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The news of Nigeria's progress, made by the World Health Organization on late Friday, leaves only Pakistan and its war-battered neighbor Afghanistan as countries where the disease is prevalent. Polio which can cause life-long paralysis can be prevented with a simple vaccination. "It's a great moment for Nigeria," Dr. Tunji Funsho, chairman of Rotary International's anti-polio campaign in Nigeria, told The Associated Press. "We should celebrate but with a caveat that we should not let our guard down." He attributed the success to teamwork between government and non-governmental health organizations.
A health official administers a polio vaccine to a child in Kawo Kano, Nigeria Polio is no longer endemic in Nigeria, the World Health Organization said late Friday, Sept. 25, 2015 leaving only Pakistan and its war-battered neighbor Afghanistan in the list of countries where the disease is prevalent.
Nigeria's main goal now is maintain vigilance to make sure that Nigeria has no new polio cases in the next two years so that the WHO can declare Nigeria a polio-free country, Dr. Funsho said. "Until that happens we are not out of the woods yet," he said. Once stigmatized as the world's polio epicenter, Nigeria in late July celebrated its first year with no reported case of the crippling disease, having overcome obstacles ranging from Islamic extremists who assassinated vaccinators to rumors the vaccine was a plot to sterilize Muslims.
Just 20 years ago this West African nation was recording 1,000 polio cases a year — the highest in the world. The last recorded case of a child paralyzed by the wild polio virus endemic in Nigeria's impoverished and mainly Muslim north was on July 24, 2014. WHO said Nigeria and Africa as a whole are now closer to being certified polio-free. The agency warned polio remains endemic in Pakistan and Afghanistan and that as long as the disease exists anywhere "it's a threat to children everywhere."
Nigeria revels in removal from list of polio-endemic nations
Active strain of the polio virus was found in sewage samples in southern India collected last month, officials announced Wednesday. Around 300,000 children ages three to six in Hyderabad, a city of nearly 7 million, will be vaccinated in the coming week. India's last case of polio was in 2011, and the country was officially declared polio-free in 2014.
A man bathes a child with a water pump beside a polio awareness campaign poster on the wall of a small shop in the village of Kosi, some 180 kilometers (113 miles) from Patna, India.
National health officials are calling on residents of Hyderabad to remain calm, maintaining that India is still polio free. "This is not the first time that a strain has been found but it is a vaccine-derived polio strain that is found com,monly in children with low levels of immunity," CK Mishra, a Health Ministry secretary told reporters. "They excrete it, which is why it is found in the sewage samples."
Indian Lambadi tribal villagers fill drinking water from a leaking pipe on a roadside at Chandampet Mandal in Nalgonda east of Hyderabad on April 25, 2016, in the southern Indian state of Telangana.
State health officials also told residents not to panic, saying that tests to find traces of the polio virus in the environment have been carried out regularly since the country was declared polio free five years ago. India worked with the World Health Organization, UNICEF, and several volunteer organizations to fight a decades-long battle eradicating the crippling disease.
India: Traces of Polio Found in Water Sample
About 350,000 children aged 6 weeks to 3 years old will be vaccinated next week in Hyderabad and the neighboring Ranga Reddy district in the state of Telangana. The Health Ministry said the discovery did not reflect a resurgence of polio in India, which was declared free of polio in 2014. "India continues to be polio free as the country has eradicated wild polio virus," the ministry said in a statement, noting the last case was recorded in January 2011. "It has been more than five years that no wild polio has been detected."
Polio affected Indian man Mastan (60) moves on a wheel chair with the help of another man through a crowded street in Hyderabad, India
The poliovirus detected last month in Hyderabad was a strain that had mutated from the vaccine itself, the ministry said. Its detection "only indicates the robustness of the surveillance system," the ministry said. Nevertheless, Telangana declared a high alert in 24 sectors of Hyderabad identified as "most-sensitive areas," the state's top health official Rajeshwar Tiwari told reporters. "There is no need to panic," he said. The virus detected last month was found by one of the random tests done regularly throughout India since the disease was eradicated.
A health worker administers a polio drop to an infant in Kolkata, India
India's federal and state governments, the World Health Organization, UNICEF and other groups united to fight the crippling disease, succeeding with the polio-free declaration in 2014. WHO and others will assist in the vaccination drive, Tiwari said. Hyderabad is often referred to as "Cyberabad" because technology giants, including Accenture, Microsoft, Verizon and Oracle, have their India headquarters in the city.
Indian city on alert as polio strain found in sewage water
The southern Indian state of Telangana declared a "high alert'' for polio after an active strain of the virus was found in samples of sewage water in the state capital, Hyderabad. India was declared polio free in 2014 and Paarul Ratra spoke to some health officials to understand how such threats are neutralised.
What causes strains of the polio virus to be found in sewage?
According to Dr Rajesh Singh, who is the regional health officer for the northern Indian city of Allahabad, one major factor for the re-emergence of the polio virus in sewage is the fact that many children are immunised against polio through oral vaccination. "When the vaccine is given through the mouth, the liquid that gets dissolved and passed on in the form of stool accumulates in the sewage system. The virus in that vaccine becomes a stronger and more resistant strain," he said. Dr Pradeep Haldar, the deputy chairman of the national immunisation programme, said, "People will continue to suffer as long as the oral vaccine is around. It tends to circulate for a long time. It has been happening, it never stopped and it won't stop unless, and until, we stop using the oral vaccine". Internal migration and water pollution are also likely causes.
A woman walks to a polio vaccine camp with her baby
How do health officials respond to such a situation?
"When it was found that Hyderabad might be at risk of polio, an environmental sample was taken immediately - and the report proving that it was in fact polio came within a week on 7 June. If there's a case spreading in the environment, all the concerned areas are scanned and action is taken," Dr Haldar said. The scanning phase has three aspects - immunisation coverage, testing of all lame children in case they carry a virus and polio surveillance. "If these three parameters are clear, then we can confidently say that the risk is low because our surveillance methods are of a high standard. "Even if one child out of 2,000 is affected, then the risk would be 5% higher or if even one child is missed out during the surveillance, the risk would be high. But we are confident that this is not the case," he said. Dr Singh added that everyone within a five kilometre radius is vaccinated as soon as possible to mitigate the chances of the virus spreading. Officials in Hyderabad plan to vaccinate more than 300,000 children, starting on 28 June.
Is there a strong possibility that polio can resurface in India?
According to Dr Singh, the chances of polio resurfacing are very low. "If the child is tracked over the first year and if the vaccine is given on time, it can be completely eradicated," he said. However Dr Haldar said that given the problems with oral vaccinations, there are bound to be at least between 100 and 1,000 low-risk carriers of polio, as vaccinations against the "wild" polio virus - which occurs naturally - were stopped in 2011 after no new cases of the disease were reported.
How is India dealing with the Hyderabad polio scare? - BBC News
Nigeria's removal from WHO's list of polio-endemic countries in October had meant the entire African continent was free of the crippling disease. Two children have been paralyzed by polio in northeastern Borno state in two different local government areas that had been cut off by Boko Haram's Islamic extremist uprising, Health Minister Isaac Adewole said in a statement Thursday night. "Our overriding priority right now is to rapidly boost immunity in the affected areas to ensure that no more children are affected by this terrible disease," he said.
He ordered the deployment of a national emergency response team. WHO said it was working with the government to urgently prevent more children from being paralyzed, with large-scale immunizations and other measures. It was unclear how accessible the two areas are. The United Nations last month suspended aid to newly liberated but still dangerous areas of Borno after Boko Haram ambushed a humanitarian convoy, wounding three civilians including a UNICEF worker. That came even as aid groups declared half a million people are starving in those areas and children are dying daily of starvation.
Because of the Islamic uprising in the northeast, health workers have been testing sewage and stool samples of refugees from areas too dangerous to access. Nigeria's fight against polio has been dramatic. Two decades ago, it was recording 1,000 polio cases a year, the highest in the world. The Islamic extremists opposed the anti-polio campaign. Boko Haram gunmen killed nine women vaccinators in northern Kano state in February 2013, but the vaccinations continued.
News from The Associated Press
Nigerian health officials say they plan to vaccinate nearly 5 million children beginning this month in the country's northwestern state of Borno where the latest cases emerged. The Associated Press news agency quoted Borno state health commissioner Ibrahim Miringa as saying that military helicopters have already begun transporting polio vaccines to the volatile state, where Boko Haram Islamist insurgents operate.
The World Health Organization said Friday polio has circulated undetected for years in Borno state. "This is an area which is not easily accessible and this is probably why the virus has been able to circulate without being detected and it's causing these cases," said WHO Director of Polio Eradication Michel Zaffran. Boko Haram militants based in Borno state have publicly denounced vaccination campaigns and prevented health workers from operating in the area.
An unidentified health official administers a polio vaccine to a child in Kawo Kano, Nigeria
The new polio cases — two children who were paralyzed with the virus -- came Thursday on what would have been Nigeria's two-year anniversary of being polio free. The country was on track to be certified free of the virus next year. Nigeria's health minister, Isaac Adewole, issued a statement Thursday saying that the cases were only detected because of a military offensive against Boko Haram. "I can assure the nation that we will do everything possible to be on top of the situation," he said.
Polio is a viral disease that usually affects children and can cause permanent paralysis. It is spread by poor sanitation and contaminated water. Last month, Doctors Without Borders issued a statement calling the health situation in Borno State "critical" with at least 500,000 people in urgent need of drinking water, food, medical care and shelter. The group called for a "massive relief operation" as the Nigerian army retook control of the main towns and villages, some of which had been under Boko Haram's sway for two years.
Nigeria Gears Up for Massive Polio Vaccinations After New Cases
Last year, the World Health Organization declared the country to be "polio-free." That milestone meant the disease was gone from the entire continent of Africa, a major triumph in the multibillion-dollar global effort to eradicate the disease. But that declaration of "polio-free" turned out to be premature. Three new cases of polio have been confirmed in areas liberated from Boko Haram militants, prompting health officials to launch a massive campaign to vaccinate millions of children across four countries in West and Central Africa Before the cases were found, the world appeared extremely close to making polio the second human disease after smallpox to be eradicated. There had been fewer than two-dozen polio cases in 2016, clustered in Pakistan and Afghanistan.
Then health officials in Nigeria found three paralyzed kids inside parts of Borno state that had been held by the Islamic militant group Boko Haram. Dr. Chima Ohuabunwo, an epidemiologist who's been working with the U.S. Centers for Disease Control and Prevention in Nigeria for the past five years, says Boko Haram has cut off parts of Borno state, in Nigeria's northeast, from the rest of the world. "There's been no direct in and out movement of persons, or access to health care, for the past two to three years," Ohuabunwo says.
A health official inks a child's finger to indicate she has received a polio vaccine last month at a camp of people displaced by Islamist extremists in Nigeria.
Earlier this year, he says, half of Borno state was a no-go zone. Government health care workers and international relief groups, including polio vaccination teams, could be attacked or killed if they tried to enter those areas. At the same time, Boko Haram was pillaging farms and destroying health clinics. "Of about 38 secondary health care facilities in the entire state, 16 were totally burnt down by these insurgents," Ohuabunwo says. It's only after recent military offensives by the Nigerian army into Boko Haram territory that health officials were able to find the three kids who'd been paralyzed by polio. One was a 4-year-old girl in a family that had escaped and made it to a displaced persons camp.
The immediate concern is to make sure all children in Borno state are vaccinated, but parts of the state remain under the militants' control. So polio immunizers have set up vaccination posts on the roads just outside the Boko Haram-controlled areas. "We only get access to the children when there's some incursion by the military and they [the children] come out," Ohuabunwo says. "We have prepared health teams called border post teams who sit and wait. As soon as the children come out, we get them, assess them, administer vaccines."
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After concluding a five-day response campaign across the provincial capital of Quetta earlier this month, health officials said they plan to give anti-polio drops starting January 16 to millions of children across 27 districts of the province, including those near the Afghan border. The new, intensified immunization effort follows detection of the rare Type 2 strain of polio, which the World Health Organization found in sewage samples in one of the districts in the province. Pakistan, Afghanistan and Nigeria are the only three countries in the world where the crippling virus is still active.
Remarkable progress
Despite security challenges and administrative weaknesses in national immunization efforts, Pakistan’s anti-polio fight achieved remarkable progress in 2015 when the country of about 200 million reported only 19 cases, down from a record of 309 cases in 2014. Aftab Kakar of the provincial emergency operation center in Quetta says that Type 2 polio struck about 15 children three years ago in the Killa Abdullah district toward the Afghan border.
A Pakistani health worker gives a polio vaccine to a child in Karachi, Pakistan, Dec. 1, 2016. Polio remains endemic in Pakistan after the Taliban banned vaccinations, instigated attacks targeting medical staffers and spread suspicions about the vaccine.
But routine immunization campaigns coupled with special response efforts at the time stopped the transmission of the virus until WHO’s findings released a couple of weeks ago confirmed its re-emergence in Baluchistan, where only one polio case was reported in 2016, Kakar said. “The international community has shown its concern over the detection of this (Type 2) virus in Pakistan because the rest of the world has eliminated it and reported no new cases for years,” he noted.
Type 2 virus
Pakistan stopped vaccinating children against the Type 2 polio during routine immunization campaigns since last April, believing the strain had been successfully eliminated from the country as in the rest of the world, Kakar said. “Now, our major concern and fear is that the group of children who were born after April 2016 are not immunized against Type 2 poliovirus. That group is now vulnerable and is in danger of contracting the virus,” he warned. On Wednesday, provincial health officials reported the first polio case of the new year in Killa Abdullah, but the strain of the virus was not known immediately.
Border campaign
