PHA-Exchange> WHO optimistic on global polio goals

[Claudio Schuftan]

From: Vern Weitzel vern at coombs.anu.edu.au
http://news.yahoo.com/s/ap/20070810/ap_on_he_me/un_polio

WHO optimistic on global polio goals
GENEVA - Four children in the southern African country of Angola have been
infected with polio, but the number of cases around the world has been cut
in
half so far this year, the U.N. health agency said Friday.

The new cases bring to 10 the number of Angolans who have caught polio this
year, the World Health Organization said. A national vaccination day is
scheduled for Aug. 31.

"For us, this isn't really a surprise. Angola has been clearly infected.
They
already have an outbreak," said Oliver Rosenbauer, a spokesman for WHO's
polio
eradication program. He said the agency was working with Angolan authorities
to
improve the quality of immunization efforts and surveillance in the country.

The re-emergence of polio in 27 countries in Africa, Asia and the Middle
East
was largely blamed on a 2003 vaccine boycott by hard-line Nigerian Islamic
clerics who claimed that an immunization campaign was part of a U.S.-ledplot to
render Nigerian Muslims infertile or infect them with AIDS.

Angola was re-infected in 2005 after a four-year lull in cases, but all
infections have been linked to a separate Indian strain of the virus. The
disease is also endemic in Afghanistan and Pakistan.

WHO registered 1,999 cases of polio around the world last year, an increase
from
1,749 in 2005. The vast majority of cases were in the endemic countries.

So far in 2007 there have been only 345 cases globally, compared with 872 at
the
same time last year, and Rosenbauer said officials at the health body were
"more
optimistic than they have been in a long time" about the prospects of
ultimately
eradicating the disease.

He said vaccination campaigns in India are reaching more and more people,
bringing rates down dramatically in the Western parts of Uttar Pradesh
state,
where the bulk of India's 676 cases of polio were last year.

There have only been three cases this year of type-1 polio _which causes the
greatest rates of paralysis and is easiest to catch — in what WHO calls the
"epicenter" of India's outbreak.

Most polio cases are recorded in India's rainy season, which has not yet
begun.

In India, polio cases persist despite widespread vaccination campaigns.
Health
officials suspect that the vaccine may be less effective in children who
have
other gastro-intestinal diseases like diarrhea or cholera, which are
widespread
across the sub-continent.

When WHO and partners began their anti-polio campaign in 1988, the worldwide
case count was more than 350,000 annually. The health body has missed goals
of
eradicating the disease by 2000 and 2005, and critics have wondered whether
eradication is logistically possible. No new target date for eradication has
been set, and the campaign has already cost over US$4 billion (euro2.9billion).

For every case of polio that causes paralysis, there are approximately 200
others that are asymptomatic, which makes stopping disease transmission
difficult. The oral polio vaccine used by health authorities also causes one
case of polio for every 2.5 million doses, and in rare instances, can mutate
into an even deadlier form of the disease that sparks new outbreaks.

Unlike smallpox, which was erased in 10 years, the polio eradication program
is
now entering its 19th year. No new target date for eradication has been set,
and
the campaign has already cost over US$4 billion (euro2.9 billion).

In the Nigerian state of Kano, where the 2003 crisis originated, officials
have
yet to report any type-1 cases, Rosenbauer said. But there have been 33
cases of
type-3 polio, which causes much fewer infected people to develop symptoms.

Polio is spread when unvaccinated people come into contact with the feces of
those with the virus, often through water. It usually attacks the nervous
system, causing paralysis, muscular atrophy, deformation and sometimes
death.
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