Nigeria goes three years without a case of polio - BBC News

Posted: 21 Aug 2019 09:10 AM PDT

Boy being vaccinated against polio — Image caption Polio can only be prevented through immunisation

Nigeria has gone three years without a case of polio, putting it on the brink of being declared free of the disease.

This is a dramatic change from 2012 when the country accounted for more than half of all polio cases worldwide, the World Health Organization has said.

The head of the primary health care agency, Dr Faisal Shuaib, said Nigeria had reached a "historic milestone".

But it will be several months before the country can officially be labelled polio-free.

The first criteria, no case for three years, has been achieved.

But now the WHO needs to make sure there is a robust surveillance system in Nigeria to be certain that there are no further cases of the wild polio virus, chairman of Nigeria's polio committee, Dr Tunji Funsho, told BBC Newsday.

Image copyright Getty Images

Image caption Health workers have been vaccinating people against polio across northern Nigeria

Nigeria is the last country in Africa to have witnessed a case of polio - in Borno state, in the north-east. Outside of Nigeria, the last case on the continent was in the Puntland region of Somalia, in 2014.

Insecurity in the north-east of Nigeria had hindered the polio vaccination programme, but success in fighting the Boko Haram militant group has been cited as one of the reasons behind getting polio under control.

In addition, officials have said that political support and an injection of funds have also helped.

In 2018, there was a total of 33 polio cases confined to just two countries: Afghanistan and Pakistan.

An achievement for Africa

Anne Soy, BBC News, Nairobi

This is not just a milestone for Nigeria but also for the rest of Africa.

The newly re-appointed WHO Africa head Dr Matshidiso Moeti said the continent is "on the verge of an extraordinary public health achievement; one which will be our legacy to our children and children's children".

But health experts urge caution.

They must first be sure that every part of the continent has been reached and no cases have been missed.

For now, there are renewed calls to vaccinate children against polio.

It has taken the effort of thousands of volunteers who have risked their lives in some instances to deliver the much-needed vaccines to all parts of the continent.

But "to end polio, at least 95% of children must be vaccinated, no matter where they live," says WHO head of polio eradication Michel Zaffran.

What is polio?

Polio, or poliomyelitis, mainly affects children aged under five
It is a highly infectious disease caused by a virus. It invades the nervous system and can cause total paralysis in a matter of hours
Initial symptoms include fever, fatigue, headache, vomiting, stiffness of the neck and pains in the limbs
One in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilised
Today, only two countries - Afghanistan and Pakistan - remain polio-endemic, down from more than 125 in 1988

Source: World Health Organization

The history of polio

OPINION | Colorado is lax on vaccinations, tempting fate — and history - coloradopolitics.com

Posted: 28 Aug 2019 11:15 PM PDT

The new school year gives Colorado's children a new year's opportunity to catch infectious diseases. It won't be hard, especially for unimmunized 5-year-olds.

In past years, many kindergartners went to half-day school. Thanks to Gov. Jared Polis, they can now all go to full-day kindergarten. That advance gives these children more time to catch measles, mumps, or rubella, which can only be prevented with "herd" level immunization. As of 2017, according to the state's reporting, under 90 percent of the state's children are immunized, with numbers varying by vaccine and geography. Measles prevention occurs at 90 to 95 percent "herd" levels.

Rep. Kyle Mullica, Democrat from Adams County and a nurse, sponsored HB19-1312 on school immunization requirements. The bill continued to allow non-immunization of children for religious or personal beliefs. It changed requirements for reporting non-immunization.

The legislation told the Colorado Department of Public Health and Environment (CDPHE) to develop a standardized non-medical immunization exemption form that parents would have to deliver in person to the CDPHE or a local health agency in the first year of the exemption. After that, online notification would be accepted.

An unruly brouhaha erupted in committee hearings at the Capitol with anti-vaccination parents objecting to the additional effort to not immunize their kids. The legislation passed the state House of Representatives, but died in the Senate when Gov. Jared Polis said he didn't support the bill as written. He didn't mean that the bill was too weak. He sided with parents and their anti-vaccination personal beliefs.

The state's largest school districts are generally meeting CDPHE immunization goals. Boulder Valley School District, the governor's home base, is an outlier. Enough parents of students there haven't immunized their children so the district doesn't meet health department goals for any vaccinations.

Boulder High School kids are significantly under-immunized, according to most recent health department data, with only 87 percent immunized for measles, mumps and rubella (MMR), 82 percent for polio, and 84 percent for hepatitis B. The large majority of parents of these children use "personal beliefs" as their rationale for non-immunization.

New York state, with 1,046 measles cases this year, delivers the most current news on how infection spreads among the non-immunized. Patient Zero, a 14-year-old student visitor from Israel, was absent from school the day his classmates got their mandatory MMR shot. He probably caught the virus from a child who'd visited Uman in Ukraine, where there's a low vaccination rate and 50,000 measles cases last year, according to a recent New Yorker article. The 14-year-old boy went to synagogue in an Hassidim community where many parents do not vaccinate children for religious reasons. According to NY's state health department, eleven people caught the measles from Patient Zero during the religious service.

Before mass vaccination, whole classrooms of students could be wiped out repeatedly when infected kids spread measles, mumps, rubella, and chicken pox. Polio was a scourge to early baby boomers, before the three-shot Jonas Salk vaccine in 1955 and the Sabin oral vaccine on sugar cubes in 1961.

Maurice Hilleman invented the MMR vaccine available in 1971. Worldwide deaths from these diseases plummeted from 2.6 million before vaccine to 122,000 in 2012. Measles officially disappeared from the U.S. in 2000, with occasional spikes of infection catching the unvaccinated, such as at Disneyland in 2015 with 147 cases related to a single exposure.

Colorado's "personal belief" exemption for vaccinations exceeds New York's. The Empire State only exempted immunization based on religious beliefs. New York's legislature pulled that exemption in June.

The U.S. Supreme Court in Jacobson v Massachusetts established the right of the state to enforce "restraints" for the "common good" in implementing smallpox vaccinations in 1905. That decision is the basis for mandatory vaccination today.

Rep. Mullica's bill was killed 114 years after the Supreme Court's decision in the Jacobson case. The legislature's leniency isn't really tempting fate. It's tempting history.

Paula Noonan owns Colorado Capitol Watch, the state's premier legislature tracking platform.

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