Polio levels on the down since 1988
For the past few decades international efforts have been focused on the global eradication of polio. Over a quarter of a century of polio vaccine programmes across the globe have made a huge impact on eradicating this disease from many countries.
Whilst small pockets of polio outbreaks still occur, and the disease cannot yet be declared polio-free, the number of cases has fallen by a dramatic 99%, from 350,000 in 1988 to 223 in 2012.
So far this year there have been 18 cases up to the beginning of April, and whilst this would seem to indicate that we are on the verge of eliminating this disease – even small outbreaks have the potential to spread, especially in under vaccinated areas. The elimination of polio is tantalisingly close but still an evasive target.
Now more than 400 eminent scientists from 80 countries around the world have announced their backing for an ambitious global plan to eradicate polio. Despite security threats and doubts about funding, scientists say the aim of ending polio, so that “no child will ever again be crippled by this disease,” is achievable.
Polio, or poliomyelitis to give its full name, is a viral infection that can easily spread from person to person, especially in unsanitary conditions. Most cases of polio cause little or no symptoms but if the virus enters the central nervous system it can destroy motor neurons leading to muscle weakness and paralysis. In many cases the legs are affected and this can affect growth and development of the limb.
Outbreaks can spread throughout communities and in the past it was a much feared childhood disease causing many deaths and leaving thousands crippled or paralysed.
Vaccination programmes eradicated polio in the UK many years ago and since then most of the world has been declared polio free too.
Launching the Scientific Declaration on Polio Eradication, the scientists have called on governments, international organisations and philanthropic individuals to fund the $5.5bn (£3.5bn) cost of eliminating the few remaining cases of polio and end transmission of the disease by 2014, so that the world may be declared polio-free in 2018. There are three main countries left where the disease is still endemic, Afghanistan, Pakistan and Nigeria.
The Global eradication of polio programme has already missed four deadlines for eradicating the disease as it has met with a range of problems and barriers in the process of setting up vaccine programmes to reach the last few affected areas. Problems such as funding shortages, re-occurrence of polio in countries that had been polio-free and difficulties reaching isolated communities, especially in times of conflict and unrest, have all hampered efforts to complete the programme and eradicate the disease.
For example, in the mid-2000s, an outbreak of polio in Nigeria spread across West Africa, re-infecting countries that had previously eliminated the disease. Funds then needed to be directed to target the new outbreaks and put the programme back on track.
Another major threat to the success of the programme is security issues. In Pakistan and Nigeria health workers have been targeted and 23 clinic workers have been shot dead between December and January by terrorists who believed the vaccination programme is part of an American plot.
Chair of Public Health England, David Heymann, said: “Eliminating the last 1 per cent of cases is an immense challenge. But by working together we can make history.”
At a briefing in London, experts said 90 per cent of the funding for the first year of the programme was already in place, but a further $2bn was required in later years. It is a challenge but the eradication of polio is hopefully now in sight.
Measles outbreak continues
The measles outbreak in South Wales is continuing as doctors urge people who have not received two doses of the MMR (measles, mumps and rubella) jab to come forward. Special clinics have been set up around South Wales to administer the vaccine and hundreds of people have come forward to receive the MMR jab.
There have been around 700 cases of measles in parts of south, mid and west Wales and it is estimated around 6,000 children remain unvaccinated in south west Wales. There are now fears that the measles outbreak could spread to other parts of Britain, with London and the North particularly vulnerable, a leading expert has warned.
Dr David Elliman, an immunisation expert at the Royal College of Paediatrics and Child Health, warned that the capital is at especially high risk because it has the lowest uptake of MMR vaccinations in the UK.
This has been the biggest outbreak of measles in recent years. There were 2,016 confirmed cases of the disease in 2012, twice the number in the previous year and the highest total since 1994. The cases of measles were largely confined to prolonged outbreaks in the north-west and south-east. In the first half of the year the disease spread through pre-school children in Cheshire and Merseyside, followed by clusters in schools and nurseries across the north-west.
The reasons for the latest measles outbreak in Wales is thought to be related to low uptake of the vaccine in the late 1990s, following the controversy surrounding the vaccine and its possible links to Autism, largely based on the work of Dr Andrew Wakefield.
Numerous studies have been conducted on the safety of the vaccine since then, and the vaccine has been used across the globe, and no major safety issues have been highlighted.
The uptake of the vaccine amongst pre-school children has increased in recent years following the scare, but many children from the late 1990s and early 2000s either did not receive the vaccine or did not receive two doses of the vaccine. For this reason quite a few children, some of whom are now teenagers, are vulnerable to catching measles.
Although unpleasant measles is generally a mild illness in most cases, however it can cause serious complications in some patients, including meningitis, brain damage and death.