UN agency calls for continued surveillance after polio spreads to Saudi Arabia

UN agency calls for continued surveillance after polio spreads to Saudi Arabia

The crippling effects of polio
The United Nations health agency today stressed the importance of continued surveillance for polio following the spread of the potentially paralyzing disease from West Africa to Saudi Arabia, but a leading expert said the three new cases were not a setback for plans to interrupt transmission of the virus by the end of this year.

The World Health Organization’s (WHO) Representative for Polio Eradication, David Heyman, told a news briefing in Geneva that since September three children had carried the virus into Saudi Arabia across land from West Africa and through Sudan, and that the Muslim pilgrimage to Mecca was one way it could spread further.

Polio began to spread again from the only six remaining endemic countries – Afghanistan, Egypt, India, Niger, Nigeria and Pakistan – when various Nigerian states suspended immunization in 2003 over concerns by public figures about the safety of the vaccine, including rumours that it was contaminated by the HIV virus or could sterilize young girls. The suspension was later lifted but not before the disease re-infected 10 other previously polio-free African countries.

WHO Coordinator of the Global Polio Eradication Initiative Bruce Aylward told a questioner the new cases were not a setback in terms of plans to interrupt transmission of polio by the end of 2005. Among other steps, Saudi Arabia had held immunization campaigns in advance of the pilgrimage in areas at risk of communicable diseases and its normal immunization coverage was over 95 per cent.

It was not possible to quantify the risk at this point, but there were a number of positive elements including the fact that this was the low season for polio and the pilgrimage mainly involved adults, Dr. Aylward added.

WHO is seeking to make polio, which once paralyzed hundreds of thousands of children worldwide each year, the first disease in the 21st century to be totally eliminated through mass immunizations – and only the second ever after smallpox.

Dr. Heyman said that in the latest case a Nigerian boy living with his family near Mecca, who had not travelled outside Saudi Arabia for two years but whose home had been visited by travellers with children from Nigeria, became sick in mid-December despite having been vaccinated. For every child paralyzed there could be up to 250 others in the area who carried the virus without showing symptoms, he added.

He noted that five of the six endemic countries were members of the Islamic Conference, but he also stressed that sanitation at the annual Muslim pilgrimage to Mecca, which has just ended, is impeccable and there are very seldom outbreaks of any disease.

WHO’s guidance to pilgrims around the world was that as long as polio was present anywhere in the world, it remained a risk to any other country through any international travellers, he said.

So pilgrims were one way that the polio virus could be spread, but there were also many other ways. For countries which might feel that they were at risk from Saudi Arabia or any other country, the most important thing to do was to continue their surveillance for polio, he stressed.