By Elizabeth Sitotombe
A YOUNG girl’s life will never be the same again after being paralysed by an undiagnosed wild polio infection in Malawi’s capital Lilongwe in February.
The strain found in the child was linked to one circulating in Pakistan.
Polio caused by the wild virus is still endemic in Afghanistan and Pakistan.
The case was confirmed by the Regional Reference Laboratory in South Africa as well as by the Global Polio Reference Laboratory in CDC Atlanta.
On March 8 2022, Israel detected its first polio case since 1989, in a four-year-old boy in Jerusalem, according to an announcement from the country’s Ministry of Health. Both children had not been vaccinated against polio.
It is a development that is worrisome and threatens to derail efforts by governments all over the world whose aim is to completely do away with polioviruses.
A drive to vaccinate more than nine million children against polio was launched this month in Southern and Eastern African countries following a confirmed outbreak in Malawi. The size of the outbreak remains unclear.
Polio is a highly infectious disease caused by a virus that invades the nervous system and can cause permanent paralysis within hours (approximately one in 200 infections) or death (approximately 2-10 percent of paralysed cases).
The virus is transmitted by person to person either through droplets from the upper respiratory tract during the early days of infection or more commonly through the ingestion of infectious faecal-contaminated material in circumstances of poor hygiene.
In theory, polioviruses may be transmitted to persons outside the laboratory through contaminated laboratory effluents released into sewage, solid wastes transported to landfills, spent air exhausted to surroundings or contaminated workers’ skin clothing.
Polio usually affects children under the age of five and those living in areas with poor sanitation are most at risk.
Early symptoms of polio include high fever, headache, stiffness in the back and neck, asymmetrical weakness of various muscles, sensitivity to touch, difficulty swallowing, muscle pain, irritability, constipation or difficulty urinating.
Those who are infected may spread the diseases for up to six weeks even if no symptoms are present.
The disease may be diagnosed by finding the virus in the faeces or detecting antibodies against it in the blood.
This is the first case of wild polio detected in Africa in years.
In 1996, about 75 000 children were paralysed by the disease. Since then, more than nine billion doses of oral polio vaccine have been provided throughout the region, preventing an estimated 1,8 million cases of paralysis.
The last case of wild polio virus was identified in northern Nigeria in 2016.
There are three variants of wild or naturally occurring polio. Two types have been eradicated (WPV2 and WPV3), while WPV1 is the remaining one found in Pakistan and Afghanistan.
Africa was declared free of the wild polio virus on August 25 2020 after a sustained vaccination programme across the continent and going for four years without a single case of wild polio.
The emergency immunisation campaign where vaccine drops are to be administered to children across the country has begun in Malawi.
Over the next four months, vaccines will also be offered to children in Mozambique, Tanzania, Zambia and Zimbabwe.
There is no cure for the disease but an effective vaccine that was developed in the 1950s has led to it being completely eradicated in most parts of the world.
The vaccine protects children for life.
Since 1988 global cases of the virus have dropped by a resounding 99 percent from more than 350,000 to just five cases in Afghanistan and Pakistan last year according to Al jazeera.
According to Dr Modjirom Ndotabe, polio co-ordinator in WHO regional office for Africa: “Any case of wild polio virus is a significant event and we will mobilise all resources to support the country of Malawi’s response.”
The poliovirus can easily be imported into a polio-free country and can rapidly spread among unimmunised populations.
The lockdown measures brought about by the COVID-19 pandemic impacted greatly on general vaccinations of children in many countries, including Zimbabwe.
“The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunisation services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life,” said Dr Matshidiso, WHO regional director for Africa.
In Zimbabwe, some children are lagging behind on their vaccination schedules and parents are encouraged to take this time, when the lockdown measures have been eased, to get their children vaccinated. There are certain religious sects, like the apostolic sect, that do not believe in getting their children vaccinated against these killer diseases.
They travel a lot, gathering in various places that usually have little or no sanitary facilities, making the chances of transmission high.
According to Dr Chirisa, a well-known paediatrician: “We can never be too careful about vaccinating our children. We have so much evidence that vaccines work, they protect us. We cannot take our eyes off the ball. Zimbabwe has not had active cases for several years now, but we need to redouble our monitoring efforts as it can happen here and we miss it. However, health officials are always on the alert for any scare. The Health Ministry doubled its efforts during the lockdown in order to ensure that children did not lag behind in getting vaccinated.”
WHO Africa states that this new detection of wild poliovirus does not affect the region’s wild poliovirus-free certification status. However, it takes the world several steps backwards in the effort to completely do away with the virus.
Eliminating polio is the only way to ensure that children do not have to suffer from a completely avoidable illness.
There is no cure for polio. Doctors treat symptoms only when the virus runs its course. Vaccination is the best way to prevent polio.
Save your children from polio with the co-operation of Government and spread awareness among other parents.
Let us not give polio a chance to come back again.