Kelli Tapley, MD
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