Poliomielitis: climatic changes and impossibility in border control - The European Sting

Poliomielitis: climatic changes and impossibility in border control - The European Sting
The Dream of a Polio Free World Can be Realized. Here's How - Kashmir Reader
Global Poliomyelitis Vaccine Market 2019 | Industry Share, Analysis, Research and Demand 2019-2024 - Education Market

Posted: 21 May 2019 12:00 AM PDT

(Copyright: World Health Organization)

This article was exclusively written for The European Sting by Ms. Ana Flávia Cury Ivantes and Rariane Bernardino Marani, two third-year medical students from a private university in south region of Brasil. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong to the writers and do not necessarily reflect IFMSA's view on the topic, nor The European Sting's one.

Climatic and global changes affect the life of the world population directly and indirectly, and these changes can contribute to the spread of diseases¹, as is the case of Poliomyelitis, a fecal-oral disease that since 1988 with the World Polio Eradication Campaign², the World Health Organization (WHO) has distributed certificates to regions where, in other criteria, the absence of wild poliovirus transmission is at least 3 consecutive years. According to WHO, the region of the Americas received the certificate in 1994, the Western Pacific region in 2000, the European region in 2002, and South-East Asia in 2014, with only the African and Eastern Mediterranean regions being required³.

In Brazil, the last case of wild poliovirus was in 1989; however, countries such Afghanistan, Nigeria, and Pakistan are considered as endemic areas, another 6 countries are in an outbreak situation, and approximately 15 countries are at risk. Efforts are being made both by WHO and by groups such as the Global Polio Eradication Initiative (GPEI) to strengthen immunization, once the substantial migration across borders and climatic diferences between regions, which makes the spread of poliovirus na international concern and a public health emergency^4,5.

Poliomyelitis is an acute viral infectious contagious disease that occurs primarily through nasopharyngeal secretions, food, water, objects, and contaminated feces, caused by three types of poliovirus. Most of its occurrences have a form of asymptomatic presentation or non-specific febrile condition, but in more severe cases, Aseptic Meningitis, which is characterized by flaccid paralysis, may be present⁶.

Post-polio syndrome, in turn, is a derangement of the nervous system characterized by motor neuropathies, being an acute muscular atrophy and a motor neuron disease that has as main signs and symptoms myalgia, arthralgia, loss of strength and muscular fatigue, respiratory and swallowing dificulties. Such syndrome is manifested in individuals who had Poliomyelitis after approximately 15 years, and are diagnosed by excluding mainly neurological, orthopedic and psychiatric diseases⁶.

Immunization of polio occurs through natural infection, which generates lasting immunity to the particular type that caused the stimulus, or through vaccination that, for Brazil, occurs in the first year of life². However, currently, both Brazil, Europe and United States have seen a general drop in the rate of people seeking to vaccinate themselves, leading to a fragility in the health-disease process. This situation, coupled with the climate change, bad conditions of tratment of water and food, lack of knowledge about the risks of the disease, fears of symptoms due to vaccination and problems with the vaccine registration system, is related to the fact that many people find it necessary to vaccinate themselves only at an imminent risk of a particular disease, and when there is no such risk or when the disease is already eradicated, immunization for a particular pathology is not treated as a priority and vaccination does not occur. Therefore, there is the inverse effect, which is the greater spread of the disease favoring the sickness of the population, and the vaccination becomes the victim of its own success.

References

1) (LIS/ICICT/FIOCRUZ), Christovam Barcellos. Estudo sobre o impacto das mudanças climáticas na ocorrência de doenças vetoriais como dengue e malária nos biomas brasileiros. Available from: <https://www.icict.fiocruz.br/content/estudo-sobre-o-impacto-das-mudancas-climaticas-na-ocorrencia-de-doencas-vetoriais-como>. Access from: 17 jan. 2019.

2) BARRO, Pedro; RIBEIRO, Particia; GASPAR, Margarida. A Poliomielite. 2004. 20 f. TCC (Graduação) – Curso de Biologia, Universidade de Évora, Évora, 2004. Available from: <http://home.uevora.pt/~sinogas/TRABALHOS/2003/Polio.pdf>. Access from: 17 jan. 2019.

3) INITIATIVE, Global Polio Eradication. Certification. Available from: <http://polioeradication.org/polio-today/preparing-for-a-polio-free-world/certification/>. Acesso from: 17 jan. 2019. . Certification. Disponível em: <http://polioeradication.org/polio-today/preparing-for-a-polio-free-world/certification/>. Acess from: 17 jan. 2019.

4) INITIATIVE, Global Polio Eradication. Where we work. Available from: <http://polioeradication.org/where-we-work/>. Access from: 17 jan. 2019.

5) ORGANIZATION, World Health. Statement of the Nineteenth IHR Emergency Committee Regarding the International Spread of Poliovirus. Available from: <https://www.who.int/news-room/detail/30-11-2018-statement-of-the-nineteenth-ihr-emergency-committee-regarding-the-international-spread-of-poliovirus>. Access from: 17 jan. 2019.

6) VRANJAC, Alexandre. Poliomielite e Síndrome Pós-Poliomielite. Rev. Saúde Pública, São Paulo, v. 40, n. 6, p.941-945, 2006.

About the authors

Ana Flávia Cury Ivantes and Rariane Bernardino Marani are third-year medical students from a private university in south region of Brasil. Ana is a member of the academic league of Gastroenterology and the Humanization Project in health care (Humanizart), while Rariane is a part of the academic league of Maternal and Child Health and the Oncology and Hematology league. Both academics participate in extracurricular activities, and believe that the primordial principle for the formation of a good doctor and the realization of a quality medicine is the development of scientific research since graduation, which promotes new discoveries for health and minimizes the challenges of the health-disease process.

The Dream of a Polio Free World Can be Realized. Here's How - Kashmir Reader

Posted: 06 May 2019 12:00 AM PDT

Zeeshan Rasool Khan

Polio or poliomyelitis is a viral infectious disease caused by poliovirus, which mainly affects young children. The disease culminates in rendering the infected person paralyzed. It has no cure and can be prevented by immunization only. Due to efforts of major health organizations, the disease has almost been wiped out from the face of the planet – Earth. However, when the rest of the world is celebrating triumph over polio, Pakistan, Afghanistan, and Nigeria continue to make news for not accomplishing this goal. In these three countries, polio is still endemic. The reason for failure in the eradication of Polio is mainly poor health infrastructure, malnutrition and so on but the three countries have many other unfortunate reasons. These countries face hurdles in various forms pertaining to the suppression of this disease .However, the main obstructions that have made the big chunk of the population to suffer are misinformation, misconceptions, credulousness ,and petty-mindedness of some people.
The misinformation stymies the progress in prevention and cure of this disease. A myriad of myths exist that has clogged activities in this direction. Relating a thing to the religion multiplies the influence of that thing because the religion is attached to the sentiments of a person. Obviously, when some activity would be declared religiously impermissible, it will surely create an impact. Moreover, when people would have become dependent on 'Mullahs' who according to Allama Iqbal have only one objective to spread anarchy in the name of God, the problem becomes worse. And it is happening in above-mentioned countries. In these countries ,people are being intercepted from receiving immunization for polio by promulgating myths that polio vaccine contains pig fat, alcohol (things forbidden in Islam) and so on Another misconception, which has been created, is that the polio vaccine causes sterility. Some clerics have issued fatwas denouncing vaccination as a western gambit to sterilize Muslim population, thus jeopardizing the children. The rumor about vaccine and infertility actually ran in Nigeria, where political and religious leaders brought immunization campaign to a halt on the suspicion that polio vaccine could be contaminated with sterilizing agents. Although the committee of doctors later proved it wrong, yet this rumor became so powerful that people began believing it, not only in Nigeria but also in other countries. Some so-called religious leaders have even issued decrees saying that any person who will become paralyzed or die from polio would be given the status of a 'martyr' for denying to be duped by 'western conspiracy'.
Notwithstanding, this misconception has many buyers, which has made the treatment next to impossible. Besides, some have spread the superstition that vaccination is an attempt to upset the divine apple cart; in other words, it is an attempt to preclude the will of God. Unfortunately, this superstition, too, has gained support from different quarters.
One more barrier is political instability. In many areas of all the three countries, polio workers are considered as intelligence agents aimed at carrying forward foreign sponsored un-Islamic agenda and so on. They are threatened, targeted, attacked and killed for carrying vaccination campaigns. Hence, many vaccinators lost their lives during their services and fell victim to barbarity.
Creating scare, promoting myths, misconceptions and accepting them as facts, without thinking about repercussions is not sanity. Similarly, seeing everyone through the prism of espionage is not maturity. The million dollar question that has emerged is: how long people would suffer because of ignorance-cum-dogmatism of others?
All and sundry have a role to play. The need of the hour is to create awareness, stop spreading myths and clear the misconceptions. Religious scholars, preachers, and intellectuals need to come forward to spread truism with regard to polio vaccination. Media has a very crucial role to play to motivate people to receive the vaccination. Physicians and medical experts have a great responsibility to remove confusions among masses. Together doctors need to organize awareness programs, workshop at schools, colleges, and universities to inform youngsters about the importance of polio vaccines.
The concerned people also need to make efforts to reach out to rural areas to educate the public about poliomyelitis, its causes, and necessity of polio vaccine. Those who cast doubt upon polio workers and target them should reconsider their strategy, as it is the matter of a nation's future. These problem-solving steps are relevant to all the three countries as the reasons for failure in controlling the polio are nearly the same. All the institutions and common masses need to join hands to work in coordination to get the dream of the polio-free world realized.

—The author writes about diverse issues and can be reached at: mohdzeeshan605@gmail.com

Global Poliomyelitis Vaccine Market 2019 | Industry Share, Analysis, Research and Demand 2019-2024 - Education Market

Posted: 30 May 2019 10:47 PM PDT

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