Tuesday, October 26, 2010

Time for some good news

Polio. The word can still send a chill of fear through people above a certain age. A crippling, uncurable disease that can leave its victims paralyzed - or dead. As recently as 1952, in the US alone there were 60,000 cases of polio and 3000 deaths.

I had an uncle who was stricken with polio as a child. He lived, but as a bed-ridden invalid unable to walk or even feed himself for the rest of his life. It is something we grew up with; we all knew what an iron lung is. My brother, not three years older than me, was a "polio pioneer," one of the 1.8 million children who participated in the first full field trial of the Salk vaccine, the first polio vaccine.

As a result of the Salk and later Sabin vaccines, polio has all but disappeared from the US; there has not been a naturally-occurring case since 1979. The disease is so rare here that in dealing with the teenagers I meet in my work, I often encounter ones who had never heard of it.

With aggressive immunization programs, that success has spread acoss most of the world. As recently as 1988, the number of countries where polio is endemic stood at 125. By 2005, the figure was four. The number of cases dropped from 350,000 to just 1600 in 2009.

Still, the disease continues to appear in outbreaks in various areas - but those outbreaks can be contained with immunization programs. The real problem area has been central Africa, most recently in Angola, where a 2007 outbreak has spread to the Democratic Republic of Congo because, the World Health Organization says, too few children were vaccinated in previous campaigns to eradicate the disease. Now, the intent in Angola is to vaccinate every child under five.

So where's the good news? It comes in two parts. First part is that Oliver Rosenbauer of the WHO's Global Polio Eradication Initiative, said that
"[W]e know this outbreak [in Angola] could be stopped very rapidly.

"If these upcoming immunisation campaigns are effectively implemented, this outbreak can be stopped in its tracks even by the end of the year.

"Africa is on the verge of being polio-free...."
I added the emphasis and I think it is well deserved.

The other part is that according to research published in the medical journal The Lancet, a new polio vaccine already in use in Afghanistan, India, and Nigeria
is about 30% more effective in protecting against polio than the most commonly used vaccine to date. ...

In India the number of cases this time last year was 464. Over the same period this year there have only been only 39 cases.

Nigeria has seen an even greater difference, with cases falling by 95%. ...

Dr Roland Sutter, from the WHO and the lead author of the study, told BBC News: "This (new) vaccine could get us over the top and get us to the finish line for eradication."
I don't want to get over-excited: We have been here before. The WHO once predicted that polio could be eradicated by the end of 2004. And there have been both disappointments when immunization campaigns didn't reach as many children as was intended and setbacks as outbreaks spread to countries that had been polio-free. But with the new emphasis on inoculating every child under five, not just those "at risk," and with a new, even-more effective treatment, maybe, just maybe, this time it can be done and polio can join smallpox in the trashbin of history.

And wouldn't that be sweet.

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