Fear of possible polio re-infection in Nigeria persists

• As Israel finds the first case of polio in over 30 years in a three-year-old girl
• NPHCDA prepares against possible importation of poliovirus from Malawi, others

The fears of possible polio reinfection in Nigeria has become more palpable as a three-year-old girl in Jerusalem, Israel, has come down as the first case of polio in the Middle Eastern country in over 30 years.

The World Health Organisation (WHO) declared Nigeria and indeed Africa polio-free on August 20, 2022.

Local officials, according to the Wall Street Journal, report that the girl, who was unnamed by the Jerusalem District Health Bureau, was not vaccinated against the virus, which has largely been defeated around the world due to widely available jabs.

The young girl’s case was reported to local health authorities after she felt symptoms of paralysis.

It is the first Israeli case of the potentially debilitating virus since 1988. Officials have not yet determined the origin of the infection, or whether she has passed it on to anyone else.

Also, the WHO, penultimate week, reported the first case of polio in Malawi after over five years.

Following the recent outbreak of the Wild Polio Virus (WPV) in Malawi, after five years, the Federal Government, yesterday said it has put measures in place to safeguard the country against the importation of the virus.

Executive Director and Chief Executive Officer (CEO), National Primary Health Care Development Agency (NPHCDA), Dr. Shuaib Faisal, in a statement, yesterday, said one of such measures is the reactivation and reconstitution of the Expert Review Committee on Polio Eradication and Routine Immunization (ERC).

Faisal, who is also a consultant public health physician and epidemiologist, said the ERC provides expert advice and guidance on strategies and approaches for polio eradication and routine immunization. He said the committee meets periodically to review the country’s polio eradication and routine immunization programmes taking into consideration population-based and laboratory studies, programmatic approaches, cost information, and other issues so as to provide holistic and practical advice to the country.

Faisal said the ERC’s expert advice contributed immensely to the country’s achievement of WPV-free status in August 2020 and it has become imperative to reactivate the committee following the recent outbreak of WPV in Malawi and the outbreaks of circulating variant of poliovirus type 2 (cVPV2) in Nigeria.

He said the ERC is expected to work with the National Primary Healthcare Development Agency (NPHCDA) to come up with multi-stakeholder plans to strengthen surveillance, build population immunity, militate against and control all forms of polioviruses.

Faisal said the reconstituted 12-member expert committee chaired by a public health expert; Prof. Akin Osibogun has members drawn from the academia, the media, donors and development partners including the WHO, United States Centres for Disease Control (CDC) and the Bill and Melinda Gates Foundation (BMGF). Members include Prof. Dorothy Esangbedo, Prof. Shuaib Bello, Prof. Clara Ejembi, Prof. Sade Ogunsola, Prof. B.S.C. Uzochukwu, Prof. Ilayisu Zubairu, Dr. Muhammad Dallatu, Mr. Mannir Dan Ali, Dr. Steve Cochi (CDC), Mr. Aidan O’Leary (WHO) and Jay Wenger (BMGF). The reconstituted ERC have a renewable tenure of two years and will be inaugurated at a date to be announced soon.

The NPHCDA is a parastatal of Nigeria’s Federal Ministry of Health, which was established in 1992 and merged with the National Programme on Immunisation (NPI) in 2007. NPHCDA’s vision is to make primary healthcare services available to all. The NPHCDA provides technical and programmatic support to States, LGAs, and other stakeholders in the functioning, planning, implementation, supervision and monitoring of primary health care services in Nigeria.

The agency strives to fulfil seven corporate goals: control preventable diseases, improve access to basic health services, improve quality of care, strengthen institutions, develop high performing health workforce, strengthen partnerships and strengthen community engagement.

Polio infection can be catastrophic, causing an infected person to suffer paralysis. Vaccines are widely available, though the virus still remains a problem in Afghanistan and Pakistan.

A spokesman said that the case in Israel was likely vaccine-derived polio, which is a mutation of the strain used for the oral polio vaccine distributed across the world.

The young girl was not yet vaccinated. In Israel, children are recommended to get the vaccine as soon as they can, though the window of recommendation does not end until seven years old.

It has not been reported whether the girl’s parents had plans to get her vaccinated in the future.

While this is the first confirmed case of polio in the country since 1988, the virus has been detected in wastewater, meaning that there has been some undetected spread.

Eradicating polio has been a challenge for health officials for decades, but their efforts have been a great success.

The United States Centers for Disease Control and Prevention (CDC) reports that the virus has been around since ‘ancient times’, citing records that the ancient Egyptians were aware of the condition, and the paralysis that comes with it.

Prevalence of polio has greatly declined in recent decades after the emergence of the vaccine in the 1950s.

The World Health Organization has prioritised the eradication of polio, which at this point may not be possible.

The virus has reached an endemic phase in both Pakistan and Afghanistan, and while not as devastating as it was in previous years, its rapid spread makes it hard to control.

It often spreads through fecal matter contaminating water or other food or drink that goes into a person’s mouth.

It can also spread via person-to-person contact. In its most devastating cases, the virus will move into a person’s central nervous system and cause paralysis.

The United States has not recorded a polio case since 1979, and nearly all of the nation’s children receive a vaccine for the virus in a young age.