W.H.O., Fighting Polio in Syria, Says More Children Need Vaccinations

Escalating its emergency battle to stop the spread of a polio revival in Syria, the World Health Organization has doubled the number of children it says should be urgently vaccinated to more than 20 million throughout the Middle East, the organization's top official in charge of eradicating the highly contagious and crippling disease said Wednesday.

The official, Dr. Bruce Aylward, also said the organization's projection of a two-month vaccination campaign — envisaged just a few weeks ago for 10 million Middle East children — would now take six to eight months, require at least 50 million doses of vaccine for repeated treatments and might require the diversion of vaccine originally intended to be used elsewhere.

Dr. Aylward said the decision to increase significantly the number of children to be vaccinated — from the original two and a half million in Syria and more than eight million in six neighboring countries — was made during a meeting of the W.H.O. regional committee for the eastern Mediterranean last week in Muscat, Oman, which he attended, after the outbreak of polio in the eastern Syrian city of Deir al-Zour had been confirmed.

"The reality is, you've got a reinfection of the Middle East," Dr. Aylward said in a telephone interview from Geneva, the W.H.O. headquarters. "This is going to require a massive coordination."

Experts at the W.H.O. in viral infection believe that the Syria strain is the same as a polio virus first detected in Pakistan, which was found recently in sewage from Egypt, the Palestinian territories and Israel. Tests to determine its precise lineage are expected to be completed by the end of this week.

Dr. Aylward, a Canadian who has overseen the organization's antipolio effort since 1998, said health ministers from Syria and its neighbors shared a concern for the urgency of defeating the return of the disease, once thought to be eradicated in the region.

Polio primarily afflicts children ages 5 and under, infecting their digestive systems and leading to paralysis and sometimes death. It had not been seen in Syria for 14 years until last month, and the collapse of the country's public health system because of the civil war has been blamed in part for the disease's revival. The unrest has left many young children unprotected not just from the ravages of polio but also from other communicable diseases.

The W.H.O. began a polio eradication campaign 25 years ago and has basically conquered the disease in all but three countries — Pakistan, Afghanistan and Nigeria — down from more than 125 in 1988. But the polio virus has a remarkable ability to find vulnerable populations, and outbreaks were reported last spring in Somalia and Kenya.

Dr. Aylward acknowledged that the vaccination effort in Syria could be particularly difficult because the government does not control some parts of the country and has been criticized by international relief agencies for impeding the delivery of emergency aid to civilians, particularly those in rebel-held areas. The United Nations has said more than nine million people — 40 percent of Syria's population — have been uprooted by the war, either internally displaced or living as refugees in neighboring countries.

Nonetheless, Dr. Aylward said, Syrian health officials have responded positively to the need to fight polio, which knows no political boundaries.

"There's a sense of obligation and responsibility," he said. "Syrians aren't stupid people, they're very smart people. With polio, speed is everything — you want to get in there as quickly as possible.".

source: www.nytimes.com