Health officials in Syria are scrambling to urgently vaccinate 320,000 children in some of the country’s most difficult to access areas, following an outbreak of polio that has left at least 22 children paralysed. Health workers will likely have to coordinate with Isis and other extremist groups to carry out the work.
It was recently revealed that 17 children had been affected by an outbreak of vaccine-derived polio. One of the cases was in Raqqa, the de facto Syrian capital of Isis, while the remainder were in the Mayadeen district of eastern Syria.
Officials told The Independent the number of youngsters paralysed by the disease had risen to 22 and that a mass vaccination programme was soon to be launched.
“It’s very much a concern that there is a vaccine-derived polio outbreak,” said Rod Curtis, Unicef’s polio spokesperson in New York. “Our plan is to vaccinate 320,000 children under the age of five – including 90,000 in Mayadeen – using our partners on the ground. Not all the children are located in government areas.”
The outbreak of the disease, which has all but been eliminated but for three countries – Afghanistan, Nigeria and Pakistan – is another insight into the horrors wreaked upon a country that has been gripped by a brutal civil war since the spring of 2011. Up to 500,000 people have been killed, five million have fled the country and more than six million have been internally displaced from their homes.
Syria once had an effective healthcare operation for addressing challenges such as polio, but that has changed. At the start of the conflict, vaccination rates were around 95 per cent but they have now tumbled to around 60 per cent, said Oliver Rosenbauer, spokesperson for the World Health Organisation’s (WHO) Global Polio Eradication Initiative.
“I think the [outbreak] indicates poor vaccination coverage. The polio virus does not care why a child is not vaccinated,” he said, speaking from Geneva.
This is not the first time that war-stricken Syria has experienced an outbreak of polio, a crippling and potentially deadly infectious disease that typically affects children aged less than five and can take effect in just hours. In October 2013, more than 20 children were affected by an outbreak of wild polio, again in the eastern Deir ez-Zour province.
In that episode, the first for 14 years, the polio strain was traced to Pakistan, one of the countries where it remains endemic, and where the city of Peshawar has been described as the “largest polio virus reservoir of the world”.
There was immediate speculation it could have been carried by a Pakistani fighter joining Isis or another extremist group. Genetic sequencing showed the same strain from Pakistan had been found in sewage in Egypt, Israel and Palestinian territories.
The most recent outbreak of polio is not of the same strain and ought to be less of a challenge to counter. While the type of polio responsible for the 2013 outbreak was wild polio, the current strain is vaccine-derived.
Mr Curtis said cases of vaccine-derived polio were very rare; in 2016, more than 450 million children were vaccinated against polio, and there were five cases of paralysis caused by polio that originated from a vaccine. He said the threat only existed in under-immunised populations, where the live, weakened virus originally contained in the oral polio vaccine (OPV) can mutate over time and circulate in the environment.
He said that if a community was fully immunised, it will be protected against both vaccine-derived and wild polioviruses. “The benefits of oral polio vaccine (OPV) far outweigh the extremely low risk of a vaccine-derived polio. OPV has reduced the global incidence of polio by more than 99 per cent since 1988,” he said.
The tech billionaire and philanthropist Bill Gates, who has said it is his personal mission to eradicate the disease, has poured vast sums of money into the effort, and the Gates Foundation is part of the global initiative.
Jay Wenger, director of the foundation’s polio programme, said the new outbreak in Syria was saddening.
“This outbreak is an unfortunate consequence of poor immunity due to low vaccination rates over a long period of time in Syria,” he said.
“Syria is an extremely challenging environment to deliver health services including vaccines, however, the Global Polio Eradication Initiative has a proven track record of stopping outbreaks in difficult and conflict ridden areas.”
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