Many experts believed polio was on the verge of eradication, particularly after India, the most polio-endemic country in the world just a few short years ago, eliminated the crippling viral disease with it’s last case being reported on January 13, 2011.
In fact, The World Health Organization (WHO) Director-General Margaret Chan said of India’s achievement, “India’s success is arguably its greatest public health achievement and has provided a global opportunity to push for the end of polio.”
Three and one-half years later and it seems the polio situation has got worse in certain areas of the Middle East and Africa. The World Health Organization (WHO) recently declared the international spread of wild poliovirus (WPV) a public health emergency of international concern and the Centers for Disease Control and Prevention (CDC) issued new vaccine requirements July 25.
The CDC recommends that travelers to any country with WPV circulation in the last 12 months protect their health by being fully vaccinated against polio, including a single lifetime polio vaccine booster for adults, these include the following 10 countries: Afghanistan, Cameroon, Equatorial Guinea, Ethiopia, Iraq, Israel, Nigeria, Pakistan, Somalia, and Syria.
A Department of Defense (DOD) spokesperson elaborated on the seriousness of polio, being vaccinated and the risk to the United States. Army Col. (Dr.) Margaret Yacovone said, “We don’t want to bring polio back into the United States, she said, noting that some groups in this country are opposed to vaccinations. “All it will take is someone to bring it back here and infect a community that is unvaccinated,” she emphasized. “Even one case would one would be devastating.”
The CDC updated travel notices for several of the affected countries Friday, emphasizing the new temporary polio vaccine requirements.
According to the Global Polio Eradication Initiative, 128 cases of polio have reported to date, with 77 percent of cases (99) being reported from Pakistan.
Polio is caused by the poliovirus types 1, 2 and 3. All three types cause paralysis, with wild poliovirus type 1 being isolated from paralysis cases most often. This viral infection is primarily spread from person to person through the fecal-oral route. However, in places where sanitation is very good, transmission though throat secretions may be considered more important.
Polio is recognized in about 1 percent of infections by flaccid paralysis, while over 90 percent of infections are unapparent.
Paralysis of poliomyelitis is usually asymmetric and the site of paralysis depends on the location of nerve cell destruction on the spinal cord or brain stem. Legs are affected more often than the arms. Paralysis of the respiration can be life threatening. Polio must be differentiated from other paralytic diseases like botulism and Guillain-Barre Syndrome.
The countries that have not succeeded in interrupting polio transmission and are considered endemic include Afghanistan, Nigeria and Pakistan.
Most cases of polio are in children under the age of three. Prevention of polio is through immunization, either through the live oral poliovirus vaccine (OPV) or the inactivated poliovirus vaccine (IPV).