After changing the status of Covid-19 and Mpox, polio is currently the only public health emergency of international concern maintained by the World Health Organization (WHO).
Experts gathered by the WHO to discuss the scenario of polio in the world decided to maintain the highest status granted by the entity for polio, popularly known as infantile paralysis.
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“The committee unanimously agreed that the risk of international spread of the poliovirus remains a public health emergency of international concern and directed the extension of the temporary recommendations for another three months”, highlighted the WHO report, which considered, among other factors, the ongoing transmission of polio in eastern Afghanistan with spread across the border into Pakistan.
recent cases
For the decision, the organization also considered the large group of children without any type of immunization in southern Afghanistan; the importation of wild poliovirus from Pakistan to Malawi and Mozambique; and suboptimal vaccination coverage in southeastern Africa, Malawi, Mozambique, Zambia and Zimbabwe, which, according to WHO, means that there may be insufficient population immunity to stop transmission.
The most recent cases of wild poliovirus were identified in April of this year in Afghanistan and in February in Pakistan. Last year, the disease was confirmed in Mozambique and, at the end of 2021, in Malawi.
The WHO is still attentive to cases of poliovirus derived from the oral vaccine, which contains attenuated live virus to remove the ability to produce paralysis. In children vaccinated with the so-called droplet, the attenuated virus reproduces and persists in the intestine for about six weeks until it is excreted into the environment. This vaccine virus can even reach other susceptible children and provide protection – a phenomenon known as herd immunity.
vaccination coverage
“However, in places where polio vaccination coverage is low, these viruses can be transmitted on many occasions between unvaccinated or partially vaccinated children. In very rare cases, these multiple transmissions can cause viruses to mutate or change their genetic characteristics, and may regain their ability to produce paralysis. This allows the appearance of cases with paralysis derived from the vaccine “, explained the WHO.
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The most recent cases of vaccine-derived poliovirus were identified in March of this year in Madagascar and the Democratic Republic of Congo, in addition to another case detected in February in Mozambique. Last year, Malawi and Congo also confirmed cases. The WHO warns that the withdrawal of the oral dose against polio from the vaccination schedule of some countries contributes to the drop in intestinal immunity of young children and to the consequent increase in vaccine-derived infections.
The disease
Data from the entity show that polio mainly affects children under five years of age. One in 200 infections leads to irreversible paralysis, usually of the legs. Among those affected, 5% to 10% die from paralysis of the respiratory muscles.
Polio cases have declined by more than 99% over the last few years, from an estimated 350,000 cases in 1988 to six reported cases in 2021.
“As long as there is an infected child, children in all countries are at risk of contracting polio. If the disease is not eradicated, up to 200,000 new cases may occur in the world each year within a decade,” estimates the WHO.
Brazil received the certificate of elimination of polio in 1994. However, until the disease is eradicated throughout the planet, there is a risk that the country will register imported cases and the virus will circulate again in the national territory.
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The post Polio continues as the only global health emergency maintained by the WHO first appeared on Metropolis.
