Nigeria is still one of the most entrenched reservoirs of wild poliovirus in the world. Experts, who warned that the spread of the virus is supported by poor environmental and personal hygiene, stated that both the young and the old that fail to take the full dose of oral polio vaccine could risk paralysis, reports Sade Oguntola.
Our health is something we take for granted – until it lets us down. But, it is a fact of life. Illnesses do come and when a chronic long-term illness like cancer, diabetes, arthritis or multiple sclerosis, to name a few, afflict us, then comes worry, anxiety, depression. Worst still with long-term illness, mounting medical bills and, in many cases impaired mobility, become a bitter pill to swallow.
Mrs Kemi Haruna, a 45-year teacher is a case in point. She woke up to found she had become weak, in pain, and fatigued. Her panic attacks intensified and she became terrified when she realised that she could not stand up from her bed. Surprisingly, the doctor diagnosed that she had become paralysed because of polio.
Today, polio affects mainly children under five years of age. Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs.
According to the world health body, World Health Organisation (WHO), one in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, between five and 10 per cent of people infected die when their breathing muscles become immobilised.
Paradoxically, Dr Adekunle Adeniji, Director, WHO National Polio Laboratory, Ibadan, stated that when adults who are not fully immunised contract the virus, say from contaminated food items or water sources, the symptoms of the disease are more severe and even lead to paralysis.
According to him, “just this year in Congo, the majority of people infected are adults and once it gets to adults, it causes paralysis. In children, it may be about one per cent of the infected people that would be paralysed. But in adults, more often than not, it is more severe.”
Basically, to attain immunity, a minimum of three doses of the oral polio vaccine (OPV) should be taken. “If an individual receives either one or two doses of the vaccine, such a person might still stand the risk of the infection, depending on the strain the person becomes exposed to later on.
According to Dr Adeniji, ‘there are three subtypes of the virus- polio type 1, polio type 2 and polio type 3. For you not to be paralysed by the virus, you must have immunity against the three polio subtypes. So an adult that has immunity against polio subtypes 1 and 2 stands a risk of becoming paralysis if exposed to polio subtype 3.”
Fortunately, the whole world is eradicating polio from everywhere. But for some years, polio had remained endemic in Nigeria, Indian, Pakistan and Afghanistan. “We started its eradication well in Nigeria, but at a stage, based on religion, some people in the northern part of the country asked their wards not to take the vaccine. But recently, the Emirs have been talking to them and they are now receiving the polio vaccine,” Dr Adeniji declared.
Nonetheless, Nigeria still has polio cases in the northern part of the country and incidentally, those who later are found paralysed are usually those that never took any dose of oral polio vaccine, those that had zero doses of the vaccine.
He stated, “a few children are still not taking the vaccine. But the only solution to eradicate polio is for every eligible person to be vaccinated. It is a good and safe vaccine. In most cases, it does not give any problem. In some instance, however being a live vaccine, the body temperature might rise slightly and merely taking an analgesics would be correct it.”
Unfortunately, interrupting the transmission of wild poliovirus is a problem because of unclean environment, poor sewage disposal and personal hygiene as well as inadequate intake of nutritious food. According to him, “an individual cannot contract polio unless he or she takes feace-contaminated food or water. Each time a polio-infected person defecates in the open, the virus is released into the environment in large numbers.”
“There are so many houses in Nigeria without toilet facilities and so people just throw feaces in the open. Now this, coupled with people throwing refuse into drainages, ensures that the virus can easily be contracted by both the young and the old because its route of transmission is through the mouth.
“There is the possibility of an housefly that has visited an infected feaces also spreading the virus to foods.”
In addition, for vaccination to confer immunity, Dr Adeniji stated the need for good nutrition. “That is why sometimes, when we give the oral polio vaccine, it is usually accompanied with Vitamin A. The Vitamin A will help to boost the immune system for the vaccine to work well and ensure immunity is conferred.”
As long as a single child remains infected, children in all countries are at risk of contracting polio. Currently, there has not being any case of polio paralysis in the southern part of Nigeria in the last 18 months. According to Dr Adeniji, “cases of wild polio virus are now in Kebbi and Maiduguri axis. Much more recently, some cases were discovered in Zamfara. But Kano is still a threat.”
In 2009, Nigeria had over 350 cases of wild polio virus. But in 2010, it came down to only 10. However in 2011, the signals are indicating almost 40 cases. These are indications that progress are being made in the eradication of the disease.
Even as President Goodluck Jonathan restated his commitment to eradicating polio by next year, he stated that prioritising vaccination and campaign to ensure all children, including those that were just born, received polio vaccine the day they were born was imperative, to successfully eradicate polio.
“As long as we continue to have children that have zero doses of oral polio vaccine, they are highly susceptible to acquiring the infection. But if all people are immunised, even if the virus is everywhere, it will not have anywhere else to go to or easily get multiplied and, as such, it will die naturally in the environment.”
“A lot of countries used the vaccine to eradicated polio. Our problem in Nigeria is ensuring that people take the vaccine,” he concluded.