May 17, 2005

Push to rid Africa of polio marches onward

A massive campaign this week to immunize more than 77 million children across Africa against polio is the latest effort to stop the spread of the disease by the end of this year.

But an official with the Centers for Disease Control and Prevention said Tuesday it is not likely that the goal will be met.

"We are probably looking at Asia becoming polio-free by the end of this year, and Africa still having some transmission into 2006," says Hamid Jafari, director of CDC's polio program. India has had only 14 cases this year and Pakistan just seven, but "as long as Nigeria is infected, surrounding countries are at risk."

Polio had been eliminated in all but six countries, but in the past couple of years, the virus has been reintroduced into 16 countries that had not seen a case in years. Health officials moved quickly to launch immunization programs, and this year, only nine countries have reported cases so far.

The reinfection of polio-free areas occurred because many countries quit vaccinating children, leaving them vulnerable to infection, says Claire Hajaj, a spokeswoman for UNICEF, which is leading the global eradication campaign along with the CDC, World Health Organization and Rotary International.

When authorities in northern Nigeria stopped immunizing children from August 2003 to July 2004, wrongly suspecting that the vaccine could cause HIV infection or sterility, polio rates shot up.

"It was like a spark that hit a lot of dry tinder in the region," Hajaj says.

In 2004, Nigeria reported 792 cases of polio, up from 202 in 2002 and 355 in 2003, according to the WHO. Cases spread across Africa and beyond, as far away as Indonesia. In Indonesia, no polio had been found since 1995, but last week, two more cases were confirmed, bringing the total to eight this year.

The massive immunization campaign in Africa, which began last weekend, is the third one this year, Hajaj says. "The priority is to reach children at the heart of this epidemic to close it down."

The Nigerian outbreak is coming under control with 77 cases this year, compared with 119 at this time last year, but "what we are feeling still is the ripple effect" as cases spread to other countries and within those countries, Jafari says.

Smallpox is the only disease ever eradicated, but Hajaj says polio is more tenacious because most infections are not recognized. About one in 200 children with the virus become paralyzed.

The fact that it is on the run in some of the poorest and most densely populated regions "is a testament to possibility," Hajaj says.

"These are the hardest places in the world to fight any disease, never mind one as difficult as this one. Everybody knows polio is a very, very difficult disease to beat."





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