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Current Events & Hot Topics Current Events & Hot Topics

Violence, Chaos Let Polio Creep Back Into Syria And Horn Of Africa

7 min 19 sec



In the border town of Waajale, Ethiopia, a frayed, knotted rope marks the international boundary with Somalia. The rope is ignored by just about everyone.

In the border town of Waajale, Ethiopia, a frayed, knotted rope marks the international boundary with Somalia. The rope is ignored by just about everyone.

Jason Beaubien/NPR

Global efforts to eradicate polio have made impressive progress over the past decade. Last year there were only 223 cases anywhere in the world.

But armed conflict and chaos are making it tough for the world to wipe out the virus completely.

Polio has re-emerged in war-torn Syria after more than a decade, the World Health Organization Tuesday. "The original cluster of suspected cases was 22 cases," the WHO's Oliver Rosenbauer says. "Out of those, 10 have now been confirmed as polio. The others are still being processed in the laboratory."

Earlier this year, Ethiopia carried out five mass immunization campaigns against polio along the Somali border. But to be fully protected, kids need several doses of the oral vaccine.

Earlier this year, Ethiopia carried out five mass immunization campaigns against polio along the Somali border. But to be fully protected, kids need several doses of the oral vaccine.

Jason Beaubien/NPR

Over in the Horn of Africa, an outbreak has ballooned into more than 190 cases. The outbreak's epicenter is , where fighting and violence have kept vaccinators from reaching hundreds of thousands of kids in the past few years.

Health officials are concerned that polio could become endemic in Syria and the Horn of Africa. They have launched massive emergency vaccination campaigns in both regions to try to protect millions of children against the crippling virus.

But polio infections in Somalia have already spread to , South Sudan and Ethiopia. A recent visit to the Somali-Ethiopian border highlights just how easily the virus can move silently around rural areas — and eventually find kids who aren't vaccinated.

So far Ethiopia has reported only six cases of polio compared to 174 in Somalia. But the landlocked country shares a thousand-mile border with Somalia. Most of it's unmarked and uncontrolled. Goat, sheep and camel herders move back and forth across the arid plains between the two countries seeking fresh pastures for their animals.

At the border town of , a frayed, knotted rope strung across the road marks the international boundary. The rope is ignored by just about everyone. Young men step over it. Vendors with wheelbarrows full of vegetables scoot under it.

Ethiopian authorities acknowledge that it's impossible to completely control the flow of people between the two countries. But in an effort to limit the importation of polio, Ethiopia has set up 13 vaccination checkpoints at major crossings. The Health Bureau has also deployed vaccinators to nearly 40 informal points of crossing along the border.

In Wajaale, the vaccination station is a small shack next to the rope on the Ethiopian side. When I visited the station one morning in early October, the vaccinator was absent. The sign announcing mandatory polio vaccination for all children had been tied back so that it was unreadable.

The town of Wajaale, Ethiopia, is located along the Somali border. The region around the border here is peaceful. But farther south, armed militants rule the area on the Somali side.

The town of Wajaale, Ethiopia, is located along the Somali border. The region around the border here is peaceful. But farther south, armed militants rule the area on the Somali side.

Jason Beaubien/NPR

The goal of these border vaccination posts is to immunize every child, under the age of 15, who crosses in either direction, says Abdulahi Mohamed, who is with the government's regional health bureau. "They have their vaccines there," he says pointing to a small ice chest. "They check the children. Everyone under 15, they give one dose of polio [vaccine]."

Abdulahi and other Ethiopian officials say that each border vaccination post is immunizing hundreds of kids every day. But during my visit, only 10 children had been vaccinated by noon.

The vaccinators are poorly paid, Abdulahi says — the equivalent of about $30 a month. He concedes that it's difficult to keep them motivated.

Nevertheless, Ethiopia's health ministry says that containing this polio outbreak is a top priority. "If you have a house that's caught fire, you need to extinguish (the flames)," says the country's health minister, Dr. . "So we take this seriously."

Ethiopian health official Abdulahi Mohamed says vaccinators along the Somali border are charged with immunizing all kids crossing who are under age 15. But he concedes that extremely poor pay may sap the workers' motivation.

Ethiopian health official Abdulahi Mohamed says vaccinators along the Somali border are charged with immunizing all kids crossing who are under age 15. But he concedes that extremely poor pay may sap the workers' motivation.

Jason Beaubien/NPR

Soon after polio was detected in Somalia this spring, Ethiopia carried out five mass immunization campaigns against the virus along the Somali border. Earlier this month they launched a national campaign to try to reach every child in the country — some 13 million kids. The World Health Organization and UNICEF have helped to fund the drives and stock them with vaccine.

But the vaccination campaigns are organized, run and largely paid for by Ethiopia's ministry of health, and the operation has put huge new burdens on an already strained national health system. The Ethiopian government even had to deploy special security details to travel with the vaccination teams in some parts of the country along the Somali border.

"The other side of the border [in Somalia] is totally insecure," Kebede says. "Some of the areas are governed by militants." These militants include, which claimed responsibility last month for the attack on a Nairobi shopping mall that left more than 60 people dead.

Another challenge of running a polio vaccination campaign in remote parts of the Horn of Africa is that the vaccine needs to be kept cold. Most Ethiopian health clinics in the province bordering Somalia don't have electricity. The health ministry has to use ice packs and portable, kerosene-fired refrigerators to keep the polio vaccine chilled.

The mass immunization campaigns are also complex and expensive logistical operations, Kebede says. They require hundreds of additional staff, hundreds of thousands of vaccine doses, extra kerosene for the refrigerators, and vehicles to deliver supplies to the targeted area. Each immunization team needs tally sheets and maps.

Plus, polio infects some people without ever making them sick. These so-called asymptomatic carriers appear healthy and can spread the virus to new communities.

"With polio ... the vast majority of the people who are infected and spreading [virus] are not paralyzed," says Dr. , a vaccine specialist at Emory University in Atlanta. "So there's a lot of "silent transmission."

"For every case of paralytic polio, we can assume there are at least a 100 to 200 — maybe a thousand people," Orenstein says, "who are infected and potentially spreading the virus."

National Woman's Party


by on Oct. 30, 2013 at 9:07 AM
Replies (11-20):
meriana
by Platinum Member on Oct. 30, 2013 at 11:32 AM
1 mom liked this

Whenever there is a situation where people are poor, living in refugee camps that are generally anything but clean; fighting/war is going on, etc. etc. disease/illnesses show up.

They are giving these kids a live virus vaccine and sending them on their way and they wonder why it's spreading to new areas?  Since a live virus vaccine can and often does shed, they are potentially adding to the spread  in what they term a "silent transmission".  Interesting that they point to those having the illness but not becoming ill as those who are potentially spreading the illness (making it appear that it's those who are not vaccinated) but fail to mention that a person/child recently vaccinated with a live virus vaccine is also capable of spreading the illness and is just as, perhaps more, likely to do so.

lga1965
by on Oct. 30, 2013 at 11:51 AM
1 mom liked this
That's quite rare. The answer to prevention is vaccinations. All of them.

Quoting meriana:

Whenever there is a situation where people are poor, living in refugee camps that are generally anything but clean; fighting/war is going on, etc. etc. disease/illnesses show up.

They are giving these kids a live virus vaccine and sending them on their way and they wonder why it's spreading to new areas?  Since a live virus vaccine can and often does shed, they are potentially adding to the spread  in what they term a "silent transmission".  Interesting that they point to those having the illness but not becoming ill as those who are potentially spreading the illness (making it appear that it's those who are not vaccinated) but fail to mention that a person/child recently vaccinated with a live virus vaccine is also capable of spreading the illness and is just as, perhaps more, likely to do so.

Posted on CafeMom Mobile
survivorinohio
by René on Oct. 30, 2013 at 12:10 PM


Quoting norahsmommy:

Polio is horrid. My dad and mom are old enough to vividly remember it. Their town was hit hard by it when they were kids. They each know people around their age that died from it and a few that recovered but needed wheel chairs or crutches after.

I have a friend who was crippled by polio:(  He is about 20 yrs older than me.

How far you go in life depends on your being: tender with the young, compassionate with the aged, sympathetic with the striving and tolerant of both the weak and strong.  Because someday in life you would have been one or all of these.  GeorgeWashingtonCarver


meriana
by Platinum Member on Oct. 30, 2013 at 12:39 PM
2 moms liked this

Quoting lga1965:

That's quite rare. The answer to prevention is vaccinations. All of them.

Quoting meriana:

Whenever there is a situation where people are poor, living in refugee camps that are generally anything but clean; fighting/war is going on, etc. etc. disease/illnesses show up.

They are giving these kids a live virus vaccine and sending them on their way and they wonder why it's spreading to new areas?  Since a live virus vaccine can and often does shed, they are potentially adding to the spread  in what they term a "silent transmission".  Interesting that they point to those having the illness but not becoming ill as those who are potentially spreading the illness (making it appear that it's those who are not vaccinated) but fail to mention that a person/child recently vaccinated with a live virus vaccine is also capable of spreading the illness and is just as, perhaps more, likely to do so.


It may not be as rare as people are led to believe. The thing is that the medical community immediatly goes to the Unvaccinated as the cause or the spread. They don't look at possible spread via shedding. In this article they mention those that don't become ill but are carriers but there is NO mention of those recently vaccinated as being carriers even though they are. In places like Nigeria, it's not uncommon for young children, especially those living in camps, to urinate and even poop in the same river that others are playing in, sanitation in many areas is non-existant making it very possible for a shedding vaccine to infect others. In this article these kids are receiving a live virus vaccine and then they are around any number of other people living in any number of conditions meantime, that live virus is active in their systems. They are just as capable of spreading it to others as those that are termed "asymptomatic carriers" because they've had polio but not ever been actually ill. My Mil also had a life-long friend crippled by polio, she got it from the vaccine.
lga1965
by on Oct. 30, 2013 at 12:50 PM
1 mom liked this
If she actually got polio from the vaccine, it was a fluke. I bet she was about to show symptoms and had it ,but nobody knew, and then got the vaccine.


Quoting meriana:



Quoting lga1965:

That's quite rare. The answer to prevention is vaccinations. All of them.



Quoting meriana:

Whenever there is a situation where people are poor, living in refugee camps that are generally anything but clean; fighting/war is going on, etc. etc. disease/illnesses show up.

They are giving these kids a live virus vaccine and sending them on their way and they wonder why it's spreading to new areas?  Since a live virus vaccine can and often does shed, they are potentially adding to the spread  in what they term a "silent transmission".  Interesting that they point to those having the illness but not becoming ill as those who are potentially spreading the illness (making it appear that it's those who are not vaccinated) but fail to mention that a person/child recently vaccinated with a live virus vaccine is also capable of spreading the illness and is just as, perhaps more, likely to do so.





It may not be as rare as people are led to believe. The thing is that the medical community immediatly goes to the Unvaccinated as the cause or the spread. They don't look at possible spread via shedding. In this article they mention those that don't become ill but are carriers but there is NO mention of those recently vaccinated as being carriers even though they are. In places like Nigeria, it's not uncommon for young children, especially those living in camps, to urinate and even poop in the same river that others are playing in, sanitation in many areas is non-existant making it very possible for a shedding vaccine to infect others. In this article these kids are receiving a live virus vaccine and then they are around any number of other people living in any number of conditions meantime, that live virus is active in their systems. They are just as capable of spreading it to others as those that are termed "asymptomatic carriers" because they've had polio but not ever been actually ill.

My Mil also had a life-long friend crippled by polio, she got it from the vaccine.
Posted on CafeMom Mobile
beesbad
by Bronze Member on Oct. 30, 2013 at 2:01 PM
2 moms liked this

First, a couple of links with accurate data:

http://www.historyofvaccines.org/content/timelines/polio

http://www.immunize.org/catg.d/p4215.pdf

It is true that people who have had the oral polio vaccine can shed the weakened version of the polio virus, for that reason, in the U.S., only the IPV vaccine is now given.

However, to insinuate that the outbreak is because of the vaccinations is just wrong. In the U.S., when the oral vaccine was being given, only 8-10 cases in the entire nation were due to the vaccine.

Since 95% of people who contract the virus show no symptoms it is far more reasonable to assume that they would be the main source of the outbreak.

OHgirlinCA
by Platinum Member on Oct. 30, 2013 at 2:28 PM

It's disheartening that these vaccination programs have so many issues to overcome. 

meriana
by Platinum Member on Oct. 30, 2013 at 7:18 PM

Quoting lga1965:

If she actually got polio from the vaccine, it was a fluke. I bet she was about to show symptoms and had it ,but nobody knew, and then got the vaccine.


Quoting meriana:



Quoting lga1965:

That's quite rare. The answer to prevention is vaccinations. All of them.



Quoting meriana:

Whenever there is a situation where people are poor, living in refugee camps that are generally anything but clean; fighting/war is going on, etc. etc. disease/illnesses show up.

They are giving these kids a live virus vaccine and sending them on their way and they wonder why it's spreading to new areas?  Since a live virus vaccine can and often does shed, they are potentially adding to the spread  in what they term a "silent transmission".  Interesting that they point to those having the illness but not becoming ill as those who are potentially spreading the illness (making it appear that it's those who are not vaccinated) but fail to mention that a person/child recently vaccinated with a live virus vaccine is also capable of spreading the illness and is just as, perhaps more, likely to do so.





It may not be as rare as people are led to believe. The thing is that the medical community immediatly goes to the Unvaccinated as the cause or the spread. They don't look at possible spread via shedding. In this article they mention those that don't become ill but are carriers but there is NO mention of those recently vaccinated as being carriers even though they are. In places like Nigeria, it's not uncommon for young children, especially those living in camps, to urinate and even poop in the same river that others are playing in, sanitation in many areas is non-existant making it very possible for a shedding vaccine to infect others. In this article these kids are receiving a live virus vaccine and then they are around any number of other people living in any number of conditions meantime, that live virus is active in their systems. They are just as capable of spreading it to others as those that are termed "asymptomatic carriers" because they've had polio but not ever been actually ill.

My Mil also had a life-long friend crippled by polio, she got it from the vaccine.

A Fluke? No, it's something that can and does happen to some people just as some people have other serious adverse reactions to vaccines. If one only hears about one case of something happening it's pretty easy to term it a fluke but that doesn't change the fact that severe adverse reactions including getting a bad case of the illness from the vaccine itself, do happen. Passing them all off as just a fluke is unrealistic and a bit silly. There's also the fact that the virus in a live virus vaccine can mutate into a stronger strain. Not vaccinating is risky but vaccinating can be/is just as risky.
T-HoneyLuv
by on Oct. 30, 2013 at 7:23 PM
2 moms liked this
Are you speaking about the majority in your last sentence or for some? Because for the MAJORITY, the risk from not vaccinating is MUCH higher.


Quoting meriana:



Quoting lga1965:

If she actually got polio from the vaccine, it was a fluke. I bet she was about to show symptoms and had it ,but nobody knew, and then got the vaccine.





Quoting meriana:




Quoting lga1965:

That's quite rare. The answer to prevention is vaccinations. All of them.





Quoting meriana:

Whenever there is a situation where people are poor, living in refugee camps that are generally anything but clean; fighting/war is going on, etc. etc. disease/illnesses show up.

They are giving these kids a live virus vaccine and sending them on their way and they wonder why it's spreading to new areas?  Since a live virus vaccine can and often does shed, they are potentially adding to the spread  in what they term a "silent transmission".  Interesting that they point to those having the illness but not becoming ill as those who are potentially spreading the illness (making it appear that it's those who are not vaccinated) but fail to mention that a person/child recently vaccinated with a live virus vaccine is also capable of spreading the illness and is just as, perhaps more, likely to do so.








It may not be as rare as people are led to believe. The thing is that the medical community immediatly goes to the Unvaccinated as the cause or the spread. They don't look at possible spread via shedding. In this article they mention those that don't become ill but are carriers but there is NO mention of those recently vaccinated as being carriers even though they are. In places like Nigeria, it's not uncommon for young children, especially those living in camps, to urinate and even poop in the same river that others are playing in, sanitation in many areas is non-existant making it very possible for a shedding vaccine to infect others. In this article these kids are receiving a live virus vaccine and then they are around any number of other people living in any number of conditions meantime, that live virus is active in their systems. They are just as capable of spreading it to others as those that are termed "asymptomatic carriers" because they've had polio but not ever been actually ill.



My Mil also had a life-long friend crippled by polio, she got it from the vaccine.




A Fluke? No, it's something that can and does happen to some people just as some people have other serious adverse reactions to vaccines. If one only hears about one case of something happening it's pretty easy to term it a fluke but that doesn't change the fact that severe adverse reactions including getting a bad case of the illness from the vaccine itself, do happen. Passing them all off as just a fluke is unrealistic and a bit silly. There's also the fact that the virus in a live virus vaccine can mutate into a stronger strain. Not vaccinating is risky but vaccinating can be/is just as risky.

Posted on CafeMom Mobile
cjsbmom
by Lois Lane on Oct. 30, 2013 at 7:24 PM

Indeed.

Quoting romalove:

Very scary, and frustrating since this is so preventable.


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