Nigeria resuming polio immunization

Jun 30 2004

The World Health Organization (WHO) has been informed by the Governor of Kano, Nigeria, of the intention to resume polio immunization campaigns there in early July.

This is further to confirmation from the Governor that he accepts that the oral polio vaccine is safe and effective. Training for the July campaigns began on Saturday, 26 June and the Governor has requested assistance from WHO in planning and implementation of the campaigns. WHO and other partners in the Global Polio Eradication Initiative have offered their full support.

These developments coincide with discussions between the Director-General of WHO, Dr LEE Jong-wook, the President of Nigeria, Olusegun Obasanjo, and the federal Minister of Health, and requests from WHO member countries for advice on the status of the polio epidemic in Nigeria. The resumption of immunization campaigns in Kano is now critical to rapidly increase population immunity and to help contain the international spread of polio from Nigeria which is key to the global effort to eradicate the disease.

In 2004, as a result of the success in eradicating smallpox, the WHO announced a $3 billion campaign to eradicate polio worldwide by the end of 2006. Most remaining polio infections are located in two areas: the Indian sub-continent and Nigeria. Eradication efforts in the Indian sub-continent have met with a large measure of success. Indian Government started the Plus-Polio Campaingn to get rid of Polio. Most families allowed their children to take the vaccine. Some Muslim families refused due to false rumors that the vaccine causes sterility in boys. In northern Nigeria, the location of half of all documented polio cases in 2003, Muslim clerics have repeated inveighed against the vaccine as a effort by Westerners to sterilize young Nigerian Muslim girls. As of March 2004, the polio eradication efforts in northern Nigeria are largely ineffective. By May, polio was reported to have spread from there to several other African nations.

Countries across the African continent and the world are increasingly concerned about the rate at which wild poliovirus continues to spread internationally from northern Nigeria. Ten previously polio-free countries across Africa have now been re-infected, most recently the Sudan, where a case in Darfur was confirmed last week.

"I welcome these steps towards the resumption of polio immunization reported by the Governor of Kano," commented Dr LEE. "To date, the ongoing suspension of immunization campaigns in Kano has put thousands of children in African countries at risk of polio paralysis. The suspension has also resulted in the re-emergence of polio in countries which had been polio free. If the campaigns were not resumed in Kano, a twenty year, three billion dollar effort involving 20 million people to eradicate polio would be in jeopardy."

Because international travellers to northern Nigeria remain at high risk of polio, it is important that they protect themselves by being up-to-date with vaccination against poliomyelitis as outlined in WHO's International Travel and Health. A booster dose of polio vaccine is recommended four to six years after the primary series of vaccinations. Any individuals intending to travel to Nigeria should have completed a full course of polio vaccination, as recommended by their national governments.

The poliovirus can, however, infect persons who have been vaccinated, and they can spread the virus. Poliovirus, carried by such persons, has caused outbreaks of polio in the past.

In order to ensure that all possible measures are considered to prevent the re-emergence of endemic polio in countries previously polio-free, WHO has begun a consultative process with experts to evaluate additional measures that might be required to prevent the further international spread of wild poliovirus from northern Nigeria.

WHO will continue to monitor, with federal and Kano state authorities in Nigeria, the impact of the July polio immunization campaigns and provide additional advice, if required.

Poliomyelitis ("polio") is a viral paralytic disease. The causative agent, a virus called poliovirus, enters the body orally, infecting the intestinal lining. It may proceed to the blood stream and into the central nervous system causing paralysis and muscle weakness.

Polio may be spread through contact with feces or through airborne particles.

The first effective polio vaccine was developed by Jonas Salk, and inoculations of children against polio began in Pittsburgh, Pennsylvania on February 23, 1954. Through mass immunization, the disease was wiped out in the Americas, although it recently has re-appeared in Haiti, where political strife and poverty have interfered with vaccination efforts.

Young children who contract polio are likely to suffer only mild symptoms, and as result they may become permanently immune to the disease. Hence inhabitants of areas with better sanitation may actually be more susceptible to polio because fewer people have the disease as young children. People who have survived polio sometimes develop additional symptoms, notably muscle weakness, decades later; these symptoms are called post-polio syndrome.

The first medical report on poliomyelitis was by Jakob Heine in 1840. Karl Oskar Medin was the first to empirically study a poliomyelitis epidemic in 1890. The work of these two physicians has led to the disease being known as the Heine-Medin disease.