Polio Virus: Infectious Outbreak In Syria?

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On October 19th, the World Health Organization (WHO) reported it is investigating a possible outbreak of “Wild Polio Virus” in Syria. An outbreak of this highly contagious polio virus in war torn Syria is a public health disaster, added on top other public health issues that are already at crisis state – such as malnutrition.

The WHO said it has received reports of a cluster of “Acute Flaccid Paralysis” (AFP) cases Thursday, October 17th. The cluster was detected earlier in the month in the eastern province of Deir Ezzor. WHO Spokesperson said “Initial results from the National Polio Laboratory in Damascus indicate that two of the cases could be positive for ‘Wild Poliovirus.'”

What is Acute Flaccid Paralysis (AFP)?

AFP is a clinical manifestation characterized by weakness or paralysis, and reduced muscle tone without other obvious cause (e.g., trauma). This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles. When muscles enter this state, they become limp and cannot contract. This condition can become fatal if it affects the respiratory muscles, posing the threat of suffocation. AFP is often used to describe a sudden onset, as might be found with polio.

What About Syria?

Wild Poliovirus is highly infectious. The last outbreak in Syria was in 1999. According to CNN, “Syria’s Ministry of Health confirms that it is treating this event as a cluster of ‘hot’ AFP cases, pending final laboratory confirmation, and is planning an urgent, nationwide response.” With the entire country in a war-torn state, getting an urgent public health message the people to report to health clinics for immunizations would be impossible. Additionally, considering the fact that the Assad Regime has a history of lies and manipulation, it is hard to imagine any message resonating with the Syrian People.

damaged buildings in homs syria
Children walk in the rubblefilled streets, between ruined buildings in Homs, Syria

According to the WHO, “Syria is considered at high-risk for polio and other vaccine-preventable diseases due to the current situation.” The WHO has issued a surveillance alert for the region to actively search for additional potential cases. They said, “Additional emergency immunization activities are also being planned in neighboring countries.”

Is Wild Poliovirus one more issue that neighboring countries will need to worry about when they consider hosting refugees? Considering the current underfunding that the United Nations is already facing, what plan will they put in place in conjunction with UNICEF to immunize refugees should the WHO make this recommendation.

Worldwide Eradication of Polio

  • A worldwide eradication effort has been credited with helping reduce the incidence of the disease, which primarily affects children younger than 5, by more than 99% in the past quarter century, from 350,000 cases in 1988 to 223 reported cases last year, according to the WHO.
  • In 1988, the disease was endemic in more than 125 countries; this year, it is endemic in only three countries – Afghanistan, Nigeria and Pakistan.
  • One in 200 infections results in irreversible paralysis. Of those who become paralyzed, 5% to 10% die when their breathing muscles are affected.
  • There is no cure for polio, but the vaccine – given multiple times – can protect for life.
  • Despite its precarious public health infrastructure, India succeeded in stopping polio in 2011.
  • The WHO recommends that all travelers to and from polio-infected areas be fully vaccinated.

    Kimberly Jones is a global nomad with a special interest in the Middle East and North Africa. She grew up in Saudi Arabia and traveled throughout the MENA growing deeply attached to the people and the culture.