It’s Polio!

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By Wezi Tjaronda WINDHOEK The mysterious disease that has killed seven people and infected 34 others is polio, according to the Ministry of Health and Social Services (MOHSS). Preliminary results on the specimens that were sent to South African laboratories indicate that the disease that is causing acute paralysis of lower limbs is a poliovirus 1 (PV1) Wild Type, MOHSS Permanent Secretary Dr Kalumbi Shangula said yesterday. “Out of the 11 specimens collected from 11 patients in Katutura and Windhoek State Hospitals, five of them were confirmed cases of wild polio virus type 1,” Dr Shangula said. In the wake of this, everybody living within the borders of Namibia will be vaccinated against the virus. The first patient, who is from Aranos, was admitted on May 10 to the Katutura Hospital and within the space of 28 days, 38 further cases were reported but four were removed off the list because they were diagnosed as other diseases. Five died in the hospital while two were dead on arrival and one has been discharged. Although initially the ministry wanted to vaccinate only children under five, the speed at which the disease has progressed has made it necessary for the close to 2 million inhabitants of Namibia to be vaccinated against polio depending on how soon the ministry can mobilize the necessary resources. “The ministry shall embark on a mass public education and vaccination campaign. The National Health Emergency Preparedness and Management Committee shall work out modalities for these campaigns (vaccines, logistics, personnel),” he said. The main aim though, said Shangula, is to do it as quickly as possible. Since the amount of vaccine required will be high, Shangula said the ministry is mobilising additional resources from its partners to meet its targets. Polio, short for poliomyelitis, is a virus that enters the body through the mouth from hands contaminated with the stool of an infected person. No drug developed so far has proven effective and treatment is entirely symptomatic, said Shangula. The poliovirus lives in the throat and intestinal tract of infected persons. Objects such as eating-utensils can also spread the virus. The age group affected is five to 76 years, with the majority of cases (12) being in the 24 to 29 age group. The age group of 30-34 years has four reported cases, 20-24 has three cases, the 15-19 and 35-39 groups have two cases each while 5-9, 10-14, 40-44 and 76 years have one case each. Most cases reported are from Katutura Township, specifically Ombili, Havana, One Nation, Babilon and Single Quarters. The other affected regions are Hardap and Otjozondjupa. The patients have the following symptoms: back pain, headache, neck ache, fever, weakness of lower limbs, paralysis, epigastric pain, chest pain, diarrhoea and vomiting. Namibia has been free of polio for more than 10 years now as the last polio case was reported in 1995 and according to Dr Shangula, Namibia was close to achieving the Polio Free status. The outbreak is a setback to Namibia which has invested so many resources in the immunization campaigns, he added. The reason for the outbreak could be that since the NID started, the focus has been on the under-5s and not adults, explaining why the majority of cases are in the older group. “Since independence, the majority who are below 17 years were protected but others not,” said Shangula. The ministry is also trying to establish whether it is dealing with an indigenous or an imported outbreak, to enable it to do the necessary follow-ups. The Global Polio Eradication Initiative says in a globalised world of modern transport, all countries have regular contact with at least one of the six remaining polio-endemic countries, name-ly Nigeria, India, Pakistan, Niger, Afghanistan and Egypt. Therefore, Namibia is at risk due to close links with one of the six remaining polio-endemic countries. Even though the country does not border any of the polio endemic countries. In 2003, a new outbreak originating in northern Nigeria spread across eight previously polio-free neighbouring countries. Additionally, it says that not just neighbouring countries are at risk because earlier in 2004, Botswana was re-infected, due to the spread from an outbreak from Nigeria. “Geographic proximity, or strong cultural or economic links, to a polio-endemic country increases the risk of potential re-infection, as populations travel between countries and bring the poliovirus with them. Remember – polio does not need a passport to travel across borders,” it says, adding, “Polio importations will remain a risk until polio is eradicated everywhere and should be treated as an urgent public health threat.”

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