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Just weeks ago India was declared polio-free and the world appeared to be getting closer to the goal of eradicating the debilitating disease globally. But the news of wild polio virus crossing transnational borders to spread to countries from where it was said to have been eradicated, has come a severe setback to achieving the goal, set nearly three decades ago.
The World Health Organization (WHO), which convened an emergency meeting, termed the development as an “extraordinary event” on Monday. It said that if the situation goes unchecked, it could result in failure to eradicate the deadly disease globally.
According to report, polio virus has spread from the three countries where it was confined—Pakistan, Afghanistan and Nigeria—and has been reintroduced in seven others—Cameroon, Equatorial Guinea, Ethiopia, Israel, Nigeria, Somalia and the Syrian Arab Republic—in the past six months.
Expressing concern, the apex health agency admitted that this is in stark contrast to the near-cessation of international spread of wild poliovirus. WHO South East Asia region, which includes India, was declared polio free in a programme organized in New Delhi in March. Americas, European region and Western Pacific region were freed earlier.
Read more on global fight to eradicate polio
These successes are now under serious threat, warned WHO.
Call for global, coordinated response
To face the new challenge and prevent the international spread of wild poliovirus, WHO has recommended a coordinated international response with the onset of the high transmission season in May/June 2014. It also warned that unilateral measures may prove less effective in stopping international spread as compared to a coordinated response.
According to WHO, interrupting wild poliovirus transmission within country borders should be the utmost priority for all polio-infected states and that this has to be done rapidly.
It has suggested strategies like supplementary immunization campaigns with oral poliovirus vaccine (OPV), surveillance for poliovirus, and routine immunization.
The expert committee which discussed the matter also suggested few measures to the director-general of WHO, based on a risk stratification of the 10 states with active transmission.
Recommended strategy
For states currently exporting wild poliovirus like Pakistan, Cameroon, and the Syrian Arab Republic which pose the greatest risk of further wild poliovirus exportations in 2014, the suggestions include:
Officially declare, if not already done, at the level of head of state or government, that the interruption of poliovirus transmission is a national public health emergency
Ensure that all residents and long-term visitors (for less than four weeks) receive a dose of OPV or inactivated poliovirus vaccine (IPV) between four weeks and 12 months prior to international travel
Ensure that those undertaking urgent travel (within four weeks), who have not received a dose of OPV or IPV in the previous four weeks to 12 months, receive a dose of polio vaccine at least by the time of departure as this will still provide benefit, particularly for frequent travellers
Ensure that such travellers are provided with an international certificate of vaccination or prophylaxis in the form specified in Annex 6 of the International Health Regulations (2005) to record their polio vaccination and serve as proof of vaccination
Maintain these measures until the following criteria have been met: (i) at least six months have passed without new exportations and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until at least 12 months have passed without new exportations.
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