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The Consequences of a Polio Outbreak in Syria
Posted on Nov 01, 2013 by Ailee Slater (G+)
These days, the disease polio rarely comes up in conversation. Although endemic in many parts of the world at the start of the 20th century, a polio vaccine developed in the 1950s lead to a dramatic reduction in the disease. The number of global polio cases in 1988 was 350,000, and in 2012, there were just 223 incidences. However, these huge improvements in polio vaccination belie the fact that the disease is still endemic in some parts of the world; Afghanistan and Pakistan, for example. And, just this week, the World Health Organization confirmed what some health experts have suspected for months: that a polio outbreak is currently affecting Syria.
Prior to this current outbreak, Syria spent more than a decade keeping Polio kept firmly under control – not one single recorded case for 14 years. As in many countries, close to 100 percent of children in Syria had been vaccinated against the disease. However, with the outbreak of civil war in 2011, infant vaccinations decreased. In 2010, 91 percent of children received the polio vaccine; today, as a result of the war and a country-wide breakdown in health care services, just 68 percent of children are being vaccinated.
The polio vaccine is a key preventative measure because, although some symptoms can be treated, there is no polio cure. Vaccines are especially important because of the rate at which the disease can spread. Polio is a highly contagious virus, usually transmitted through the fecal-oral route. The polio virus commonly lives in the intestines of an infected person; if a healthy person comes into contact with that infected stool, through drinking contaminated water for example, they too can become ill. The virus will multiply in their intestines, where it can once again spread to another person, especially if that person is living with less-than-adequate sanitary conditions where they are likely to come into contact with infected fecal matter.
Because civil war in Syria has meant a decrease in sanitation services and fewer vaccinations for children, the country is now contending with at least 10 cases of polio. Ten incidences of a disease might not sound like much, but because polio is so contagious, even 10 cases is a huge concern for health care workers around the world. The World Health Organization has said that as long as even one child remains infected with the disease, the entire world lives with a polio risk. If vaccinations are not maintained, WHO estimates that every single person on the planet could be infected with the disease in as little as 10 years, making it important that health groups focus on vaccination efforts and on figuring out how to eliminate polio strongholds in Pakistan, Afghanistan and Nigeria.
According to the World Health Organization, the outbreak in Syria began in Deir al-Zour, an eastern province of the country. Health workers have said that disease probably entered Syria through Pakistan, a country still struggling with polio wherein more than 1 million children have not been vaccinated. It is estimated that in Syria, there are now around 500,000 children without the vaccine, which means that the recently discovered polio cases, although few in number, may have extremely dangerous consequences for the entire country. Also concerning is the fact that due to the civil war, many families are in a state of movement; going from home to home and city to city in an effort to find safety from the fighting. Refugees could already be bringing polio to new areas of Syria, and of course, the lack of adequate sanitation that goes along with staying in a refugee or makeshift living situation can further the spread of polio.
The World Health Organization has reported that around 100,000 children in Syria, all under the age of five, are now at risk of contracting polio. The virus affects children disproportionately, because most adults have already been vaccinated against it. The initial symptoms of polio are much like symptoms of the flu: headache, fever, vomiting and fatigue. However, one in 100 people infected with the polio virus will experience muscle weakness or paralysis, usually of the legs, and up to 10 percent of those with paralysis will die when their breathing muscles become paralyzed as well. Children infected with the polio virus can experience paralysis many years later, even if they appeared to have fully recovered from the initial polio symptoms.
Syria is already struggling to contain a number of other health care issues: measles, typhoid and hepatitis A, for example. Civil war has lead to a breakdown in the function of health facilities across the country, and both local and foreign health care workers have left Syria in droves. The World Health Organization estimates that of the 1,919 hospitals and health centers which used to exist in Syria, more than 10 percent have been damaged or destroyed. Those health care clinics that are still functional have seen a huge increase in patients – due to closure of hospitals as well as the war itself – meaning long wait times for everyone and a difficulty in distributing medicine and services to all those in need.
As for stopping the current polio outbreak, Syria’s Health Ministry has already started a vaccination drive to protect as many children as possible. Other aid agencies are working on emergency vaccination plans to get immunizations to children living in refugee camps, and vaccination campaigns are also underway in neighboring countries such as Turkey, Lebanon and Iraq.