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SPECIAL POSTING: SIX ITEMS ON POLIO

Tuesday, 10th of September 2013

SPECIAL POSTING: SIX ITEMS ON POLIO

•  POLIO REPORTS, SOMALIA

Allow me to share with you the latest update on WPV case count from the polio lab (as of September 10, 2013).

• 6 new polio cases were reported from the lab yesterday.  This brings the total number of polio cases in Somalia to 169.
• All these new cases are in inaccessible and partially accessible districts of Lower Shabelle (Balad district), Middle Shabelle (Jowar district), Middle Juba (Jilib East) and Lower Juba (Jamaame, Badade and Kismayo). No new case was reported from Banadir region in this last lab update. This confirms the trend observed earlier; the shifting of the outbreak from accessible districts to inaccessible and partially accessible districts of South and Central Somalia.
• There is one new infected district (Badade, which is inaccessible for SIAs) in Lower Juba. The total number of infected districts is now 46. The date of onset of the most recent polio case is 14 August 2013, from Jowhar district.
• The oldest polio case in Somalia is 27 years old.

 

The file attached includes the most recent WPV line list (with selected variable) and a succinct analysis of WPV/District accessibility status

 

Sincere regards

 

Raoul Kamadjeu, MD, MPH

Medical Officer / Surveillance Coordinator

Tel:  +254 714 606 223

Fax: +254 7623725

WHO Somalia Liaison Office

Warwick Center, Gigiri

United Nations Avenue

P.O. Box 63565-00619

Nairobi, Kenya

 

• ELIAS DURRY, POLIO WARRIOR, AWARDED MEDAL 

http://www.polioeradication.org/tabid/488/iid/320/Default.aspx

 

• POLIO OUTBREAK IN THE HORN OF AFRICA: RED CRESCENT/RED CROSS KEY TO VACCINATING KIDS

http://www.huffingtonpost.co.uk/siddharth-chatterjee/polio-outbreak-horn-of-africa_b_3864527.html?just_reloaded=1

 

• POLIO: WE’VE STARTED, SO WE WILL FINISH

http://www.huffingtonpost.co.uk/gareth-williams/polio-weve-started-so-wel_b_3549917.html

 

• POLIO SHOTS A MUST FOR SOMALI, KENYAN HAJIS

 

RIYADH: MD RASOOLDEEN

The Arab News

Published — Monday 26 August 2013

The [Saudi] Ministry of Health has made it mandatory for all Haj pilgrims coming from Somalia and Kenya to produce polio vaccination certificates upon arrival in the Kingdom following the outbreak of an epidemic in the two countries.
A ministry official told Arab News on Sunday that the decision was taken after monitoring the polio outbreak situation in the two countries.

“These pilgrims should produce their polio vaccination certificate at the port of arrival in the Kingdom,” he said, adding that they should take the vaccination six weeks prior to arrival.

“Upon arrival, these pilgrims will be given another dose of polio vaccine irrespective of their age.”

He said the ministry has been following up on developments of epidemiological diseases in the world and was taking measures to keep them under control during the pilgrimage season. Besides polio, the focus this year is also on diseases such as yellow fever, meningitis and influenza.

In accordance with the health regulations of 2005, all travelers arriving from countries or areas at risk of yellow fever must present a valid yellow fever vaccination certificate attesting that the person was vaccinated at least 10 days and at most 10 years prior to arrival at the border.

In case of the absence of such a certificate, the individual will be placed under strict surveillance for six days from the date of vaccination or the last date of potential exposure to infection.

Health offices at entry points will be responsible for notifying the Director General of Health Affairs in the region or the Governorate about the temporary place of residence of the visitor.

Aircraft, ships and other means of transportation coming from countries hit by yellow fever have to submit a certificate indicating that it applied disinfectant in accordance with methods recommended by the WHO.

• POLIO PROVOCATION: A LINGERING PUBLIC HEALTH DEBATE

OUP Blog

Best viewed, with photos, at http://blog.oup.com/2013/09/polio-provocation-a-lingering-public-health-debate/?utm_source=feedblitz&utm_medium=FeedBlitzRss&utm_campaign=oupbloghealthmedicine

 

Posted on Tuesday, September 3rd, 2013 at 6:30 am

By Stephen E. Mawdsley

In 1980, public health researchers working in the United Republic of Cameroon detected a startling trend among children diagnosed with paralytic polio. Some of the children had become paralyzed in the limb that had only weeks before received an inoculation against a common pediatric illness. Further studies emerging from India seemed to corroborate the association. Health professionals discussed the significance of the findings and debated whether they were due to coincidence or due to the provocation of polio from immunizations. The theory of ‘polio provocation’ was of historical significance and had been hotly contested by doctors and public health officials many decades earlier.

Whether polio provocation really existed or was simply a clinical chimera waxed and waned. The theory first came to light in the early 1900s, just as epidemic polio began to plague industrialized countries. However, most of these studies were based on clinical observation and did not utilize placebo controls for comparative purposes. In the United States, the theory of polio provocation was fiercely contested in the 1940s and 1950s. As laboratory technology at the time could not unlock the mechanism behind polio provocation, health professionals considered how to balance the health risks. Were all injections guilty of triggering polio infection? Should immunization programs be banned during polio epidemics? Was the risk of declining herd immunity from halting pediatric immunizations greater than the risk of inciting polio from inoculations?

The theory of polio provocation divided medical communities and inspired temporary shifts in public health policy. Some health departments even shut down child immunization clinics and discouraged throat operations out of concern that the risk of causing polio was too high. After the vaccine was licensed in 1955 and the incidence of polio began to plummet, the risk of provocation waned in relation to the rise in herd immunity. Children who were vaccinated against polio did not face the risk of polio provocation from other inoculations. Traditional public health practices were soon restored and the theory seemed no longer applicable. Concerns regarding provocation disappeared in nations where immunization against polio was commonplace.

Polio provocation resurfaced in the medical literature during the 1980s when large aid agencies, such as Rotary International and the World Health Organization, undertook immunisation programmes in regions where polio raged unabated. A few observers turned to timeworn medical journals to better understand polio provocation, only to uncover the debates of old. Freighted on public health activism and the evidence of health workers, medical researchers deployed modern laboratory equipment to unlock the secrets of the theoretical adverse health link. By the 1990s, researchers announced their discovery of the mechanism behind polio provocation: tissue injury caused by certain injections permits the virus easy access to nerve channels, thereby heightening its ability to cause paralysis. Over the course of a century, polio provocation had migrated from a theory to a clinical model.

Just because the mechanism behind polio provocation was identified did not mean that changing immunisation policies was immediate. In regions where polio remains endemic, such as Afghanistan, Pakistan, and Nigeria, the consequences of this issue continues to concern public health officials.

Stephen E. Mawdsley is the Isaac Newton – Ann Johnston Research Fellow in History at Clare Hall, University of Cambridge. He is interested in the history of twentieth century American medical research and public health. His forthcoming monograph examines one of the first large clinical trials undertaken to control polio in the United States. He is the author of “Balancing Risks: Childhood Inoculations and America’s Response to the Provocation of Paralytic Polio” (in advance access and available to read for free for a limited time) in the Social History of Medicine.

Social History of Medicine is concerned with all aspects of health, illness, and medical treatment in the past. It is committed to publishing work on the social history of medicine from a variety of disciplines. The journal offers its readers substantive and lively articles on a variety of themes, critical assessments of archives and sources, conference reports, up-to-date information on research in progress, a discussion point on topics of current controversy and concern, review articles, and wide-ranging book reviews.