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Rumor, Fear and Fatigue Hinder Final Push to End Polio A New York Times article in the March 20, 2006 issue discussed many of the difficulties encountered in trying to vaccinate children in several foreign countries Nearly 18 years ago, public health officials and volunteers throughout the world committed themselves to eliminating polio by the year 2000. Since then, two billion children have been vaccinated, cutting the incidence of disease to more than 99%. However, the goal of reaching 100% faces several obstacles: cultural suspicions, logistical nightmares, competitions for resources, and simple exhaustion. This year, in addition to India and Nigeria, cases have been reported in Somalia, Niger, Afghanistan, Bangladesh and Indonesia. Eradication costs have reached $4 billion, so far. The biggest donors have been the United States and Rotary International. It becomes harder as interest lags, yet even one unvaccinated child can allow a new pocket of the disease to bloom. Now that official opposition to Nigeria’s eradication drive has dissipated, there are still problems of logistics and pockets of resistance. The vaccine must be kept chilled from the time it leaves the factory until it reaches a child’s mouth, and many refrigeration units are badly damaged. Entering homes can sometimes be difficult, as only women can enter a Nigerian Muslim household if the husband is away. While Nigeria struggles to restart its campaign, India uses more than half the world’s two billion polio vaccine doses each year. In India, living conditions are so dense with hot summers, open sewers, and monsoon flooding, that polio can easily flourish. Polio spreads through oral-fecal contact, and children can get it by drinking well water tainted by sewage or simply by picking up a ball that rolled through a gutter. International leaders were hopeful last year that the country would finish off the disease, but there were still 66 cases. Through the years, thousands of Rotary volunteers have worked on eradicating polio. On a recent trip to India, Ann Lee Hussey of Maine was among the volunteers. She got down on the floor with one little child with polio and compared their deformed feet. The little girl ran her hand on Ann’s foot and scars, and then other children came forward. Last year, India and other countries began trying a new eradication strategy using a “monovalent” vaccine that focuses only on the most common strain of polio, but gives immunity in fewer doses. Another eradication problem is that a tiny number of healthy people with a rare immune-system defect can keep excreting polio virus for decades, thus, theoretically, allowing a new outbreak many years in the future. That appears to be what happened in the Amish community in Minnesota last year. In another article written by Dr. Richard Bruno, he mentioned that the Centers for Disease Control estimate that 90% of U.S. children under 3 years old are vaccinated against polio. Yet, that means one million toddlers (remaining 10%) in the U.S. are not vaccinated. America’s next paralytic polio epidemic could be just a plane ride away. A Senate-passed resolution proclaims 2006 as national “year of polio education”; reminding people that polio should not be forgotten as it is not yet gone. Further legislation and public awareness may be necessary if every child is to be vaccinated and an unnecessary epidemic avoided. |
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Winter 2006-2007 |