Polio Stages a Comeback


SPECIAL REPORT

Like phoenix that rises from the ashes, this crippling disease has staged a threatening comeback in the country with cases already reported

By Henrylito D. Tacio


Nearly two decades after the Philippines was declared polio-free, the highly contagious disease has reemerged.

The Department of Health (DOH) confirmed that a 3-year-old girl from Lanao del Sur has been infected with poliovirus. In addition, environmental samples from sewage in Manila and waterways in Davao were confirmed to contain the virus.

But on September 20, the health department again announced that a five-year-old immuno-compromised boy who suffers from multiple pediatric diseases from Laguna has also contracted the virus.

Because there were already two cases, the Philippines was delisted as a polio-free nation. “Not only do we lose it, but we have an epidemic,” said DOH Secretary Francisco Duque III. “Because, based on WHO (World Health Organization) standards, there is a declaration of epidemic in a polio-free country, even if just one case of polio has been confirmed.”

“It is deeply disconcerting that poliovirus has re-emerged in the Philippines after nearly two decades,” deplored Oyon Dendevnorov, Philippines Representative of the United Nations Children’s Fund (UNICEF).

According to WHO, even if there is only one child infected, children in all countries are at risk of contracting polio. “Failure to eradicate polio… could result in as many as 200,000 new cases every year, within 10 years, all over the world,” the United Nations health agency said.

The last known case of polio – shorter term for poliomyelitis – recorded in the Philippines was in 1993. In 2000, the country was declared polio-free, along with the rest of WHO’s Western Pacific Region.

Highly infectious

“Polio is a highly infectious disease caused by a virus,” WHO explains of the disease that mainly affected children under 5 years of age. “It invades the nervous system and can cause total paralysis in a matter of hours.”

In the early part of the 20th century, few diseases frightened parents more than polio did. “Polio struck in the warm summer months, sweeping through towns in epidemic every few years,” the website of History of Vaccines states. “Though most people recovered quickly from polio, some suffered temporary or permanent paralysis and even death. Many polio survivors were disabled for life. They were a visible, painful reminder to society of the enormous toll this disease took on young lives.”

According to the aforementioned website, polio is caused by one of three types of poliovirus. “These viruses spread through contact between people, by nasal and oral secretions, and by contact with contaminated feces,” it said.

“Poliovirus enters the body through the mouth, multiplying along the way to the digestive tract, where it further multiplies,” the website continued to explain. “In about 98 percent of cases, polio is a mild illness, with no symptoms or with viral-like symptoms. In paralytic polio, the virus leaves the digestive tract, enters the bloodstream, and then attacks nerve cells.

“Fewer than one percent to two percent of people who contract polio become paralyzed,” it further said. “In severe cases, the throat and chest may be paralyzed. Death may result if the patient does not receive artificial breathing support.”

Physical handicap

In most cases, polio doesn’t have fatal consequence, but it physically handicaps a person, preventing him or her from leading a normal life. American President Franklin D. Roosevelt and Oscar-winning film director Francis Ford Coppola were among those who had to deal with the disease.

Other famous personalities who have/had polio include Scottish novelist Walter Scott, American golfer Jack Nicklaus, British writer Arthur Charles Clarke, American singer Judy Collins, Italian opera singer Renata Tebaldi, French mathematician Laurent Schwartz, and German singer Hildegard Knef.

In the Philippines, the late Senator Ernesto Herrera comes to mind. Like Apolinario Mabini before him, the overcame a physical handicap caused by polio during his childhood to become one of the country’s outstanding leaders.

Then, there’s Grace Padaca, a Ramon Magsaysay laureate. Born in 1963, she was crippled early in childhood by polio. “Having been physically handicapped since I was 3, I have learned that life is not worth living if you are dependent on others. I have learned that despite tremendous limitations, physical or otherwise, no one is ever too inadequate to cope, to adjust and even to shine,” she said.

Vaccination for polio

Until now, there is still no cure for polio but it can be prevented through a safe and effective vaccine. “Vaccination is the only and best protection against polio,” Dendevnorov pointed out.

The oral polio vaccine (OPV), which has been introduced in 1988, is a safe and effective vaccine that has saved millions of lives over the years. “More than 18 million people are able to walk today who would otherwise have been paralyzed, and 1.5 million childhood deaths have been averted thanks to the polio vaccine,” the WHO says.

OPV actually contains an attenuated (weakened) form of the virus, activating an immune response in the body. “When a child is immunized with OPV,” the WHO explains, “the weakened virus replicates in the intestine for a limited period, thereby developing immunity by building up antibodies. During this time, the virus is also excreted in their feces. In areas where there is inadequate sanitation and hygiene, the excreted weakened virus can spread in the immediate community before eventually dying out.”

Now, if a population is not sufficiently immunized, the weakened virus can continue to circulate. “The longer it is allowed to survive, the more changes it undergoes,” the WHO says. “In rare instances, the virus can change to a vaccine-derived poliovirus (VDPV), a form that has regained the ability to cause paralysis.”

The polio outbreak in the country is confirmed to be from a circulating VPDV type 2. “This is of particular concern, as wild poliovirus type 2 was certified as globally eradicated in 2015,” the WHO says. “Poorly conducted immunization activities, when too few children have received the required three doses of polio vaccine, leave them susceptible to poliovirus, either from vaccine-derived or wild polioviruses. Full immunization protects them from both forms of the virus.”

The sad thing is that vaccination coverage in the country has been steadily declining over the past few years. “To stop the spread of polio in the Philippines,” the WHO recommends, “at least 95 percent of children under 5 years of age need to be vaccinated.”

This is the main reason why Dr. Abeyasing he appealed to all parents to have their children vaccinated with OPV. “We urge all parents and caregivers of children under 5 years of age to have them vaccinated so that they are protected against polio for life,” the WHO official said.

The WHO, along with UNICEF, also remind Filipinos to wash their hands regularly with soap and water, use a toilet, consume food that is fully cooked, and drink safe water. “If the safety of your water is in doubt,” the WHO states, “boil it, ensuring it is bubbling vigorously for a least one minute before allowing it to cool.”

“In rare instances, the virus can change to a vaccine-derived poliovirus (VDPV), a form that has regained the ability to cause paralysis”

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