The Return of the Polio Threat

CEBU, Philippines — The Department of Health has recently announced that the country is currently at a "high risk" for poliovirus transmission. The announcement came as a shock to many, considering that the Philippines had been said to be “polio free” since 2000. What has happened between then and now?

The health department sees the high risk for transmission of poliovirus, the virus that causes poliomyelitis or polio, to be due to low vaccination coverage, poor early surveillance of polio symptoms, and substandard sanitation practices. It seems that people have become rather complacent in their guard against the disease, because there has not been a reported case for many years. As it turns out, the threat would come back.

Up until recently, the word “polio” would be mentioned only upon sight of a person who’s a victim of the disease. But aside from the resulting physical deformity, today’s general population understands little about polio since it was gone from the public mind for quite a long time. An intensive public information campaign is certainly necessary.

Polio is a highly contagious disease caused by poliovirus invading the nervous system. The common symptoms include fever, fatigue, headache, vomiting, stiff neck, abnormal reflexes, and sudden onset of floppy arms or legs. Difficulty in swallowing and breathing is a symptom, too. To confirm the diagnosis, the doctor will take a sample of the patient’s throat secretions, stool or a colorless fluid that surrounds the brain and spinal cord, called cerebrospinal fluid.

In severe cases, polio can lead to permanent paralysis, which can in turn result in eventual physical deformity or even death. Children under five years old are most vulnerable to the disease.

The Philippines was declared polio-free since October 2000; the last case of wild poliovirus in the country was reported in 1993. The health department, however, noted that “vaccination coverage for the third dose of the oral polio vaccine (OPV) has [since] fallen below 95 percent, the target required to ensure population protection against polio.”

Open defecation and poor sanitation in communities are cited as triggers that have put the country back at risk of polioviruses. This is a widespread concern in inner cities and remote rural areas. The highly infectious viral disease primarily spread through feces.

On the side of the health authorities, Health Secretary Francisco Duque III warns that “unless we act quickly in putting our surveillance on alert to detect signs of poliovirus transmission, in strengthening our immunization program, and in improving environmental hygiene and sanitation, we risk losing our polio-free status.” It doesn’t make sense, he adds, to “risk the health and future of children due to a disease which otherwise could have been prevented.”

Measures to enhance prevention of the disease were set to start in Metro Manila for mid-August, including an immunization campaign for children below five years. The campaign was to eventually expand to the other “priority regions” that the health department would identify. Local governments were urged to intensify their “Zero Open Defecation” program and push harder for proper sanitation practices in their own communities.

There is no cure for polio. When the disease strikes, the only thing that can be done for the patient is for increasing comfort, speeding recovery and avoiding complications. The best way to deal with polio, therefore, is to prevent it.

Complete vaccination is the best preventive measure against polio. It advised that all children under one year of age to complete three doses of oral polio vaccine and one dose of inactivated polio vaccine. The government provides these for free.