Concerns over polio resurgence in Nigeria
*As COVID-19 lockdowns increase number of cases in Pakistan
There are concerns over possible resurgence of Wild Polio Virus (WPV) in Nigeria as Pakistan has recorded increase in number of cases due to the COVID-19 lockdowns.
According to a study published online in the journal Public Health, a spike in the number of polio cases in Pakistan, the last refuge of the virus in the world along with neighbouring Afghanistan, is being attributed by health experts to disruption in vaccination services caused by lockdowns and restrictions against spread of the COVID-19 pandemic.
Researcher in molecular biology and immunology at Quaid-i-Azam University, Islamabad and lead author of a study, Misbahud Din, said: “The increase in polio cases could result in the global export of infections and healthcare authorities must intensify efforts to track and vaccinate unvaccinated children.”
Din told SciDev.Net: “80 cases of wild polio virus (WPV) and 64 cases of circulating vaccine-derived poliovirus (cVDPV) have been reported in 2020.”
Africa was on August 25, 2020 declared free from wild polio by the independent body, the Africa Regional Certification Commission. Polio usually affects children under five, sometimes leading to irreversible paralysis. Death can occur when breathing muscles are affected.
Twenty-five years ago thousands of children in Africa, were paralysed by the virus. The disease is now only found in Afghanistan and Pakistan. There is no cure but the polio vaccine protects children for life.
Nigeria is the last African country to be declared free from wild polio, having accounted for more than half of all global cases less than a decade ago.
The vaccination campaign in Nigeria involved a huge effort to reach remote and dangerous places under threat from militant violence and some health workers were killed in the process.
Meanwhile, according to the study, around 40 million children missed polio vaccination after Pakistan, on March 26, suspended a mass vaccination programme being carried out under the Global Polio Eradication Initiative (GPEI).
With support from United Nations Children Fund (UNICEF), World Health Organisation (WHO) and GPEI partners, the Pakistan government resumed polio immunisation late July and conducted the second of two sub-national campaigns in August as COVID-19 cases started declining in the country.
But enforcement of social distancing, vaccine supply disruptions and elevated shipment costs during the four-month break had caused a momentum loss in a concerted drive to make the country polio-free.
Two years ago, with only 12 reported cases, Pakistan had come close to becoming polio-free. But the number of cases rose to 147 in 2019. According to Din, the sharp reversal was due to “illiteracy, vaccine refusal by parents, poverty, conspiracy theories and rejection of vaccination by some local religious scholars”.
Concerted efforts early 2020 led to expectations that the year would see a halt in polio transmission by 2021. But the country was then hit by COVID-19, resulting in massive diversion of public health resources to tackle the new threat.
According to a UNICEF report, the suspension of immunisation activities and disruptions in other health-related interventions due to COVID-19 pandemic from March to mid-July has increased the number of unimmunised children, including close to 700,000 new-born per month, leading to widening immunity gaps.
“It could be concluded that diverting public health funds to fight against other outbreaks disrupted polio eradication plans, which could lead to the spread the of poliovirus in areas of low immunization coverage and immunity,” the new study noted.
Din added that it is “challenging for countries like Pakistan with limited health care facilities to deal with the current pandemic along with other outbreaks liked dengue, malaria and typhoid because COVID-19 overburdened the health care system. Staff already trained to handle polio vaccinations were directed to fight against the COVID-19 pandemic”.
WHO representative in Pakistan, Palitha Mahipala, commented on World Polio Day on October 24 that following the certification of the African region as free of wild poliovirus in August, his organisation is “working hard to ensure that Pakistan can be the next country on the journey to a polio-free world.
“The polio programme with its partners has now been able to ramp up activities with a revitalised resolve to end polio in Pakistan as recently done by Africa.”
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