to 2 weeks after symptoms appear. The virus can live in an infected
person’s feces for many weeks. It can contaminate food and water in
unsanitary conditions.
People who don’t have symptoms can still pass the virus to others and make
them sick.
Polio vaccine protects children by preparing their bodies to fight the polio
virus. Almost all children (99 children out of 100) who get all the
recommended doses of vaccine will be protected from polio.
The best way to protect against polio is to get the polio vaccine, also
called IPV (or inactivated poliovirus vaccine). Doctors recommend all
children get the vaccine.
Polio is a disease caused by poliovirus. It can cause lifelong paralysis,
and it can be deadly.
The polio shot:Protects your child from potentially serious disease.Prevents
your child from developing lifelong paralysis from polio.
Vaccines, like any medicine, can have side effects. Most children who get
polio shots have no side effects. When side effects do occur, they are
usually mild, like temporary redness and pain where the shot was given.
Pakistan is the most populous country in the WHO’s Eastern Mediterranean
Region and one of the least developed, with a large population of
approximately more than 200 million people including 30 million children
under 5 years old and 70.2 million children under 15 years old, making it
critical to polio eradication efforts.
There is a strong correlation between low immunization completion and
negative socioeconomic factors, in addition to conflict, such as illiteracy,
poverty and difficulty accessing community health and immunization services.
Pakistan faces all of these challenges coupled with a difficult geography,
from the Himalayan mountain range and glaciers of the north to the harsh
terrain of Balochistan in the south, contributing to poor public health
delivery.Additionally,With less than 2 % of the Gross National Product (GNP)
spent on healthcare.
There are concerns regarding OPV efficacy.There is also Vaccine
hesitancy.Cultural issues such as the presence of all-male vaccinator teams
when the mother is alone, or when family or community elders have not given
consent for vaccination have also been cited as important barriers to
immunisation in some communities.Conflict, militancy and the polio
eradication campaign.
Despite the multitude of challenges facing Pakistan’s polio eradication
campaign, the annual number of polio cases has declined by more than 90 %
since 1994. Conflict and insecurity in KP and FATA led to a dramatic rise of
reported paralytic polio cases in Pakistan.
However,Different Strategies can improve the polio eradication campaign
like:Strengthening Pakistan’s health infrastructure,Community engagement and
education,Prioritising vaccination in polio-endemic regions and by adopting
Global health, diplomacy and foreign policy.