Polio is endemic in three countries due to the indigenous wild polio virus: Nigeria, Afghanistan and Pakistan. Importation of disease continues to be a problem worldwide with outbreaks seen regularly in other countries.
This year there have been outbreaks in Cameroon, Chad, Somalia, Kenya, Ethiopia, South Sudan and Niger as well as continued cases in Nigeria, Afghanistan and Pakistan. Disturbingly the wild virus has also been found in sewage samples from Israel, the West Bank and Gaza, where they have embarked on a supplementary immunisation programme for all children under 10 and continue to give routine childhood vaccines with the live oral vaccine.
This week there has also been worrying news that there is a suspected outbreak in war torn Syria (WHO), 14 years since the last reported case in the country. There have been 22 cases so far which have been reported in the Deir al-Zor area of Syria which is still controlled by government forces. The majority of these have caused acute flaccid paralysis and have affected children under two years of age. Concerns about spread of the disease is high, due to an estimated 4000 refugees fleeing the country daily to neighbouring countries.
Polio is spread through the faecal oral route (when food and drink is contaminated by faeces) so people living in poor sanitation and hygiene are particularly at risk. Young children who are not toilet trained can transmit the virus readily and are also at high risk. Good vaccination of a high percentage of children can soon eradicate an outbreak by preventing the virus from spreading and so it dies out.
The GPEI states that 90% of infected individuals show no signs of disease at all but can become carriers who will shed the virus in their faeces. One in 200 infections will lead to irreversible paralysis usually in the legs, this is also known as Acute Flaccid Paralysis. Occasionally polio can cause Bulbar polio which involves paralysis of the trunk, throat and abdomen and which can result in death when muscles involved in breathing stop working. There is no cure for polio but immunisation programmes are very effective at stopping the cycle of the disease and preventing further outbreaks. The GPEI is working with governments around the world to eradicate this disease once and for all.
All travellers to infected areas and areas of recent outbreaks are advised to have a booster of polio. The Travel Clinic Ltd. says: "We would be delighted to discuss your individual travel plans here. Please book an appointment to see one of our specialist nurses who can discuss all vaccination, malaria and other travel related needs with you."
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