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The re-emergence of polio in Papua New Guinea shows global eradication remains elusive
Recent cases of polio in PNG have concerned health authorities.
Last week the World Health Organisation (WHO) declared a polio outbreak in Papua New Guinea (PNG).
The highly infectious virus was found in two healthy, polio-vaccinated children who were screened following detection of the virus during routine wastewater sampling in Lae, PNG’s second largest city. Wastewater samples are also positive in the capital Port Moresby, indicating the potential of spread around the country.
The strain has been identified as circulating vaccine-derived poliovirus type 2, similar genetically to a strain circulating in Indonesia.
So what does this mean? And what will happen now in PNG?
So, what is polio?
Polio, or poliomyelitis, is a highly contagious disease caused by the poliovirus. It primarily affects children. Poliovirus is spread by person-to-person contact or the ingestion of contaminated virus from faeces. The virus multiplies in the gut of people who are infected, and they shed the virus in their stool for several weeks. In this way it can spread through a community, especially in areas with poor sanitation.
A recent review also suggested a greater role for transmission via respiratory particles than we previously thought. Wild poliovirus (as distinct from vaccine-derived poliovirus), was a major public health issue prior to the rollout of vaccination in 1950s. This campaign led to the virtual elimination of the disease in rich countries such as Australia.
Since the Global Polio Eradication Initiative was launched in 1988, cases have decreased by 99% globally. Wild poliovirus remains endemic only in Pakistan and Afghanistan.
What happens now in PNG?
The PNG government has responded swiftly to activate its polio emergency response plan, supported by partners including WHO, UNICEF and the Australian government.
Notably, PNG’s vaccination rate is among the lowest in the world, with only about 50% of children born each year receiving the recommended childhood vaccines, including the oral polio vaccine. To induce herd immunity and prevent outbreaks of disease, coverage should be at least 95%.
PNG was declared polio free in 2000. But there was an outbreak in 2018 of vaccine-derived polio type 1 with 26 cases across nine provinces. The outbreak was brought under control through supplementary rounds of vaccination, enhanced surveillance, and expanded communication and community engagement.
How about the risk in Australia?
While the risk of spread of polio in Australia is low, the virus does not respect borders, and we cannot become complacent.
Australia’s overall coverage with the inactivated vaccine is close to 95% but there has been a concerning decline in childhood immunisation since the COVID pandemic. Australia must address this and maintain its polio wastewater monitoring system.
Supporting PNG and working with other countries towards global polio eradication is the best way Australia can protect itself.
In 1988, Rotary International promised the children of the world, that we would rid the world of Polio, we have not finished yet. It is up to all of us to support the efforts of eradicating Polio.
Remember, it has been said, Polio is only a plane ride away.
Ref: Gavi, the Vaccine Alliance
World Health Organisation
