Polio in the Middle East, the vaccination campaigns are working

Preventive vaccination campaign against polio that was conducted for twelve months in eight countries of the Middle East was able to stop the progression of the disease in this region of the world, after the appearance of more than thirty-eight cases in Syria and Iraq.

According to experts from the World Health Organization and UNICEF, other preventive vaccination campaigns against polio have yet to be conducted over the coming months.

The disease appears to be limited according to the experts who met recently in Beirut. In a statement released by UNICEF and the World Health Organization, they explain that following the diagnosis of the cases mentioned above, a wide vaccination campaign was conducted in Lebanon, Syria, Iraq, Jordan, Egypt, Turkey, Iran, Gaza and the West Bank, targeting some 27 million children aged between 0 and 5 years. More than a year has passed since the onset of the last case in Syria and nine months since the last case in Iraq.

“Under normal circumstances, we would have said that the epidemic was stopped”, said Maria Calivis, Regional Director of UNICEF in the Middle East and North Africa. “But since the conflicts continue in the area, UNICEF and its partners will spare no effort to ensure the protection the children need against this terrible disease.”

According to the experts gathered in Lebanon, many children could not receive regular vaccine, because of fighting in Syria and Iraq. This is the reason why other vaccination campaigns have yet to be conducted over the next few months, they said.

According to Chris Maher, head of department of eradication of the disease at WHO, the next step is to “reach all children in the region, even those living in the most conflict-affected areas.”

It should be recalled that WHO had confirmed the outbreak of the disease in Syria in late 2013, reporting at least ten cases of paralysis, that is to say, almost fourteen years after the disappearance of the disease in 1999. The resurgence of polio is mainly due to the deterioration of health facilities and lack of vaccination campaigns. The WHO said that the virus came from Pakistan. The disease also affected Iraq where vaccination has sometimes been hampered in some places because of the war.

Polio is a highly contagious disease that results in flu-like symptoms with fever, fatigue, headache, vomiting, neck stiffness and pain in the limbs of the body. The disease is caused by poliovirus that multiplies in the intestine and is transmitted primarily through fecal-oral route. Not everyone develops the disease. Nevertheless, when mention of a reported case of polio, that is to say a case of paralysis due to the virus, this means that 200 people are already infected.

Preventive vaccination campaign aims to create this intestinal immunity. According to the national immunization schedules worldwide, every child should receive the injectable vaccine. But it provides individual protection to the child, and does not prevent it from being a carrier of the virus, hence the importance of these massive campaigns within which the oral vaccine is administered to children. This actually allows creating the intestinal immunity, preventing the virus to multiply. There is a catch, however. The oral vaccine may represent a risk for people with severe immune deficiency (cancer, AIDS…), since it is composed of attenuated viral strains. If they receive the vaccine, these children will develop a vaccine-associated paralysis, that is to say, they will develop the disease in response to the vaccine. That is why this category of children was excluded from the vaccination campaigns against polio that were conducted to date in Lebanon.

There is no treatment against polio. It is only possible to prevent it through vaccination. Some symptoms may nevertheless be relieved with medication (such as antispasmodics to relax the muscles). The WHO says, “Polio does not respect borders – every unvaccinated child is exposed. For every case of paralysis, between 200 and 1,000 children are infected without symptoms. It is therefore difficult to detect polio and also difficult to prevent the virus from traveling. Children living in areas with low levels of immunity are particularly vulnerable. Eradication of the virus is the best defense against polio imports. It is only once this goal is achieved that all children are protected.”