Fresh concerns over polio – Thisday

The authorities should do more to ensure more children are vaccinated

Exactly a year after the Africa Regional Certification Commission (ARCC) declared Nigeria free from Wild Polio Virus, there are some disturbing developments. A new variant of the disease has been reported in at least 13 states and the Federal Capital Territory (FCT). The National Primary Healthcare Development Agency (NPHCDA) Executive Director, Dr Faisal Shuaib, had last week, raised the alarm that the country was witnessing an outbreak of Vaccine Derived Poliovirus Type 2 (cVDPV) in Abia, Bayelsa, Borno, Delta, Jigawa, Kano, Kebbi, Lagos, Niger, Rivers, Sokoto, Yobe and Zamfara States as well as in FCT. The implication is that this may draw back the clock of the country’s war against the virus, as well as send thousands of children into preventable paralysis.

First, we need to state that the Type 2 derived polio is different from the Wild Poliovirus – the ‘normal’ virus responsible for child paralysis. Type 2 is derived from the polio vaccine but it is also potent. For a child who is under-immunised, the vaccine virus may multiply and cause polio disease because of low level of immunity. When such a virus is transmitted from child to child or within a community, it is called circulating Vaccine Derived Polio Virus (cVDPV).

Despite this difference, a renowned virologist and former President of the Nigerian Academy of Science(NAS), Prof. Oyewale Tomori believed that the new strain has the potential to cancel the nation’s wild polio-free status. “Unless we take remedial action urgently, not only are we in the danger of continuous circulation of vaccine-derived polio virus, which will continue to paralyse our under-protected children, we are in addition, on the way to losing our wild polio-free status should wild poliovirus be imported and spread in Nigeria,” said Oyewole. “Years of efforts to interrupt the transmission of Wild Poliovirus will be wasted. We must urgently revive and strengthen our routine immunisation activities.”

Polio is an infectious disease caused by a virus which invades the nervous system and often causes irreversible paralysis. It can strike at any age but mainly affects children under five. In 2008 there were 803 confirmed polio cases which represented a whopping 85 per cent in Africa. By the following year the number came down to 388. As of March 2010, the country reported only one until there was a major relapse, attributed mainly to the large-scale insecurity in the Northeast of the country.

While there is no known cure for polio, it can be prevented through vaccination. Yet as long as a single child remains infected with polio, unvaccinated children all over the world are at risk. This is why the authorities should as a matter of urgency deploy health experts, vaccines and other resources to areas where children (especially newborns) are yet to be vaccinated against the disease, including hard-to-reach communities cut off by flood, bad roads, as well as areas with security challenges. Since the development partners and donor agencies withdrew their resources against polio programmes in the country due to the fortunate free status the country acquired in June last year, the federal government has to step up funding and provide an enabling environment to ensure every child below five years of age is immunised adequately against the disease.

The more government delays in addressing the security challenges, the more difficult it is to reach the hundreds of thousands of children yet to be vaccinated. As part of the strategy, traditional and religious leaders as well as other stakeholders should help educate the people on the importance of polio vaccination. There is also need for sustained campaign at the state and local government levels to ensure the Oral Polio Vaccine (OPV) reaches every eligible child in the country.

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