Curing Polio in Pakistan and Afghanistan
In 1988, polio existed in more than 100 countries and infected close to 1,000 children daily. Due to advocacy efforts and the implementation of preventable vaccinations, cases of polio have significantly dropped at a rate of 99 percent. In 1988, about 350,000 children had polio while statistics indicated that in 2017, only 22 documented illnesses existed. However, children are still struggling as Pakistan and Afghanistan attempt to eliminate polio their countries.

Children are most vulnerable to contracting polio between birth and age five. One in 200 contagions result in irreparable paralysis, most commonly in the legs; five to 10 percent of those infected die from this disease due to the disabling of their breathing muscles.

Most children that are living with polio do not experience manifestations; however, polluted water and food can still spread the disease. Polio is preventable through several doses of vaccinations, but there is no treatment.

Modernized Vaccines to Prevent Polio

In 2013, all countries began to implement one dose of the new vaccines and terminate the use of the oral vaccines by 2018, which the Polio Eradication & Endgame Strategic Plan instructed.

In order to eliminate polio in Pakistan and Afghanistan, the Polio Eradication and Endgame Strategic Plan is terminating the administrations of oral vaccines which only protected against type 2 of the virus; instead, Afghanistan and Pakistan are implementing doses of the inactivated polio vaccine, which should be more effective in preventing the disease as it prevents all three types of polio. The modern vaccine can also enhance immunity and inhibit further epidemics of polio.

Efforts to Eliminate Polio in Pakistan and Afghanistan

In 2018, The Ministry of Public Health in Afghanistan partnered with UNICEF and The World Health Organization to initiate the country’s third nation-wide polio vaccination campaign. Nearly 9.9 million children below age five received the vaccination.

Regions such as Kandahar, Helmand, Uruzgan and Zabul contained nearly 1.2 million children who did not have access to the vaccine. However, this past program and future programs will ensure that these children can also receive the necessary dosages.

Vaccinated children also received Vitamin A capsules to strengthen their immunity and decrease diarrhea. This also strengthened their immune systems from respiratory infections. Immunity can increase their chances of survival by nearly 24 percent. Nearly 70,000 health workers visited every household to administer vaccinations. This was to ensure that other children received the preventable medication as well. Because polio is contagious, each family’s chances of surpassing the disease increases if every child receives a vaccination.

In Pakistan, the number of polio infections is at a low rate. Further, improved immunity has also begun to increase. While this country has made progress in battling polio, many children have not received the preventable vaccines in high-risk areas. Therefore, Pakistan has begun to implement various solutions such as customized vaccines. Additionally, the country has partnered with the Emergency Operations Centers to administer effective prevention techniques.

Polio is most common in Karachi as well as the federally administered tribal areas, the Quetta block and the Khyber-Peshawar corridor. While the disease is highly present in these areas, other areas nationwide are susceptible to contracting the virus due to travel and migration.

The Partnership Between Pakistan and Afghanistan

To eliminate polio in Pakistan and Afghanistan, the two nations plan on partnering to identify children who are vulnerable to the disease and provide vaccinations, while also administering health campaigns to promote advocacy about the prevention of polio. Environmental surveillance has discovered the presence of polio. This serves as evidence that children with weaker immune systems are present in these areas. Consequently, this enables the disease to grow and infect other children.

– Diana Dopheide

Photo: Flickr

How to Stop Polio
In the process of discerning how to stop polio permanently, health professionals must focus on the developing world.

Poliomylelitis, commonly known as polio, is a disease that spreads through contaminated water or food supplies. It can cause paralysis and in rare cases, even be lethal.

Most infected people (90 percent) have no visible symptoms of being infected with polio. However, some initial symptoms of the disease may include fever, fatigue, headache, and vomiting. These are quite similar to the symptoms of the common influenza virus.

However, as polio progresses, stiffness in the neck and pain in the limbs will occur.

The stiffness and pain then progresses into irreversible paralysis, usually in the legs of the infected person. So how does one stop an “invisible” disease? How to stop polio throughout the world?

The Polio Eradication and Strategic Endgame Plan 2013-2018 endeavors to build a polio-free world by 2018 through a four-step plan:

1. “Detect and interrupt all poliovirus transmission;

2. Strengthen immunization systems and withdraw oral polio vaccine;

3. Contain poliovirus and certify interruption of transmission;

4. Plan polio’s legacy.”

The first two steps are the most important when discerning how to stop polio. Detection of poliovirus is difficult, because there are two strains which have the ability to paralyze: wild poliovirus and circulating vaccine-derived poliovirus (cVDPV).

According to the WHO, polio has no known cure once a person is infected. However, there is an oral polio vaccine available.

An oral vaccine works by containing a weakened form of the virus (in this case poliomylelitis). This virus then enters the child’s bloodstream and activates an immune response.

The vaccine-virus then replicates in the child’s intestine for a limited period, building up crucial antibodies necessary for fighting off a future polio infection. The child then excretes this vaccine.

This excreted vaccine-virus will continue to survive and becomes a circulating vaccine-derived poliovirus (cVDPV). In developing countries with poor sanitation, cVDPV will infect people who haven’t received the vaccine yet.

Consequently, the oral vaccine can spread the disease just as often as it prevents it.

By contrast, the injectable poliovirus vaccine (IPV) does not have an active form of the poliovirus. Therefore, it cannot infect another individuals.

Switching from an oral poliovirus vaccine (OPV) to an injectable poliovirus vaccine (IPV) eliminates the potential of cVDPV occurring in a population.

The strain of poliovirus utilized in IPV shots is inactivated. When recipients excrete it, there is no chance of contracting polio from the excrement.

OPVs are often used in developing countries with large rural populations lacking in access to medical facilities. This is because oral polio vaccines do not require the sterile needles for injections.

The Polio Global Eradication Initiative seeks to make a smoother transition from the oral vaccine to an injected one by creating a multi-step process. Instead of immediately removing OPVs from circulation, they plan to first use a different OPV and supplement it with an IPV.

This transition must occur globally in order to be successful. A bivalent OPV will decrease the chance of cVDPV. Eventually, all countries will be able to switch to using IPV shots.

How to stop polio? Ensuring that all countries have access to proper medical care and sanitation services is a start. It is also important to continue to spread awareness of the importance of vaccinating children against polio.

Bayley McComb

Photo: USAID