Polio experts cautiously optimistic, but warn that disease could make renewed comeback
27 January 2015 | BEIRUT -A 12-month emergency immunization response across the Middle East appears to have halted an outbreak of polio that began in Syria and Iraq, according to health experts meeting in Beirut.
The outbreak, which paralysed at least 38 children in Syria and Iraq and prompted fears of a major epidemic, triggered an unprecedented response that immunized more than 27 million children across 8 countries. The outbreak in Syria – which spread to Iraq in early 2014 -- occurred due to the introduction of poliovirus from Pakistan.
One year has now passed since the last confirmed case of the virus in Syria and nine months since the last in Iraq, in spite of the ongoing conflict and mass population displacement in the region. Experts say this remarkable achievement is the result of the enormous efforts and commitment shown by governments, health workers, and parents to ensure that their children receive the vaccine.
“In normal conditions we would say that the epidemic has stopped,” said Maria Calivis, UNICEF Regional Director for the Middle East and North Africa. “But given the ongoing conflict, UNICEF and its partners will spare no efforts to ensure that children continue to receive the protection they need against this terrible disease.”
Experts attending a regional Polio review meeting in Beirut January 26-27 warned that with violence still sweeping Syria and Iraq, there is a serious risk that some children are not being reached regularly by vaccination teams. They say that given the gaps in vaccine coverage and potentially in surveillance for new cases, further immunization campaigns are essential over the months ahead.
“This is no time to relax,” said Chris Maher, Manager for Polio Eradication and Emergency Support of the World Health Organization (WHO). “In spite of our success so far, we continue to work with governments and local authorities, United Nations organizations and local and international nongovernmental organizations to ensure that all children across the region are fully protected against polio, including those living in areas most affected by conflict.”
A response plan for the next six months was formulated at the Beirut meeting which was attended by expert teams from Ministries of Health from Syria, Iraq, Jordan, Lebanon, Egypt, Turkey, Gaza and the West Bank and Iran and polio experts from the World Health Organization (WHO), UNICEF, the US Centers for Disease Control (CDC), Rotary International, and the Bill and Melinda Gates Foundation. The plan will focus on strengthening the basic delivery of immunization services, and identifying children and communities who are not being reached due to conflict or population movement.
The outbreak response has brought together a wide range of local and international partners, including Rotary International. “Rotary members have been working with local health authorities across the Middle East to galvanize the outbreak response and will continue raising awareness, supporting advocacy campaigns, securing funds, and building support in the fight to end polio wherever it exists,“ the District PolioPlus Subcommittee Chair for Rotary, Michel Jazzar said.
While emergency plans are now being further intensified to ensure all children are reached with vaccine and surveillance for the disease is strengthened, WHO and UNICEF experts say the only way to definitively protect children across the Middle East is to stop transmission of the virus in the countries where poliovirus transmission remains endemic – Pakistan and Afghanistan.
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Note to editors:
Generous donor contributions from Austria, Chile, DFID, ECHO, Estonia, Germany, Luxembourg, Norway, Oman, Rotary International, United Arab Emirates, UAE Red Crescent Society and the Emergency Response Fund of UN OCHA have enabled the Middle East outbreak response to vaccinate more than 27 million children against polio across 8 countries in 56 supplementary immunization activities (SIAs) since the outbreak was confirmed.
At this review, the chiefs of the vaccination programmes of the eight countries noted that their ministers of health had been among those who had declared the outbreak a regional public health emergency days after cases were confirmed in October 2013, and that this declaration had enabled them to mount a swift and coordinated response. They applauded health workers from all the countries, working sometimes at great risk across political divides and conflict lines to protect the children of the region, and thanked international partners for their steady support. Given the situation in Syria and Iraq, frequent population movements across the region, low immunity in key areas and the continuing transmission of polio in Pakistan, they emphasized that the risk of another importation of the virus remained high and the consequences severe. Especially in areas of conflict where health service delivery has broken down, disease surveillance and vaccination activities which allowed the vigorous response must be continued, they advised.
