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Experts ‘concerned’ about uptick in polio cases
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An emergency committee convened by WHO unanimously agreed that polio remains a Public Health Emergency of International Concern, or PHEIC, and said it remains “concerned” about an increase in reported cases of wild polio in 2018, especially in Afghanistan.
Decades of immunization efforts have largely brought polio under control, ending transmission of wild poliovirus in all but three countries.
“We are so close to the elimination of polio, but we have to use all the tools,” emergency committee chair Helen Rees, MD, said during a news conference. She added that the “fear is that we might see a resurgence in polio.”
WHO first declared in 2014 that the spread of polio was a PHEIC, and continues to evaluate the designation. In light of the continuing risk for international spread, the emergency committee also recommended leaving in place for another 3 months temporary recommendations for Afghanistan, Nigeria and Pakistan — the three countries where wild poliovirus still circulates — and other countries where vaccine-derived polioviruses circulate, or that remain vulnerable to infection.
The committee noted that it has been 4 years since there has been any international spread of wild polio outside of Afghanistan and Pakistan. However, there has been cross-border spread between Afghanistan and Pakistan over the past 3 months following a 10-month period in which there was no spread between the epidemiologically linked neighbors, according to the committee.
In Pakistan, the number of cases so far in 2018 is the same as 2017, the committee said. In Afghanistan, however, the number of reported cases in 2018 has nearly doubled to 19, compared with 10 reported at the same time a year ago. This is due to “worsened security and greater inaccessibility, and persistent pockets of refusals and missed children,” the committee reported. It noted that currently 1 million children aged younger than 5 years were inaccessible in recent polio immunization campaigns.
“At a global level, this is the first time [recently] that we had an increase from year to year,” Michel Zaffran, MEng, director of WHO’s polio eradication program, said.
The committee reported that it has been more than 2 years since wild polio was detected in Nigeria and 4 years since international spread of WPV1 from the country.
Complacency is a primary concern of the committee, Rees said. This could lead to an eventual resurgence of polio, and the world could once again “go back to 200,000 to 300,000 children paralyzed each year from polio.”
“If we don’t finish this job in the next few years, we will get donor and government fatigue,” Rees said. If that were to happen, there could be a resurgence of the disease, possibly all over the world, she added. – by Bruce Thiel
Disclosures: Rees and Zaffran report no relevant financial disclosures.