Eradication of Poliomyelitis

Poliomyelitis is a life-threatening and disabling disease caused by a poliovirus virus that infects a person’s motor parts (1). The disease may be fatal to the affected person’s health and sometimes lead to total paralysis. The disease can be spread from one person to another, affecting their spinal cord and other motor part leading to paralysis of the lower part of the body. The disease symptoms may not be visible for a large percentage of the population; however, others may show flu-like symptoms such as, sore throat, fever, nausea, fatigue, headache, and stomach pain. These symptoms usually appear for a short time, like 2-5 days, then disappear. Moreover, a small group of the population may develop complicated symptoms such as paresthesia, meningitis, and paralysis that mainly affect the infected person’s brain and spinal cord (1). The most severe symptom of all is paralysis, as it can lead to total disability and sometimes death.

Statistics show that 2-10 people out of 100 who experience paralysis end up dead because poliovirus affects the body muscle, rendering the patient unable to breathe, which leads to their death (1). The severances of Poliomyelitis exceed even after recovery; some people may experience muscle weakness in their middle adulthood leading to paralysis years later after recovery. This is termed post-polio syndrome. Polio is a contagious and highly infectious disease spread through contact with an infected person. The infection lives in the infected person’s throat and intestines; hence can also be communicated through sneeze/ cough droplets and contact with an infected person’s feces.

In the war against eradicating this infectious disease, infectious agents such as the Global Polio Eradication Initiative (GPEI) were formed. GPEI is a partnership of several groups/ organizations dealing with the health care of the world population, such as WHO, the United States CDC, Rotary International, Melinda Gates Foundation, UNICEF, and lastly, the Global Alliance for Vaccines and Immunizations (4). The initiative focuses on eradicating poliomyelitis infection worldwide by providing vaccines to children, especially in developing countries.

Since the establishment of GPEI in 1988, some poliovirus like two-three wild poliovirus(WPV) has been completely eradicated (3). However, two countries (Pakistan and Afghanistan) have been left behind when it comes to dealing with the disease; both reports from 2018-2020 and 2017-2019 (2,3) show that the two polio infection in the two countries has not yet been eradicated especially WPV. This may result from the country’s poor infrastructure, poor security, illiteracy among the people, and the country’s economic state.

Poliovirus has been fatal in Afghanistan, paralyzing and killing children. Despite having the children getting their primary vaccination against the disease, it has been reported that many children deprive of the disease each year. Chard et al. summarize the poliovirus eradication process around the globe from 2018 to 2020 (3). Afghanistan and Pakistan presented the highest cases of WPV1, which is paralytic Poliomyelitis which may also happen as a result of circulating vaccine-derived poliovirus(cVDPV). The government of Afghanistan has put a lot of effort towards eradicating the disease, but still, there are several cases recorded every year besides that effort. This lagging results from people’s ignorance and refusal to take their children to be vaccinated.

Afghanistan is the second country where polio has been an issue worldwide (4). There have been several challenges and difficulties experienced in eradicating the disease in the country. This is due to illiteracy, inaccessibility of some areas with no security, citizen’s ignorance, and recently the Covid-19 pandemic. The country is now fighting two epidemics- the Covid-19 and Poliomyelitis. There has been a noticeable increase in polio cases, especially in polio-free areas. However, after the reopening of the economy in 2021 after the Covid-19 lockdown, many sectors went back to business as normal, but the mass vaccination against polio is yet to restart. Polio cases are anticipated to increase, especially in the unvaccinated population and inaccessible areas. To ensure the endemic does not reach critical, the country needs to recommence house-to-house vaccination since many Covid-19 restrictions have been loosened.

As noted earlier, eradicating polio in Pakistan has not been great either. Pakistan is the only remaining country with issues with eradicating polio through vaccination. Pakistan has had consistent barriers altering the mass-vaccination to eradicate Poliomyelitis. These barriers include Pakistan’s political interests and religious extremism (5). To fill these barriers, the government of Pakistan has involved some religious leaders, social mobilizers, and police officers in promoting vaccination against polio in the country by mobilizing parents to take their children to get vaccinated. However, these measures have been deemed ineffective after more cases compared to the past year were noted hence calling for more daring measures to curb the disease in the future.

The public can prevent Poliomyelitis using Inactivated poliovirus vaccine (IPV) injected in the arm/leg or Oral poliovirus vaccine (OPV) given orally. These vaccines are administered to children to equip their bodies with enough immunity to fight poliovirus. CDC reports that 99% of vaccinated children are protected from infection. However, as a result of ignorance, some people hesitate to take their children to the clinic to be vaccinated (5). Ali et al. state that there are two reasons behind the people’s arrogance in Pakistan. One is because children are given more doses than required by World Health Organization (WHO) hence raising speculations and public questioning the act, not knowing that it is due to their tropical region, which is like a beacon for certain infections. Second, rumors that the vaccines are handled poorly when being transported or stored, also about the vaccine’s side effects. It is anticipated that arrogance and ignorance of vaccination are the main cause of failure to vaccinate children besides rumors and speculations, which can easily be handled.

As seen above, many people ignore vaccination of their children due to misinformation and speculations. Since arrogance is the main factor that is dragging the process of eradication of polio behind, it needs to be solved through educating the public on the importance of vaccinating their children and explaining what would happen when the children fail to be vaccinated. To curb the other issue dragging eradication of polio; speculations and mistrust against the polio vaccines, it is important that in the future the health care providers educate the general public on the importance of vaccinating their children, explain how the vaccines are handled, stored, and administered and lastly ensure transparency by explaining the side effects of the vaccine. Increasing public awareness of vaccination benefits is crucial in winning the war of eradicating Poliomyelitis.

Reference List

1. Global Immunization: What is Polio. Centers for Disease Control and Prevention CDC. 2021.
2. Greene SA, Ahmed J, Datta SD, Burns CC, Quddus A, Vertefeuille JF, Wassilak, SGF. Progress towards polio eradication-worldwide, January 2018-March 2020. Morbidity and Mortality Weekly Report. 2019;68 (20): 458.
3. Chard AN, Datta SD, tallis G, Burns CC, Wassilak, SGF, Vertefeuille JF, Zaffran M. Progress toward polio eradication-worldwide, January 2018-March 2020. Morbidity and Mortality Weekly Report. 2020;69 (25): 784.
4. Ahmadi A, Essar MY, Lin X, Adebisis YA, Lucero-Prisno III DE. Polio in Afghanistan: the current situation amid COVID-19. The American Journal of Tropical Medicine and Hygiene. 2020;103 (4: 1367.
5. Ali M, Ahmad N, Khan H, Ali S, Akbar F, Hussain Z. Polio vaccination controversy in Pakistan. Lancet. 2019;394 (10202): 915-916.