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Sunday August 25, 2013 MYT 12:00:00 AM
Sunday August 25, 2013 MYT 8:26:00 AM
by datuk dr zulkifli ismail
The inactivated injectable polio vaccine (IPV) that replaced the live oral polio vaccine (OPV) in 2009 is safe and more flexible as it can also be used by people with impaired immune systems, autoimmune diseases, and those with organ transplants.
Thanks to a comprehensive vaccination programme, polio has almost been eradicated. It’s now time for the final push to wipe out this disease from the face of the earth.
THANKS to global polio eradication efforts since 1988, polio has almost been eradicated.
The US Centers for Disease Control and Prevention (CDC) is now partnering with the Global Polio Eradication Initiative (GPEI), the World Health Organization (WHO), and the United Nations Children’s Fund (UNICEF) in a final push to complete the eradication of polio.
In less than a quarter of a century, the incidence of polio has declined by 99% (from 350,000 reported cases to 650 in 2011). Unfortunately, its presence is still felt in some developing countries. In 2012, a total of 223 polio cases were reported from five countries: Afghanistan, Chad, Niger, Nigeria, and Pakistan.
Out of these cases, 97% (217 out of the 223) were reported from the three remaining endemic countries: Afghanistan, Nigeria, and Pakistan.
Global polio surveillance data from March 19, 2013, shows 11 reported cases from these three countries.
A single child infected by the disease places other children at risk of contracting polio. If polio is not eradicated from these last remaining countries, as many as 200,000 new cases could crop up every year; this could spread all over the world in just 10 years.
Global efforts have ensured the eradication of smallpox in 1979, and now, we have a similar opportunity to rid the world of polio.
All about polio
Polio (also known as poliomyelitis) can strike at any age, but it mainly affects children under five years of age. It is a highly infectious disease caused by a virus, and the disease can be classified as either symptomatic (exhibit symptoms) or asymptomatic (no symptoms).
Symptomatic polio can be sub-divided into non-paralytic polio and paralytic polio. The paralytic form targets motor neurons in the spinal cord, thus causing breathing problems and paralysis in the arms and legs. Around 5%-10% of paralysed polio victims will die because their breathing muscles are immobilised.
Polio spreads through person-to-person contact. It enters the body through the mouth and multiplies in the intestine. It is then excreted through the faeces and can spread rapidly through a community, especially in situations of poor hygiene and sanitation.
Young children who are not yet toilet-trained can easily transmit the virus, regardless of their environment. Polio can also spread when food or drink is contaminated by faeces and flies can passively transfer it from faeces to food.
Most people infected with poliovirus don’t exhibit any signs of illness and are not aware that they have been infected. For others, initial symptoms include fever, fatigue, headache, vomiting, stiffness in the neck and painful limbs. Those who exhibit no symptoms can “silently” spread the infection to thousands of others before the first case of polio paralysis emerges.
Post-polio syndrome typically develops 30 to 40 years after the initial polio infection in people who survive childhood polio. Symptoms of this syndrome include new progressive muscle weakness, severe fatigue, and pain in the muscles and joints.
There is no explanation as to why this syndrome occurs. However, it is believed that to compensate for the neuron shortage after the initial polio infection destroys the motor neurons and bends them out of shape, the remaining motor neurons become enlarged and sprout new fibres. This stresses the remaining neurons, and over the years, they deteriorate too. As a result, they begin to lose their corresponding action.
Malaysia has been polio-free since October 2000, and the Disease Control Division of the Malaysian National Health Services Department of the Ministry of Health actively monitors the situation on the ground. There is also very good immunisation coverage (about 95%), which is required to prevent a resurgence until it is globally eradicated.
Unfortunately, polio is an incurable disease. The only option available to a person suffering from polio is to opt for treatments that can alleviate the symptoms.
The use of heat and physical therapy can help to stimulate muscles, while antispasmodic drugs are given to relax the muscles. However, all that these treatments can achieve is just an improvement in mobility; none of the existing treatments or drugs are able to reverse permanent polio paralysis.
The good news is that polio can be prevented through immunisation. Multiple doses of polio vaccine are given to your child at two, three and five months as well as two booster shots at 18 months and seven years of age to protect your child for life.
The inactivated injectable polio vaccine (IPV) that replaced the live oral polio vaccine (OPV) in 2009 is safe and more flexible as it can also be used by people with impaired immune systems, autoimmune diseases, and organ transplants.
Although there has been no reported cases of polio in Malaysia since the year 2000, we must constantly be vigilant when it comes to our children’s health and well-being. With the current ease of travel, imported cases can potentially cause widespread disease. Get your child vaccinated as this will protect your entire family and the community from the disease.
Datuk Dr Zulkifli Ismail is a consultant paediatrician and paediatric cardiologist. This article is a courtesy of Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners Nutrition Society of Malaysia, Obstetric and Gynaecological Society of Malaysia, Malaysian Mental Health Association, Malaysian Psychiatric Association, National Population and Family Development Board Malaysia, Malaysian Association of Kindergartens and Association of Registered Childcare Providers Malaysia. This article is also supported by the educational grant from Sanofi Pasteur. The opinion expressed in the article is the view of the author. For further information, please visit www.mypositiveparenting.org.
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