At its peak in the 1940s and 1950s, polio paralysed more than 35,000 americans a year. But thanks to vaccines and good sanitation and sanitation, polio is largely forgotten in the developed world.
Now, even in less developed areas, it is almost completely gone. But before polio was added to the smallpox virus, there were still some challenges that needed to be overcome, because the virus had been eliminated worldwide.
With the support of the world health organization, the bill and the Melinda gates foundation, America’s strategic partners, provide international dialogue), international and other agencies, public health workers and volunteers work tirelessly and in danger around the world with each child vaccinated. The number of polio cases worldwide dropped from 350,000 in 1988 to 37 in 2016. Thirty years ago, about 125 out of 190 countries around the world were found to have polio. Today, only three countries continue to see repeated cases: Pakistan, Nigeria and Afghanistan.
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Of these, Pakistan is the country closest to polio because of its continuing innovative vaccination campaign. But it has poor safety, weak health systems and inadequate sanitation.
In Pakistan, infectious disease preparedness and response researchers like us are taking this course in the hope that eventually polio will be promoted and applied elsewhere as public health experts try to eliminate other global infections.
Polio is in people and the environment.
Wild poliovirus is not particularly cold – resistant and cannot survive long – term in the environment. If the virus cannot find unvaccinated people to host it, it will die. This fact means that vaccination efforts can eliminate the virus entirely by denying access to a human host.
The world polio eradication campaign eliminated two of the three naturally occurring wild poliovirus species. Wild-type poliovirus type 2 was last seen in 1999 and has not had type 3 wild-type poliovirus since 2012.
Polio is spread mainly through fecal water. Where water is exposed to wastewater – usually in developing countries such as Pakistan – the virus can spread easily.
To complicate matters, almost a third of people infected with poliovirus have never had any symptoms. So, most people with polio don’t know they have the virus, or they’re spreading it to other people.
In addition, people with symptoms often appear to have flu, fever, headache, physical pain and vomiting. Only about 1% of cases are temporary or permanent.
This means that even without a confirmed case of polio, it could spread the virus in the community. To that end, public health workers used two different measures to measure the success rate of vaccination: the number of cases diagnosed with polio and the number of cases found in the environment.
In Pakistan, the two measures paint a different picture of eradication. The bad news is that 16 percent of the water tested in 2017 contained polio, a slight increase from 2016.
The better news is that between 2014 and 2017, the number of new polio cases fell from 306 to 8, a 97% reduction. With the support of the international community, the government has vaccinated most Pakistanis, confirming a marked decline in diagnoses. However, because vaccination is not widespread, the virus remains in some parts of Pakistan and poses a threat to those who have not been vaccinated or have not been vaccinated as planned.
Pakistan has several cultural barriers to polio eradication. Public health workers have access to health clinics and transit points for the majority of the population. Mobile vaccination units can reach people in other areas, but not children in high conflict areas.
In many parts of the region, militants have refused to allow public health officials to vaccinate children, saying the polio vaccine is part of a western plot to eliminate muslims. In 2012, the taliban, still under mountain control, banned vaccination and slowed efforts to eradicate polio. In addition, polio vaccinators have been the target of violence. In January, the mother’s daughter’s recently vaccinated gang was killed.
Pakistani health workers have been given a home after being vaccinated against polio after being armed. Ap photo/Shakil Adil.
To overcome some challenges, the eradication campaign coordinated vaccination efforts through military action. When a massive military strike in 2015 drove the taliban out of northern Pakistan, it paved the way for thousands of children to be vaccinated.
High rates of illiteracy, extreme poverty and religious beliefs may also lead parents to refuse to vaccinate their children in Pakistan and elsewhere. In these cases, BBB 0 and publicity are very important. Helping parents understand the risks of disease may help overcome misinformation about vaccines and increase positive associations with vaccination, as in the United States.