In 2004, it was noted that 6 countries – Afghanistan, Egypt, India, Niger, Nigeria & Pakistan, have reestablished transmission of poliovirus.
Dr Ojum Ekeoma Ogwo
Last time, we discussed vaccination and the ages of administration. On 17th of April, 2016, something phenomenal happened, a new polio vaccine was introduced. Most of my patients called, and wanted to be properly enlightened. I shall do that shortly.
What is polio?
Polio (poliomyelitis) is a highly contagious, sometimes fatal, viral infection, that can produce permanent muscular weakness, paralysis, headache, vomiting, stiffness of the neck and unilateral tremor. Polio has incubation period of 5 to 9 days.
What are the types of polio?
There are 3 types of polio.
a) Type I or Brunhilde strain. b) Type II or Lansing strain. c) Type III or Leon strain.
All 3 can cause poliomyelitis, but in an epidemic, type I(Brunhilde strain), is usually implicated.
What is this “new polio vaccine”?
On April 17, 2016 , 155 Countries and territories switched over to a different polio vaccine. Let me explain.
You know I mentioned that we have 3 strains of polio. Types I, II & III. The old Oral Polio Vaccine (tOPV), protected children against the 3 strains of poliovirus. While, the new Oral Polio Vaccine (bOPV), protects against only 2 of the strains ( Types I & III). This is because type II (Lansing strain) of polio has been eradicated all over the world.
The idea behind this is that, since type II has been eradicated, its use as a vaccine, could pose a danger and reintroduce it again, into the world. That is if a poorly attenuated type II virus vaccine is given to a child.
Again since type II, has been eradicated, just like smallpox, it will be very risky to keep using the polio vaccine combination that contains type II. All health institutions must note that type II, which is a component of the old polio vaccine (tOPV), in their old stock, must be properly disposed off. This is to avoid the reintroduction of the already eradicated type II , into the world.
The Global Polio Eradication Initiative (GPEI), as detailed by The New York Times, has enumerated the approved disposal methods of type II polio vaccine as:
iv) Bleaching. Or.
v) Burying in concrete sealed containers.
I advise all Nigerian Health centres, especially Primary Health centres to immediately contact the headquarters of their polio-immunisation units in their respective Local Government Areas, for further directives. or send me an email for further enlightenment.
Nigerian Government and Private Primary Vaccination givers please note:
■ The new polio vaccination shift and switch will be completed by May 2016.
■ Any old stock of polio vaccine not dispensed or disposed constitutes a world risk.
■ The new and old vials of the polio vaccines look identical.
■ The boxes are also identical, so health workers have to read the labels meticulously, so as to decipher the differences.
The Global Polio Eradication Initiatives (GPEI), has taken various precautions just in case.
■ There is a Global stockpile of type II vaccines, ready to be used in an unlikely case of an outbreak of type II poliovirus.
Note that polio vaccine type II(Lansing strain), was last detected in the world in 1999.
Why are we worried about polio now?
● Between 1988 and 2001, polio cases decreased by 99%.
● Global Poliomyelitis Eradication Initiatives (GPEI), was launched in 1988, and this has led to elimination of wild poliovirus, from Western Hemisphere.
● In 2004, it was noted that 6 countries – Afghanistan, Egypt, India, Niger, Nigeria & Pakistan, have reestablished transmission of poliovirus.
What are the methods of polio transmission?
■ The virus is mainly carried in the alimentary tract of humans, particularly children, and is spread by faecal contamination, either from human to human, or carried by flies.
■ Poliovirus can also be present in the upper respiratory tract and and spread by droplet infection.
■ The spread of the disease is particularly favoured by poor sanitation, faulty disposal of faeces and careless personal hygiene.
What are the signs & symptoms of poliovirus infection?
At least 95% of infection are asymptomatic, but in those who become ill, manifestations include abortive poliomyelitis (minor illness), nonparalytic poliomyelitis, and paralytic poliomyelitis.
1. Abortive poliomyelitis (minor illness)
Minor illness occur in 4-8% of infections and the symptoms are fever, headache, vomiting, diarrhoea, constipation, and sore throat, lasting 2-3 days.
2. Nonparalytic poliomyelitis
In addition to the above symptoms, signs of meningeal irritation and muscle spasm occur in the absence of frank paralysis.
3. Paralytic poliomyelitis
This represents 0.1% of all poliomyelitis cases. Paralysis may occur at any time during the febrile period. Tremors, muscle weakness, constipation, and incontinent ileus may occur.
Now everybody knows there is a new sheriff in town – “the new polio vaccine”. Tell your young mothers, tell your first time daughters that are transitioning to motherhood, new polio vaccines and exclusive breastfeeding for the first 6 months are the ways to go.
For further inquiries, send me an email. Please remain vaccination compliant.