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Polio epidemics once succeed in killing thousands of children.
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As the World Health Organization (WHO) campaign to eradicate polio worldwide by 2005 gains momentum, the question arises about how realistic this is and if the price to be paid is worth it
Poliomyelitis once served to increase immunity and didn't surface as a major threat until the 20th century. Infection occurs via exposure to contaminated water, saliva and feces. As an enterovirus, poliovirus colonizes the lining of the digestive tract, and mutates rapidly causing a range of diseases (Orent p.3). Once known as infantile paralysis, poliomyelitis afflicts children via the central nervous system, often causing paralysis and deformity (Simao p.1, 2). Symptoms are minimal, but can be flu-like, showing stiffness in the neck, back and legs without paralysis. Many of the paralyzed recover completely and the affects may not surface until 40 years later as a progressive weakening of the muscles. Approximately 5%-10% die when the respiratory muscles become paralyzed (NNII, p.1)
The polio eradication campaign was launched by WHO in 1988 when the disease was endemic in 125 countries (Mayell, p.1). Now the United Nations Children's Fund (UNICEF), Rotary International and the Center for Disease Control (CDC) are involved. Part of the goal was to eliminate polio from the Mediterranean region by the year 2000, however this did not happen (CDC, p.1). Towards this goal, WHO had recommended four doses of oral polio vaccine (OPV) for up to the age of one year. Under this campaign all children up to the age of five get two to three doses of OPV one month apart during National Immunization Days (NID) regardless of any prior immunization (Mayell, p.2)
WHO's surveillance of the 23 countries in the East Mediterranean Region (EMR) in the year 2000, revealed 505 confirmed cases of which 287 were from the wild poliovirus (CDC p.4). India, Pakistan and Nigeria accounted for 90% with the epicenter of the disease in Pakistan and Afghanistan (Simao, p.1, 2,4). Cross-border dislocation of the virus contributes to the spread as Afghans continue to flee to safety in Pakistan, Iran, Turkmenistan and Uzbekistan (Dawn, p.1)
This is unfortunate, as previously Afghani's were relatively safe from the disease. For over 20 years there was a basic immunization service in Afghanistan. The 1994 polio campaign witnessed progress more rapidly than in other conflict zones. The first NID used OPV in 1997 and then again in 1988 though the campaign did not cover Northern Afghanistan (WHO #2, p.1).
In 1999, with a target of 130,000 children to be immunized under the campaign, an outbreak occurred in Kunduz Province with 26 children afflicted with paralysis (WHO #3, p.1). Fueling support for the campaign in 2000, the Ministry for Public Health and the Health Director of Rural Rehabilitation as well as others along with doctors, Shura heads, imams and khatibs spread the word and monitored the campaign. In Herat, 100 women students from the nursing school carried banners in the NID parade (UN, p.1). Early last year, a cease-fire allowed for 35,000 health workers and volunteers to reach 5.7 million children. Repeated again in April 2002, 29 million children under the age of five were vaccinated (UNICEF, p.2).
The U.S attack reversed the progress that had been made. Currently existing health services are basic and cover a limited area. Only 23% of Afghans have safe water and 12% have access to sanitation (WHO #1, p.1.2). Starting in April 2002, the intent is to hold four NIDS. Each day would target 5.5 million children (UNICEFUSA, p.1). However, as we look at other countries, we may wonder at the risks involved for Afghanistan children
Some researchers postulate that the use of live viral vaccines introduces foreign genetic material into the body. This has contributed to the escalation of autoimmune disorders: multiple sclerosis, rheumatoid arthritis, lupus, cancer, Crohn's disease and asthma. An unpublished WHO study on measles showed susceptible malnourished children that had been vaccinated, contracted measles at the normal rate of 2.4% whereas the group that had received the measles vaccine MMR stood at 33.5% Thompson, p.1). Prevention is better than cure but the nature of viruses in the environment needs to be understood more fully. Although polio vaccine appears to be the only vaccine that has effectively lowered incidence in the U.S., from 38,476 in 1954 to 5,485 in 1957, there was a similar decrease observed in Europe during the same period where there was no mass-immunization (Colbin, p.18). In Guinea-Bissau, where the BCG and measles vaccine reduces infant mortality, DPT and polio vaccines
increase mortality (Shann, p.1)
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| Health organizations have helped protect the worlds children through vaccinations. |
Furthermore, it has also been found that the vaccine can sometimes cause the disease itself. The number of confirmed cases in the EMR fell from 914 in 1999 to 505 in the year 2000. An outbreak in Iran in 1999 ended following an NID. Iraq's last confirmed case was in the year 2000 (CD, p.2). After being declared safe, President Arroyo of the Philippines ordered vaccination of 12 million children after three new cases transpired the following year. The order for OPV was for all children not older than 59 months (Agence France-Presse, p.1). The new cases had post-paralysis from a mutant strain it was reported. In fact, the three new cases had vaccine-associated paralysis. Dr.Sutter of the CDC commented, The live attenuated poliovirus contained in OPV can revert to neurovirulence and cause the paralytic disease they are designed to prevent (Reuters, p.1).
Again in Haiti the virus had mutated. It escaped into the environment through the sewers and infected 21 people and killed two children (Fox, p.1, 3). Once the virus gains contact with the water supply, the virus reverts to its wild strain and is free to spread
Paralysis isn't the only problem. In 1975, Japan raised the minimum age for vaccination to two years. As a result, Sudden Infant Death Syndrome (SIDS) and infantile convulsions almost disappeared. In the 1980's, Japan lowered the minimum age down to three months and SID returned to previous levels (Thompson, p.1). Last year, residents in Assam, India were gripped with fear with the UNICEF-sponsored anti-blindness campaign for vitamin A. Curiously, 16 children had died and hundreds fell ill after taking the vitamin last November. Tests of the sample doses proved the vitamin had met standards. Consequentially, the reaction to the polio campaign this year attracted only 47% of the targeted 4.6 million children aged up to five (AP, p.1).
Olen Kew from CDC had traced the outbreaks to OPV (Fox, p.3). The poliovirus had mutated after being introduced as part of a live vaccine (Christensen, p.1). OPV also spoils when exposed to heat
In the USA poliomyelitis killed thousands and disabled ten times as much before it was wiped-out in 1979 (Fox, p2, 3). After the inactivated poliovirus vaccine, IPV, was introduced in 1955 incidences fell dramatically. Further reduction was made with the OPV in 1961. As OPV causes vaccine-associated paralysis, a new vaccine schedule was recommended in 1997 2 IPV and 2 OPV. IPV kills the virus, but those who are vaccinated with it can become infected with wild poliovirus. Showing no symptoms, it spreads more easily but the new schedule didn't lower the risk of vaccine-associated paralysis. Regardless, OPV is no longer administered in the USA and is used in countries where wild poliovirus infection occurs. Yet the duration of immunity with IPV is unknown and the allergic reactions are many (NNII, p.1, 2)
From reports in the late 1950's, polio vaccines were shown to produce tumors in laboratory experiments on hamsters (Harris, p.1). The vaccine was contaminated. SV40 was first transmitted to humans from 1955 1963. SV40 was found in batches of polio vaccine. The monkey simian virus SV40 was also found in people born after 1963. SV40 activates the protein that controls the normal cellular life cycle, creating immortal malignant cells. Confirming the risk, recently, researchers at the Southwestern Medical Center in Dallas examined 400 tumors and controlled tissues and found the footprint of SV40 in 43% of non-Hodgkin lymphoma patients and 9% of Hodgkin's lymphoma cases. Over 287,000 new non-Hodgkin's lymphoma cases are diagnosed worldwide every year. Then Dr. Ali Gazdor of Hamon Center for Therapeutic Oncology Research and Pathology confirmed a surprising similarity between H.I.V and lymphoma subjects (ScienceDaily, p.1, 2)
As a follow-up, the U.S required all seeds used to manufacture vaccines be screened for SV40 and other tumor-causing agents. Attorney Stanley Kops who represented several plaintiffs found further evidence. From five internal memos of the manufacturer Wyeth-Lyderle, it was shown that three out of 15 vaccine pools with two types of polio vaccine contained SV40. All three were used to secure licenses from 1962 1963. SV40 also contributes to mestholioma, a rare cancer that kills 2,500 3,000 annually. SV40 is present in 80% of mestholioma subjects (Harris, p.1-3)
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| The polio virus as seen under a microscope. |
Another factor in the unlikelihood of ridding the world of the poliovirus is research. While some scientists work hard to eradicate the world of the virus, other scientists' work had to keep it alive. In genetic engineering, gene-types, functions and the nucleotide sequence for poliovirus has been available since 1981 (Orent, p.7, 8). Matthias Gromeier and colleagues at the Duke University in Washington successfully crossed a poliovirus with rhinovirus (as in the common cold).We accomplished the task by inserting a piece of genetic information of rhinovirus into the poliovirus genome, said Gromeier.
it had lost its ability to cause poliomyelitis in humans but retains excellent killing potential for malignant glioma cells (Cosmiverse, p.1).
Then there are those that are looking for an improved polio vaccine. Philip Minor and colleagues of the University of Reading, England created a new vaccine that seems not to mutate back to neurovirulence. They weakened the viral strain of oral vaccine by replacing several nucleotides. It has tested safe in animal experiments but requires human testing. As Europe is designated polio-free, it cannot be tested there. So where can it be tested?
For those in developing countries, resources are inadequate to cope with the fall-out from mass immunization programs? By contributing to the escalation of other diseases, the program will detract from improving their circumstances educationally, economically and socially.
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