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PNG's first polio outbreak in 18 years as health services decline,

PM Peter O'Neill & a child are vaccinated against polio & measles
Prime Minister Peter O'Neill & a child are vaccinated against polio

ELEANOR AINGE ROY | The Guardian

SYDNEY - The first cases of polio in Papua New Guinea in 18 years have been detected, with a six-year-old boy from the Morobe province the first confirmed case of the virus.

The boy presented to health authorities on 28 April with weakness in his lower limbs and the virus – a vaccine-derived poliovirus type 1 – was confirmed on 21 May.

Last week, the United States Centres for Disease Control and Prevention found the virus was also present in the stool samples of two children in the boy’s community; prompting health authorities to declare an official outbreak.

The World Health Organisation (WHO) declared the impoverished island nation polio-free in 2000, along with the rest of the western Pacific region. Only three other countries in the world continue to battle the virus; Pakistan, Nigeria and Afghanistan.

So far the three cases are isolated to the Morobe Province, where polio vaccine coverage is low, and only 61% of children have received the recommended three doses. WHO has assessed the risk of polio spreading to other countries as low, because travel in and out of the region is relatively limited.

In the weeks after the first case was confirmed, WHO deployed health workers for a “mop up” immunisation campaign, targeting children under the age of 15. To date, 845 children from the Lufa mountain settlement have been vaccinated.

Water, sanitation and hygiene are serious challenges in the region, adding to the crisis of controlling the highly infectious virus which mainly affects young children.

Pascoe Kase, secretary of the National Department of Health, said: “We are deeply concerned about this polio case in PNG, and the fact that the virus is circulating.

“Our immediate priority is to respond and prevent more children from being infected.”

The Papua New Guinean government is now working closely with WHO and other organisations to begin a large-scale immunisation campaign, as well as stepping up monitoring of vulnerable children.

The virus spreads through faecal-oral contamination, multiplies in the intestines, from where it spreads to the nervous system, causing paralysis.

Worldwide, cases of polio have decreased by over 99% in 30 years, largely the result of a co-ordinated global health campaign to eradicate it.

There is no cure for polio once contracted; it can be prevented only by a series of vaccinations during childhood.

Comments

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Michael Dom

That poor child does not know he has no vaccination against PNG's most virulent disease: Peter O'Neill.

Philip Fitzpatrick

This outbreak of vaccine-derived poliovirus type 1 seems to be related to the low immunisation rate in the area.

I checked it out on the WHO website and this is what is says:

Oral polio vaccine (OPV) contains an attenuated (weakened) vaccine-virus, activating an immune response in the body.

When a child is immunized with OPV, the weakened vaccine-virus replicates in the intestine for a limited period, thereby developing immunity by building up antibodies.

During this time, the vaccine-virus is also excreted. In areas of inadequate sanitation, this excreted vaccine-virus can spread in the immediate community (and this can offer protection to other children through ‘passive’ immunization), before eventually dying out.

On rare occasions, if a population is seriously under-immunized, an excreted vaccine-virus can continue to circulate for an extended period of time.

The longer it is allowed to survive, the more genetic changes it undergoes. In very rare instances, the vaccine-virus can genetically change into a form that can paralyse – this is what is known as a circulating vaccine-derived poliovirus (cVDPV).

It takes a long time for a cVDPV to occur. Generally, the strain will have been allowed to circulate in an un- or under-immunized population for a period of at least 12 months.

Circulating VDPVs occur when routine or supplementary immunization activities (SIAs) are poorly conducted and a population is left susceptible to poliovirus, whether from vaccine-derived or wild poliovirus.

Hence, the problem is not with the vaccine itself, but low vaccination coverage. If a population is fully immunized, they will be protected against both vaccine-derived and wild polioviruses.

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