Club Bulletin - No 1178 (Dec 07, 2020)

by President Doug

World Polio Day is observed on October 24^th every year to commemorate the birthday of Jonas Salk, who was the American virologist who helped create the world’s first safe and effective polio vaccine. The theme for World Polio Day 2020 was “A win against polio is a win for global health”

Although Salk’s vaccine was invented in 1955, it wasn’t until 1988, when the World Health Organization (WHO), Rotary International and others established the Global Polio Eradication Initiative (GPEI) that the idea to eradicate polio came into force.

Polio or poliomyelitis is a highly infectious viral disease that’s transmitted from person to person mainly through the fecal-oral route and sometimes through contaminated water or food. The infection mostly affects children under 5 years old, but can also attack unvaccinated adults as well. The virus enters the body through the mouth or respiratory system, multiplies in the throat and intestines, then attacks the central nervous system, producing debilitating systems like paralysis and death in severe cases.

Africa became a polio-free continent when the last African country – Nigeria – was declared polio-free on August 25, 2020. The person most responsible for this continent-wide extinction was Dr. Tunji Funsho, a former cardiologist who is now the chair of Rotary International’s polio eradication program in Nigeria. Together with the Bill and Melinda Gates Foundation, the Centre for Disease Control (CDC), and the United Nations International Children’s Emergency Fund (UNICEF), Dr, Funsho and Rotarians organized National Immunization Days and provided millions of doses of polio vaccine to children in Nigerian cities and villages, vaccinating about 50 million children during a 3-4 day National Immunization Drive, They also sponsored health education initiatives at community centres, mosques and even birthday parties. Four years without a case of wild polio, Nigeria was declared polio free this summer.

The oral vaccine uses a weakened virus which can sometimes survive in populations that are under-immunized and in so doing, revert back into a dangerous form. It’s called a circulating vaccine-derived poliovirus. There are a number of African countries fighting outbreaks of this vaccine-derived strain.

Children in developing countries are getting two doses of vaccine – the oral vaccine (two drops into a child’s mouth) and an injection (made with a completely inactivated polio virus that cannot be re-activated). Children in developed countries get only the injected virus, but need four doses to be completely protected.

Wild strains of the polio virus currently exist in only two countries – Afghanistan and Pakistan. So far this year there have been 200 cases of wild polio and close to 600 cases of the vaccine-derived polio (most of which are also in Afghanistan and Pakistan). Millions of children have not been vaccinated due to conflict and lack of access in Taliban-controlled areas in those two countries. Pandemic lock-downs don’t help either! In March, the WHO ordered a pause to polio eradication campaigns to make sure that vaccinators going door to door weren’t contributing to the spread of Covid-19. Consequently, 30 to 40 countries have not had any mass immunization campaigns, leaving up to 80 million children unprotected against polio. Cases are rising so dramatically that the WHO has authorized the reintroduction of a trivalent polio vaccine (also known as the “Sabin vaccine” for its developer, Albert Sabin.) It contains virus particles from all three strains of polio – Type 1, Type 2 and Type 3 and is administered by two drops into a child’s mouth – essentially the same vaccine that wiped out polio in many parts of the world in the second half of the 20^th century.

However, there are reports pf rogue strains of polio showing up across much of sub-Saharan Africa, Yemen, Malaysia and the Philippines.

Current plans include eliminating the circulating virus using Oral Polio Vaccine and preventing cases of circulating Vaccine Derived Polio Virus in high risk areas that are under-immunized due to conflict, insecurity or a weakened health system. Early case detection and timely response to outbreaks will be priorities.

In the future – after Wild Polio Virus transmission has been stopped, inactivated Polio vaccine (injectable, Salk) will be used worldwide because it protects against all three types of polio, contains no live virus and cannot create vaccine-derived strains of polio. In addition, an innovative new tool – the novel Oral Polio Vaccine2 could be used to stop circulating Vaccine Derived Polio Virus outbreaks. It provides the same protection as the current oral vaccine but has less risk of mutating and causing paralysis.

After his presentation, President Doug showed a brief video which followed female workers being welcomed by the moms into their homes to administer polio vaccine to children in Pakistan. Another brief video described 5 ways to end polio – raise awareness, start a social media conversation, host events or fundraisers on Polio day and throughout the year, advocate to governments about the importance of eradicating polio and donate.