The last gasp of polio

The World Health Organisation is currently vaccinating 116 million African children against the preventable disease, polio. This week, 190,000 vaccinators are on the ground  tackling the last remaining stronghold of polio across West and Central Africa. All children under the age of five in countries including Chad, Nigeria, the Democratic Republic of Congo and Sierra Leone are being immunised at the same time to try and raise childhood immunity to the infection which is spread by faeco-oral contact and cripples one in a thousand children who catch it.

I think this is an excellent initiative but it would be a lot more likely to succeed if these countries could also have better infrastructure, better hygiene and better access to clean water. Vaccines work well but they come as part of a package. You can get polio under control with vaccines alone, but you are unlikely to eradicate it if people are still forced to drink water full of sewage.

You can get polio under control with vaccines alone, but you are unlikely to eradicate it if people are still forced to drink water full of sewage.

Of course, the security situation in certain parts of Africa also mean that vaccines cannot be easily given to children in war zones or where cultural or religious dicates forbid immunisations. These are issues which will have to be tackled if the blight of polio is to be ended.

Polio can also be hard to detect, since it causes very mild symptoms in the vast majority of people who get it.

Polio can also be hard to detect, since it causes very mild symptoms in the vast majority of people who get it.

They can recover quickly from flu-like symptoms but remain carriers, capable of passing the virus on to someone else who might end up paralysed. This is why we need to be very careful not to become complacent. We will only be able to say for sure that polio is gone if we see no case at all for five years.

I am hopeful however, I remember growing up in 1950s England when you could still catch polio by swimming off Brighton pier. Untreated sewage fed into the sea around that point and you could easily catch the virus by swallowing seawater. Now, there hasn’t been a home grown case of polio in the UK for the last 20 years. Better sewage treatment and mass vaccination has helped to make this happen. It can be achieved in Africa too.

Professor John Oxford

John Oxford is Emeritus Professor of Virology at Queen Mary’s School of Medicine and Dentistry. He is Founder of Retroscreen Virology Ltd and Oxford Media and Medicine Ltd.
Professor John Oxford

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