A New Case of Polio in Mali .....

A release by the WHO on Monday states that there is a high risk of Polio spreading in Mali and Ebola-stricken Guinea.

Mali in more than four years had not experienced any case(s) of Polio until now.
A 19 month old child from Guinea who traveled with parents to Mali has become the country's first case of Polio in a long while.
The toddler was said to have been paralyzed on 20th July, seven days before being presented for treatment in Bamako, Mali's capital.

The strain of the Polio virus detected happened to be same as the one found in Siguiri, Kankan of Guinea in August of 2014.

Cory Couillard of the WHO said in a comment to Reuters that :

"The risk of spread is considered to be high in both countries due to low rates of vaccination coverage in both Mali and Guinea,"

This current case was found to have been caused by the 'type 2' strain of the Polio virus.

The case also is that of vaccine derived polio; which means that the virus was disseminated after it was passed out in the faeces of those who were previously immunized with the live oral polio vaccine.

Thankfully such cases are rare; however they serve as a big threat in areas where the health systems are fragile and rates of immunization, as well as coverage is low.

The case in Mali is the second of its kind in a one week period as two cases of vaccine derived Polio had earlier been reported in Ukraine.
These occurrences are setbacks in the global efforts to wipe out polio.

According to the WHO, Polio vaccination coverage in Guinea dropped from 63% to 42% in year 2014. The drop was attributed to the  Ebola outbreak which disrupted the services and routine of an already weak national health system.

In Mali however, the polio immunization coverage rose from 72-77% to 84 percent in 2014.

Both Mali and Guinea are working together to put an end to the outbreak in as little time as possible.

Polio affects children in areas with poor sanitation. It attacks the body's nervous system and in the span of a few hours of infection may lead to irreversible paralysis and it cannot be cured.

The disease is on it's way to being completely eradicated world wide.
This year cases of the wild Polio virus were only reported in Pakistan and Afghanistan.
However, Ukraine, Madagascar and Nigeria have recorded cases of vaccine-derived Polio.

A switch from the oral polio vaccines (OPV): (which contain strains of live viruses but have been observed to be highly effective, low priced and easily administered even by untrained personnel) to the "inactivated" vaccines (IPV), (which contain no live virus) may help prevent more cases of the vaccine derived polio experts have said.

The IPV however is expensive, not easy to administer and has to be administered by trained health workers in clinics.

It is not an easy task for developing nations to make this switch.

What are the lessons from this occurence, one would ask?

A previous post by PHNAfrica highlighted the risks posed by low rates of under five vaccination in Ebola affected regions and the implications for West Africa:

Gaps in immunization put many more children at risk.
It only takes one case of Polio crossing the border to start a polio epidemic in a neighboring country. The same can be said of measles, whooping cough and other vaccine preventable diseases.

Several borders have reopened and travelers, traders and visitors are crossing the borders at will on daily basis, although border security is still said to be tight in the Ebola affected nations. This implies that at any point in time a child incubating or actively ill with any of these diseases  may cross the border into another territory thereby putting the children in that region at risk.

If adequate care is not taken, some regions in West Africa may be plunged into epidemics that the health systems currently in operation in those communities are not equipped to handle, which could further worsen the state of things in the region. 

Hence, we call on all stake holders to continue to do all that they can to Step up under five immunization in West Africa and especially in the Ebola affected regions.