I work as a Senior Expert in communicable diseases at the European Centre for Disease Prevention and Control (ECDC). The opinions expressed in this posting are my own and may not necessarily represent the official opinions or postion of ECDC.
It is impossible to ignore the discussions these days around the risk of polio to the EU and there are two very strong reasons for this: the identification of the polio virus in the sewage system and in the faeces of asymptomatic carriers in Israel since February 2013, and the movement of people coming from countries in distress, for example Syria, where vaccination programmes have broken down since 2011. While in Israel no human cases have been recorded so far, cases have occurred in Syria starting with mid to late ‘90s.
This new risk of polio transmission takes me back in time, when my home country Romania was part of the European initiative on polio eradication. My daughter, then less than 10 years old, was one of the beneficiaries of all the vaccinations and catch-up interventions.
What impressed me most was the fact that all health staff – from the family doctor to the colleagues involved in information campaigns were all aware and very knowledgeable about their roles in this fight – working as well as a Swiss clock! The international support from UN agencies helped a lot with scarce financial resources at that time, especially for information campaigns. For me this was an excellent example about how partnerships work if they have a very clear goal and responsibilities are clearly assigned to each partner.
The EU has been polio-free since 2002, making polio seem like an old story, one that we sometimes may believe cannot return to our “ivory tower”.
So I have bad news and good news about this. The bad news is that no matter where you live, if people are not protected against a disease, they might get it. In the case of polio the disease can be extremely serious (acute flaccid paralysis); the good news is that there are cheap, effective and safe vaccines that help the body to develop the required antibodies against the polio virus.
Nevertheless, in the EU alone there is an estimated 12 million people under 30 years of age that are not vaccinated against polio. Therefore if an infected person arrives in a community with large numbers of unvaccinated people, the virus can easily spread. In Europe there are significantly large pockets of population sub-groups that are under-immunised or not immunised at all, although vaccination coverage levels can be considered satisfactory as a whole (>90% for three doses of either IPV or OPV) and can largely justify the absence of WPV circulation in the region so far.
So we have a problem for which a very effective solution exists – but isn’t this the case with vaccines in general? What else do we need? Most probably to remain vigilant rather than complacent, build partnerships with clear roles and responsibilities rather than addressing the issue as “one-disease problem”.
So let’s do it – let’s make these old stories really old …
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