By Sola Ogundipe, Chioma Obinna & Gabriel Olawale
The campaign to eradicate polio from Nigeria for more than two decades suffered unimaginable loss when on 11 August 2016, the World Health Organisation, WHO, confirmed two fresh cases of wild poliovirus in the northern part of the country.
While Nigerians were still dazed by the announcement, another fresh case was reported, soon afterwards, in Monguno Local Government Area of Borno State by the world health body.
These discoveries were among refugees from areas recently won back by the military from Boko Haram insurgents.
The Federal government, supported by the WHO, UNICEF and partners of the Global Polio Eradication Initiative, GPEI, quickly swung into action to curtail effects of the first two cases.
A plan was fine-tuned to immunise children in the troubled Northern part of the country.
An estimated one million children in Borno State and a further four million neighbouring states are now being immunised against the deadly Wild Polio Virus.
But the emergence of the 3rd case of wild polio virus just three weeks after the first two fresh cases, may have thrown a wedge in the response efforts.
Prior to the revelation, Nigeria, once one of only three countries left where polio was endemic – was on the path to becoming polio-free by 2017.
Following this development, Nigeria is now facing an epidemic situation as WHO has maintained that a case of polio is an epidemic.
It is no longer news that the world may have to wait a while longer than anticipated for eradication of one of the world’s most devastating disorders.
Confirming the newest case, the WHO said a crippled toddler tested positive to the polio virus. Federal health officials, who said the development was not unanticipated following the Boko Haram insurgency on the communities, are worried that the situation may deteriorate even further.
Nigeria has now rejoined Afghanistan and Pakistan that are still struggling to wipe out the wild polio virus. Apart from their remote and isolated populations, a common factor among the three countries is the dire security situations that are making disease prevention challenging than ever.
Although a new campaign to reach 25 million children before the end of the year is now in progress, UNICEF has warned that not less than one million children are in areas too dangerous to access. There are actual expectations that more cases will be discovered in the restive communities.
As expressed by one of the field experts, one cannot really say the country is cleared of polio cases in those regions.
PRESIDENT MUHAMMADU BUHARI (L) VACCINATING HIS THREE MONTHS OLD GRAND-DAUGHTER, ZULEIHA BELLO ABUBAKAR WITH ORAL POLIO VACCINE TO MARK
ONE YEAR OF FREE POLIO CASE IN NIGERIA AT THE PRESIDENTIAL VILLA IN ABUJA ON SATURDAY (25/7/15) WITH HIM IS THE EXECUTIVE DIRECTOR, NATIONAL
PRIMARY HEALTH CARE DEVELOPMENT AGENCY, DR ADO MUHAMMAD.(File)
Why eradication will remain elusive
However, despite all these collective efforts, health watchers are of the view that the country is not out of the woods yet. They say more fresh cases are expected to resurface in those areas once controlled by Boko Haram as little or no immunisation exercise were carried out in those areas due to insurgency activities.
The President, Nigerian Academy of Science, NAS, Prof. Oyewale Tomori, describes the new polio outbreak as a threat to Nigeria’s steady march to eradication of polio after a long and tortuous eradication campaign
Tomori who blamed the recent outbreak on waning out of commitment and complacency said: “After attaining non-polio endemic status in September 2015, commitment waned and complacency set in.
This was particularly evident at the levels of the national assembly, governors and local government area chairpersons.
“This complacency meant that polio eradication activities were no longer backed by adequate and timely counterpart funding at the state and local government area levels.
This was despite a public and often vocal commitment to polio eradication from Nigeria’s President Muhammadu Buhari,” he stated.
Tomori added: “As a result, gaps remained in the quality of immunisation and surveillance activities. These were especially prominent in the country’s security compromised areas.”
The wild poliovirus (type 1) isolates were recovered from residents in Gwoza and Jere local government areas in Borno state in northern Nigeria. Genetic sequencing suggests these isolates are most closely linked to the wild poliovirus type 1 that was last detected in the state in 2011.
Also, Project Director, the Community Health and Research Initiative CHR, Dr Aminu Magashi Garba linked the fresh outbreak to non-release of the N12.8 billion approved for routine immunization five months after the President’s accent to the 2016 budget.
Non release of funds: Magashi-Garba expressed worry that the continued delay may put the lives of over 7.2 million Nigerian children in danger even cause more outbreak of polio and other vaccine – related childhood diseases.
For Nigeria to return on track of winning the war against polio and deliver the African continent from the clutches of wild polio, immunisation is the way to go.
“To save the lives of our children and save the country the scarce resources by reducing cost of health care as well as give the future leaders the opportunity to live their potential, government at all levels must ensure 100 percent coverage of immunization.
“If we as a nation cannot provide health care to our children, what message we are sending to the world?” he queried.
Cold chain problems: In his views during a Television Programme, the Chairman, National Polioplus Committee, Rotary International, Dr. Tunji Funso, identified poor cold chain system as a major factor.
According to the eradication plan drawn by the Global Polio Eradication Initiative, the oral vaccine itself is fragile, requiring constant refrigeration. When there is significant weakness in the system, it goes along way to affect the system.
For Funso, in states like Borno where there is insurgency for the cold chain system to be effective, there must be electricity or ice to ensure effective system.
Acknowledging some form of failure on the part of the country, Funso said, Nigeria has failed in maintaining infrastructure as well as full coverage of all the children in the area.
He stressed the need to strengthen the nation’s routine immunization programme as well as intensify surveillance activities.
“Government has come up with strategies to curb the outbreak. One of the strategies is to make sure that a lot of children get immunized. Because of this outbreak we need to have three rounds of immunisation which will take place in Borno, Gombe, Adamawa and Yobe State on the 27th of August, 24th of September and 27th of October.
“The strategy is to make sure we capture as many children as possible. The second strategy is to increase the immunity of children to prevent new infection,” he said.
With the latest development, and barring further hitches, Nigeria must wait at least till last quarter of 2019 to receive a polio certification, if it holistically renewed sustained efforts in the fight against polio.
What it is
Polio (poliomyelitis) is a highly infectious disease caused by a virus. It invades the nervous system and can cause irreversible paralysis in a matter of hours.
Prevention
According to experts, Polio described as a crippling and potentially fatal infectious disease has no cure. However, there are safe and effective vaccines to prevent the disease in children. A major factor in the fight to eradicate polio through prevention strategies is by immunising every child until transmission stops and the world is polio-free.
Who is at risk?
Polio can strike at any age, but it mainly affects children between the ages of 0 – 59 months.
Mode of transmission
Polio is spread through person-to-person contact. When a child is infected with wild poliovirus, the virus enters the body through the mouth and multiplies in the intestine. It is then shed into the environment through the faeces where it can spread rapidly through a community, especially in situations of poor hygiene and sanitation. If a sufficient number of children are fully immunized against polio, the virus is unable to find susceptible children to infect, and dies out.
Young children who are not yet toilet-trained are a ready source of transmission, regardless of their environment. Polio can be spread when food or drink is contaminated by faeces. There is also evidence that flies can passively transfer poliovirus from faeces to food.
Symptoms
Ninety percent of people infected have no symptoms or very mild symptoms and usually go unrecognised. In others, initial symptoms include fever, fatigue, headache, vomiting, and stiffness in the neck and pain in the limbs.
One in 200 infections leads to irreversible paralysis, usually in the legs. This is caused by the virus entering the blood stream and invading the central nervous system. As it multiplies, the virus destroys the nerve cells that activate muscles. The affected muscles are no longer functional and the limb becomes floppy and lifeless – a condition known as acute flaccid paralysis (AFP).
Again, for bulbar polio is associated with more extensive paralysis, involving the trunk and muscles of the thorax and abdomen and can result in quadriplegia.
Treatment and prevention
There is no cure for polio, the only treatment to alleviate the symptoms. Heat and physical therapy is used to stimulate the muscles and antispasmodic drugs are given to relax the muscles. While this can improve mobility, it cannot reverse permanent polio paralysis.
Polio can be prevented through immunization. Polio vaccine, given multiple times, almost always protects a child for life.
http://www.vanguardngr.com/2016/09/polio-more-cases-imminent/
The campaign to eradicate polio from Nigeria for more than two decades suffered unimaginable loss when on 11 August 2016, the World Health Organisation, WHO, confirmed two fresh cases of wild poliovirus in the northern part of the country.
While Nigerians were still dazed by the announcement, another fresh case was reported, soon afterwards, in Monguno Local Government Area of Borno State by the world health body.
These discoveries were among refugees from areas recently won back by the military from Boko Haram insurgents.
The Federal government, supported by the WHO, UNICEF and partners of the Global Polio Eradication Initiative, GPEI, quickly swung into action to curtail effects of the first two cases.
A plan was fine-tuned to immunise children in the troubled Northern part of the country.
An estimated one million children in Borno State and a further four million neighbouring states are now being immunised against the deadly Wild Polio Virus.
But the emergence of the 3rd case of wild polio virus just three weeks after the first two fresh cases, may have thrown a wedge in the response efforts.
Prior to the revelation, Nigeria, once one of only three countries left where polio was endemic – was on the path to becoming polio-free by 2017.
Following this development, Nigeria is now facing an epidemic situation as WHO has maintained that a case of polio is an epidemic.
It is no longer news that the world may have to wait a while longer than anticipated for eradication of one of the world’s most devastating disorders.
Confirming the newest case, the WHO said a crippled toddler tested positive to the polio virus. Federal health officials, who said the development was not unanticipated following the Boko Haram insurgency on the communities, are worried that the situation may deteriorate even further.
Nigeria has now rejoined Afghanistan and Pakistan that are still struggling to wipe out the wild polio virus. Apart from their remote and isolated populations, a common factor among the three countries is the dire security situations that are making disease prevention challenging than ever.
Although a new campaign to reach 25 million children before the end of the year is now in progress, UNICEF has warned that not less than one million children are in areas too dangerous to access. There are actual expectations that more cases will be discovered in the restive communities.
As expressed by one of the field experts, one cannot really say the country is cleared of polio cases in those regions.
PRESIDENT MUHAMMADU BUHARI (L) VACCINATING HIS THREE MONTHS OLD GRAND-DAUGHTER, ZULEIHA BELLO ABUBAKAR WITH ORAL POLIO VACCINE TO MARK
ONE YEAR OF FREE POLIO CASE IN NIGERIA AT THE PRESIDENTIAL VILLA IN ABUJA ON SATURDAY (25/7/15) WITH HIM IS THE EXECUTIVE DIRECTOR, NATIONAL
PRIMARY HEALTH CARE DEVELOPMENT AGENCY, DR ADO MUHAMMAD.(File)
Why eradication will remain elusive
However, despite all these collective efforts, health watchers are of the view that the country is not out of the woods yet. They say more fresh cases are expected to resurface in those areas once controlled by Boko Haram as little or no immunisation exercise were carried out in those areas due to insurgency activities.
The President, Nigerian Academy of Science, NAS, Prof. Oyewale Tomori, describes the new polio outbreak as a threat to Nigeria’s steady march to eradication of polio after a long and tortuous eradication campaign
Tomori who blamed the recent outbreak on waning out of commitment and complacency said: “After attaining non-polio endemic status in September 2015, commitment waned and complacency set in.
This was particularly evident at the levels of the national assembly, governors and local government area chairpersons.
“This complacency meant that polio eradication activities were no longer backed by adequate and timely counterpart funding at the state and local government area levels.
This was despite a public and often vocal commitment to polio eradication from Nigeria’s President Muhammadu Buhari,” he stated.
Tomori added: “As a result, gaps remained in the quality of immunisation and surveillance activities. These were especially prominent in the country’s security compromised areas.”
The wild poliovirus (type 1) isolates were recovered from residents in Gwoza and Jere local government areas in Borno state in northern Nigeria. Genetic sequencing suggests these isolates are most closely linked to the wild poliovirus type 1 that was last detected in the state in 2011.
Also, Project Director, the Community Health and Research Initiative CHR, Dr Aminu Magashi Garba linked the fresh outbreak to non-release of the N12.8 billion approved for routine immunization five months after the President’s accent to the 2016 budget.
Non release of funds: Magashi-Garba expressed worry that the continued delay may put the lives of over 7.2 million Nigerian children in danger even cause more outbreak of polio and other vaccine – related childhood diseases.
For Nigeria to return on track of winning the war against polio and deliver the African continent from the clutches of wild polio, immunisation is the way to go.
“To save the lives of our children and save the country the scarce resources by reducing cost of health care as well as give the future leaders the opportunity to live their potential, government at all levels must ensure 100 percent coverage of immunization.
“If we as a nation cannot provide health care to our children, what message we are sending to the world?” he queried.
Cold chain problems: In his views during a Television Programme, the Chairman, National Polioplus Committee, Rotary International, Dr. Tunji Funso, identified poor cold chain system as a major factor.
According to the eradication plan drawn by the Global Polio Eradication Initiative, the oral vaccine itself is fragile, requiring constant refrigeration. When there is significant weakness in the system, it goes along way to affect the system.
For Funso, in states like Borno where there is insurgency for the cold chain system to be effective, there must be electricity or ice to ensure effective system.
Acknowledging some form of failure on the part of the country, Funso said, Nigeria has failed in maintaining infrastructure as well as full coverage of all the children in the area.
He stressed the need to strengthen the nation’s routine immunization programme as well as intensify surveillance activities.
“Government has come up with strategies to curb the outbreak. One of the strategies is to make sure that a lot of children get immunized. Because of this outbreak we need to have three rounds of immunisation which will take place in Borno, Gombe, Adamawa and Yobe State on the 27th of August, 24th of September and 27th of October.
“The strategy is to make sure we capture as many children as possible. The second strategy is to increase the immunity of children to prevent new infection,” he said.
With the latest development, and barring further hitches, Nigeria must wait at least till last quarter of 2019 to receive a polio certification, if it holistically renewed sustained efforts in the fight against polio.
What it is
Polio (poliomyelitis) is a highly infectious disease caused by a virus. It invades the nervous system and can cause irreversible paralysis in a matter of hours.
Prevention
According to experts, Polio described as a crippling and potentially fatal infectious disease has no cure. However, there are safe and effective vaccines to prevent the disease in children. A major factor in the fight to eradicate polio through prevention strategies is by immunising every child until transmission stops and the world is polio-free.
Who is at risk?
Polio can strike at any age, but it mainly affects children between the ages of 0 – 59 months.
Mode of transmission
Polio is spread through person-to-person contact. When a child is infected with wild poliovirus, the virus enters the body through the mouth and multiplies in the intestine. It is then shed into the environment through the faeces where it can spread rapidly through a community, especially in situations of poor hygiene and sanitation. If a sufficient number of children are fully immunized against polio, the virus is unable to find susceptible children to infect, and dies out.
Young children who are not yet toilet-trained are a ready source of transmission, regardless of their environment. Polio can be spread when food or drink is contaminated by faeces. There is also evidence that flies can passively transfer poliovirus from faeces to food.
Symptoms
Ninety percent of people infected have no symptoms or very mild symptoms and usually go unrecognised. In others, initial symptoms include fever, fatigue, headache, vomiting, and stiffness in the neck and pain in the limbs.
One in 200 infections leads to irreversible paralysis, usually in the legs. This is caused by the virus entering the blood stream and invading the central nervous system. As it multiplies, the virus destroys the nerve cells that activate muscles. The affected muscles are no longer functional and the limb becomes floppy and lifeless – a condition known as acute flaccid paralysis (AFP).
Again, for bulbar polio is associated with more extensive paralysis, involving the trunk and muscles of the thorax and abdomen and can result in quadriplegia.
Treatment and prevention
There is no cure for polio, the only treatment to alleviate the symptoms. Heat and physical therapy is used to stimulate the muscles and antispasmodic drugs are given to relax the muscles. While this can improve mobility, it cannot reverse permanent polio paralysis.
Polio can be prevented through immunization. Polio vaccine, given multiple times, almost always protects a child for life.
http://www.vanguardngr.com/2016/09/polio-more-cases-imminent/
Polio: More cases imminent - Health
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September 08, 2016
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