A long maligned foe has
returned to the forefront in pediatric news: Polio. While I have never seen a case, nor have most
practicing pediatricians in the United States, I can remember learning about
the structure of the enterovirus and its crippling effects. However, as
recently as 1952 there were 57,000 cases in the US.
Why is it returning? All of
the circulating polioviruses can be traced to one of three countries: Nigeria,
Pakistan, and Afghanistan, where the viruses are endemic. These viruses have
spread to places like Syria. Embroiled in civil war, Syria, a country that
currently spends only 3% of its GDP on health care, pre-conflict boasted 90%
immunization rates. Currently it is closer to 65%. Already 17 children have
been diagnosed with paralytic polio in Syria, and there have been 3 cases in
Cameroon. The Middle East, specifically Egypt, Iraq, Jordan, Lebanon, and West
Bank and the Gaza Strip, Syria, Turkey and Cameroon have declared a polio
emergency because of the concern that the viruses will spread across their
borders.
There are efforts underway in
Syria, Jordan, and Iraq to vaccinate children and prevent transmission of
polio. UNICEF has 1.35 billion doses of oral polio vaccine and hopes to have
1.7 billion doses by the end of the year.
Our role is to ensure all of our patients are
up to date on polio vaccines, especially those travelling to areas where it
polio is circulating. The CDC is recommending a one-time polio booster for
travellers going to Syria, Egypt, Iraq, Jordan, Lebanon, and Turkey, Cameroon, Central African Republic, Chad, Republic of
Congo, Equatorial
Guinea, and Gabon and Nigeria. For a full listing see
www.cdc.gov/travel/notices/alert
Dr. Tapley is with Birmingham Pediatric Associates
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