Polio outbreak in Syria poses vaccination dilemma for WHO

A health worker administers polio vaccination to a child in Raqqa, eastern Syria November 18, 2013. REUTERS/Nour Fourat

GENEVA (Reuters) – Vaccinating too few children in Syria against polio because the six-year-old war there makes it difficult to reach them risks causing more cases in the future, the World Health Organization (WHO) said on Friday, posing a dilemma after a recent outbreak.

Two children have been paralyzed in the last few months in Islamic State-held Deir al-Zor in the first polio cases in Syria since 2014 and in the same eastern province bordering Iraq where a different strain caused 36 cases in 2013-2014.

Vaccinating even 50 percent of the estimated 90,000 children aged under 5 in the Mayadin area of Deir al-Zor would probably not be enough to stop the outbreak and might actually sow the seeds for the next outbreak, WHO’s Oliver Rosenbauer said.

Immunisation rates need to be closer to 80 percent to have maximum effect and protect a population, he told a briefing.

“Are we concerned that we’re in fact going to be seeding further future polio vaccine-derived outbreaks? … Absolutely, that is a concern. And that is why this vaccine must be used judiciously and to try to ensure the highest level of coverage,” Rosenbauer said.

“This is kind of what has become known as the OPV, the oral polio vaccine paradox,” he said.

The new cases are a vaccine-derived poliovirus type 2, a rare type which can emerge in under-immunised communities after mutating from strains contained in the oral polio vaccine.

“Such vaccine-derived strains tend to be less dangerous than wild polio virus strains, they tend to cause less cases, they tend not to travel so easily geographically. That’s all kind of the silver lining and should play in our favor operationally,” he said.

All polio strains can paralyze within hours.

Syria is one of the last remaining pockets of the virus worldwide. The virus remains endemic in Afghanistan and Pakistan.

(Reporting by Stephanie Nebehay; Editing by Louise Ireland)

New Polio-Like Virus Linked to Paralysis of Children

A new strain of a polio-like virus has been suggested as the cause of paralysis of more than 100 children 34 states in the last year.

LiveScience reported on a study from the Centers for Disease Control (CDC) focused on a 6-year-old girl at the University of Virginia Children’s Hospital that showed “acute onset of progressive right upper extremity weakness.”

“Within the 2 weeks before the patient’s presentation to the hospital, she and her family members had been ill with a mild cough and rhinorrhea; 4 days before presentation, the patient had experienced low-grade fever (100.4° F), frontal headache, fatigue, and intermittent pain in the right ear and right axilla. The fever lasted only 1 day; the cough, fatigue, and headache improved over the next 2 days, but the patient continued to report right arm pain. On the day before seeking care, her parents observed that she had a right shoulder droop and difficulty using her right hand. No associated visual or mental status changes; difficulty with speech, swallowing, or respiration; or bowel/bladder disturbance were noted,” the study reads.

Enterovirus C105 was found to have caused the girl’s condition. The virus was first detected in 2010 in Peru and the Republic of Congo.

Previously, children showing paralysis had been infected with Enterovirus D68.

“We probably shouldn’t be quite so fast to jump to enterovirus D68 as the [only] cause of these cases,” Professor Ronald Turner, of the University of Virginia School of Medicine told LiveScience.

Unusual Virus Strikes Kansas City Children

A mysterious respiratory virus has been striking children in the Kansas City area.

Children’s Mercy Hospital has confirmed hospitalizing up to 30 kids a day with the virus and the hospital is as full as during the heights of flu season.

One woman whose son was struck by the virus says that he was fine when he went to pre-school on Tuesday but soon had trouble breathing.

“You could see his ribs, and his stomach was pushing out really hard… I thought it was an asthma attack,” Pam Sheldon told Fox Kansas City.

The virus has been identified as Enterovirus-68.  The virus had been considered rare until the last few years when it had increased in worldwide appearance.  The virus is suspected as the cause of a polio-like disease in California in 2009 and can cause symptoms that mimic asthma to central nervous system attacks.

In some rare cases, the virus can be fatal.

There is no vaccine or anti-viral medication for Enterovirus-68 and the only thing that doctors can do for victims is supportive care such as oxygen.

Mysterious Polio Like Illness Spreads In California

A mystery virus that is causing polio-like symptoms in children has spread to southern California.

Lucian Olivera, 2, is the latest child to be confirmed to have the illness.  Lucian was 11 months old when he had an ear infection before suddenly being unable to stand or use his legs.

Stanford University confirmed on Friday it was the mysterious virus.

Now, doctors are trying to determine if the weakness in the child’s legs is permanent.

“Really, it’s unknown the severity of this for each individual. The thought is that it is permanent, but we don’t know all the things that will happen to every patient,” Dr. John Dingilian said.

Olivera is wearing a brace on his legs and his parents are preparing that he may never be able to walk on his own.

Flesh-Eating Parasite Infections Growing In Syria

In the midst of the Syrian civil war, World Health Organization officials are noting an increase in deadly diseases and a flesh-eating parasite.

The WHO has recorded the first suspected outbreak of polio in the Syria in 14 years along with flare-ups of typhoid and hepatitis. They have also found the flesh-eating paraiste leishmaniasis and are blaming the infections on the collapse of the health care system in the country which is prohibiting vaccinations in many parts of the nation.

Oliver Rosenbawer of the WHO Global Polio Eradication Initiative told the London Daily Telegraph that while they haven’t yet received official laboratory confirmation, there are at least 22 people in the northeast province of Deir Ezzor showing symptoms of polio.

“The tragedy [of polio] is that there is no cure,” Rosenbawer said. “Once you have polio, it is for life. So the only way to tackle it is through vaccination.”

The WHO is also concerned about the mass exodus of refugees from the war-torn nation. They are worried that unvaccinated refugees could take diseases like polio to nations where the virus had been eradicated.

The WHO reports that at least 35 percent of Syria’s hospitals have been damaged or destroyed in the civil war and that up to 70 percent of health care workers have fled the country.

Global Polio Eradication Initiative Declares “Global Emergency”

“Explosive” outbreaks of polio in countries deemed previously free of the disease is resulting in the World Health Organization declaring a “global emergency.” The WHO is also launching an initiative to boost vaccinations in Nigeria, Pakistan and Afghanistan, the only countries where the disease is considered endemic.

The WHO is stating they fear the disease could come back “with a vengeance” and that large outbreaks of polio have hit Africa and Tajikistan. China has reported it’s first case of polio in more than a decade. Continue reading