Posted on 05/02/2005 9:43:19 PM PDT by neverdem
A case of polio has been detected in Indonesia, World Health Organization officials said yesterday, indicating that an outbreak spreading from northern Nigeria since 2003 has crossed an ocean and reached the world's fourth most populous country.
The virus, found in a village on the island of Java, is most closely related to a strain that was found in Saudi Arabia in December, the officials said. The most likely explanations of how it got there are that it either was brought back by an Indonesian working in Saudi Arabia or by a pilgrim who went to Mecca in January.
Indonesia's last case was in 1995, and it is now the 16th country to be reinfected by a strain of the virus that broke out in northern Nigeria when vaccinations stopped there, then crossed Africa and the Red Sea.
Officials recommended that Indonesia immediately vaccinate five million children on the western end of Java, including the capital, Jakarta, to contain the virus. The country began planning such a drive last week, they said.
Indonesia has more Muslims than any other nation, and polio is now found almost exclusively in Muslim countries or regions.
Resistance to polio vaccine has been high from northern Nigeria to the Pakistan frontier because of persistent rumors that it is a Western plot to render Muslim girls infertile or to spread AIDS. Paradoxically, after several states in Muslim northern Nigeria halted vaccinations in 2003, it was purchases of Indonesian vaccine that persuaded wary imams and politicians to drop their opposition, because it is a Muslim country.
With each new case, the W.H.O.'s goal of eradicating polio by the end of this year slips farther away. With its emergency response fund virtually depleted, the organization is pleading with donors for help with containing new outbreaks in Ethiopia, Yemen and other very poor countries.
At the disease's low point, in early 2003, it was endemic in only six countries: Nigeria, Niger, Egypt, Pakistan, Afghanistan and India.
The current case was found in a village in Sukabumi Province in West Java in an 18-month-old boy who became paralyzed in mid-March, said Dr. Bruce Aylward, coordinator of the polio eradication drive for the health organization.
Genetic typing of the virus, completed in India, shows that the original source of the strain was northern Nigeria, said Dr. David L. Heymann, the W.H.O. director general's representative for polio eradication.
Comparison with databases at the Centers for Disease Control and Prevention in Atlanta shows that it is about 99.2 percent similar to a strain circulating in Saudi Arabia and 99.1 percent similar to a strain in Sudan, suggesting that it came through Saudi Arabia, "but they're so close that it's a hard call," Dr. Aylward said.
Dr. Christopher P. Maher, chief of technical support in the health organization's polio division, visited Sukabumi last week and found that no relatives of the child had gone to areas where polio was endemic, but other families in the village had members who had gone recently to Saudi Arabia as workers or pilgrims.
There are other cases of paralysis in the village that "are very hot - they clinically look like polio," Dr. Aylward said.
It is unclear how many cases exist, but their presence suggests widespread circulation of the virus, since only one case in 200 produces paralysis. Confirmation takes time; each requires two stool samples taken at least 24 hours apart and then shipped to a laboratory and cultured for days or weeks before testing.
But vaccination should start as soon as possible, the officials said. Reaching five million children "doesn't sound like 'targeted' vaccination," Dr. Aylward conceded, "but in a country of 250 million, it is."
Only 75 percent to 80 percent of Indonesia's children get routine polio vaccinations, he said, and some areas have better coverage than others. Indonesia is a large chain of islands, and parts of it, including northern Sumatra, are in rebellion against Jakarta's rule. When polio gets into war-torn areas, as it has in Sudan and Ivory Coast, it can become much harder to eliminate.
Until recently, Indonesia also lacked a polio emergency plan that provides for vaccinating at least half a million children within four weeks of finding a case, going house to house. Still, Dr. Aylward said, "I'd rather take the virus on in Indonesia than in a Sudan or a Yemen or the Horn of Africa, where you've got less than 50 percent baseline coverage."
Many countries stopped vaccinating or cut back substantially when they eliminated polio in the 1990's. "We're paying a penalty for that now," Dr. Aylward said.
During the 11 months it took until northern Nigeria resumed vaccinations, the disease spread across Africa from Guinea on the Atlantic to Sudan on the Red Sea. One case was found as far south as Botswana. Some outbreaks have been contained quickly, but those in Sudan and Ivory Coast, and a new one in Yemen, all appear to be spreading faster than vaccinators can head them off.
The infection routes followed African highways that skirt the southern edge of the Sahara, and ferry routes on the Red Sea.
The disease was found in Jidda and Mecca in Saudi Arabia late last year, and polio eradication officials said in February that they feared that the annual Muslim pilgrimage could spread it around the world.
In 1988, when polio was endemic in 125 countries, the annual world assembly of health ministers in Geneva declared a goal of eradicating it by 2000. That target was missed, but a $3 billion campaign had it contained in six countries by early 2003.
FReepmail me if you want on or off my health and science ping list.
Thanks for the ping. Interesting.
A lethal mutant virus spread by pilgrims going to Mecca? There's hope for us after all!
Don't get cocky, jackass. A lot of kids in the U.S. didn't even get the vaccine. It could be a real nightmare for us, too, especially since we just let the SOBs walk in...and Canada is even worse.
This is a Global problem, one that politics is already affecting and preventing the scientific and health care infrastructure from addressing or resolving.
You have me wrong if you think I'll applaud any UN offshoot. We're at risk because WHO is worthless and the American customs agents don't do squat about keeping this kind of thing outside the country until it's too late. F the WHO--and I ain't talking Roger Daltrey and the boys. And I don't particularly care about the Indonesians, either. I just don't want people to forget that at the same time they're giggling about Nigerian Muslims spreading polio to Indonesia, the same crop of Muslim hajjwalkers probably had a few Americans and Canuckistanians in the crowd.
This will be SARS II, except it will result in a lot of kids being stuck in iron lungs, all because these backwards bastards are walking the globe. And the CDC will probably just wait until it gets here to do a damn thing about it.
That expectation aside, it's about time we let someone punish the people that cause things like this to happen, instead of just laughing it off. China should have paid for causing the SARS epidemic with its stupid silence. Nigeria should suffer as a result of this. Neither will, of course.
There you see, you prove my point in how politics gets in the way of health care on a global scale. I work with both the CDC and WHO on a daily basis (sentinel infrastructure), politics aside, the infrastructure provided by WHO and the liaison with the CDC prevents serious issues occurring within the US borders. In the main this results in a proactive capability for the CDC.
My point is that is counter productive to US health to assert otherwise. This attitude hurts the USA not "them". The fact that I have a large amount of disdain for any bureaucracy (UN is high on that list)is second to my desire to see the US gain a benefit from working within that structure (inclusive of the WHO). Many benefits come form these types of organization, try not view the grass roots level participants as contributory to the political a**holes that sit at the top of them (spot the "Kofi'jab)
"the same crop of Muslim hajjwalkers probably had a few Americans and Canuckistanians in the crowd."
Try to remember that most virus and bacterium are not concerned with where we hail from, they will infect with the utmost objectivity.
"This will be SARS II.."
SARS is less of a problem than influenza, which results in 20,000 deaths in the USA every year. We have the media to thank for creating hype on that issue. Compare the 2004 morbidity and mortality statistics for influenza and you will be shocked. also be aware that ALL influenza originate in the East yet we have to manage the issue in the West (see the "herald wave" explanations that are numerous with a google or yahoo search)
"China should have paid for causing the SARS epidemic with its stupid silence. Nigeria should suffer as a result of this. Neither will, of course."
Again politics.....
I'm awaiting all the "polio was cured by improved sanitation" idiots from the anti-vaccination threads to come here and tell us there's nothing to worry about.
LOL well said
How could they be more efficient without restricting travel of ANY kind into the USA? Which would of course cripple the US economy.
PING
Why so expensive? This whole thing started over a muslim mullah not wanting polio vaccines. I think a lot of money can be saved by stating the obvious about these muslim leaders' views over polio vaccines.
China should have paid for causing the SARS epidemic with its stupid silence. Nigeria should suffer as a result of this. Neither will, of course
**As an aside, I think SARS was probably manmade by the chicoms. There's a whole lot to be punishing China for that the US hasn't followed through on. Making a specific point about muslim cultural views towards polio vaccines would be an insult and we don't want to insult people do we? Even though it means polio may make a comeback.
Some religion eh, the blood of those sufferers is on his hands.
You are right about that. However, I'm sure they didn't withold it from their children. If I was a betting woman, I'd bet their children were vaccinated.
The idiots can't tell the difference between a virus like polio, and a bacilli bacteria like cholerae.
To put SARS into perspective the total Global reported cases of SARS from onset 2002 to 2004 is 9000 in approxiamately a 2 year period GLOBALLY. As I said influenza kills 20,000 persons per year(mostly from high risk groups developing ARDS and pneumonia). If this was a Chicomms operation it was probably the poorest ever conceived and implemented. Only the media and lay community think SARS is significant. the resultant disruption to society was disproportionate and extreme compared with "business as usual" for influenza. The response was public and political.....
Yes I agree with you, and I do play the odd hand of poker with the girls so I would take that bet as a safe one :-)
"Try to remember that most virus and bacterium are not concerned with where we hail from, they will infect with the utmost objectivity."
well said...pandemic pathogens arent bigots...as long as we're all in the same boat [planet] a "go it alone" approach because someone doesnt like the UN's OTHER political efforts would be folly...one doesnt have to be an overall UN supporter to see we ALL NEED a global 'mutual defence pact against disease' in an age where globally mobile populations can spread disease at jet speed.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.