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| Polio cases on the rise in north India | | |
Friday, 04 August
New Delhi: A spike in polio cases among children in northern India is raising fears of a global outbreak, with the same strain of the crippling virus cropping up as far afield as Africa, health officials said Thursday.
The northern state of Uttar Pradesh has recorded 121 polio cases among children this year - 80 in the past three months - up from 29 in 2005, said Dr LB Prasad, the state's director general of health. Nationally, there have been 137 cases.
While the situation in India is worrying in its own right, the same strain has been detected in five countries where polio had been eradicated - Angola, Bangladesh, Congo, Namibia and Nepal.
"The problem with most of these places is that they do not have very good immunization coverage so although there was no polio, their population was essentially at risk," said Jay Wenger, who oversees polio eradication efforts in India for the World Health Organization.
How polio got from northern India to southern Africa, authorities can't say.
But "it's a threat we're obviously concerned about," Wenger told The Associated Press.
The epicenter of the Indian outbreak is Moradabad, an industrial town in northwestern Uttar Pradesh, about 47 miles from New Delhi. There have been 41 cases there this year.
Polio remains endemic to India and other parts of Asia and Africa, and experts described northwestern Uttar Pradesh - one of the poorest corners of one of India's poorest states - as the perfect breeding ground for the virus, which is spread through faeces and largely attacks young children.
India's last major polio outbreak was sparked in 2002 when the virus, which causes paralysis and sometimes death, spread from the region, eventually infecting about 1,600 people.
It's a "reservoir for polio," said Michael Galway of UNICEF.
"It's got extremely high population density, large number of kids are born every month, there's a serious lack of sanitation, water is contaminated - these are the conditions the virus thrives in," Galway said.
Those factors have also made northwestern Uttar Pradesh one of the most challenging areas for India's polio eradication campaign, which was launched in 1998 and, say international experts, has been largely successful.
The vaccine is given orally, and multiple doses must be taken before a child is fully protected. But many children in the region are routinely stricken with diarrhoea and experts believe that the vaccine often doesn't spend enough time in their bodies to be effective.
Also, vaccination efforts have to be extremely thorough.
"If you miss two, three, four percent of those kids then you are leaving a gap for the virus to squeeze through and infect other kids," Galway said.
That's precisely what happened in late 2005, when about 25 percent of the targeted households were missed by the vaccination campaign.
"That's just too much," said the WHO's Wenger, diplomatically attributing the failure to "fatigue" in the program.
Parents also sometimes refuse to let their children be vaccinated.
Some "are frustrated and angry," Galway said. "They want better health service, they want employment, they want sanitation, these are concerns of parents who are saying no at the doorstep."
There has also been talk for years among Muslims, who make up a sizable minority in Uttar Pradesh, that the vaccine makes children sterile.
The same myth at one point shut down vaccination efforts in predominantly Muslim northern Nigeria.
Fueling such fears in India are local newspapers that repeat the myth as fact, and posters that have gone up around Muslim towns telling people not to let their children get vaccinated.
Although the myth is not nearly as pervasive as it is in Nigeria, three health workers were beaten in a village when they tried to vaccinate children in May.
"Health workers are now scared. They are not willing to go to Muslim-dominated localities to give polio drops to Muslim children," Dr Ramesh Kumar Shukla, a state health official, told The Associated Press.
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