Alarming polio outbreak spreads in Congo, threatening global eradication efforts

3 July, 2018

(with thanks to Global Health Now)

Extracts below. Full text here: http://www.sciencemag.org/news/2018/07/polio-outbreaks-congo-threaten-gl...

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Alarming polio outbreak spreads in Congo, threatening global eradication efforts

By Leslie Roberts Jul. 2, 2018 , 1:30 PM

Overshadowed by the Ebola outbreak in the Democratic Republic of the Congo (DRC), another frightening virus is on the loose in that vast, chaotic country: polio. Public health experts have worked for months to stamp out the virus, but it keeps spreading. It has already paralyzed 29 children, and on 21 June a case was reported on the border with Uganda, far outside the known outbreak zone, heightening fears that the virus will sweep across Africa. The DRC is “absolutely” the most worrisome polio outbreak today, says Michel Zaffran, who heads the Global Polio Eradication Initiative (GPEI) at the World Health Organization (WHO) in Geneva, Switzerland...

The outbreak also underscores the latest complication on the bumpy road toward polio eradication. It is caused not by the wild virus hanging on by a thread in Afghanistan, Pakistan, and perhaps Nigeria, but by a rare mutant derived from the weakened live virus in the oral polio vaccine (OPV), which has regained its neurovirulence and the ability to spread. As OPV campaigns have driven the wild virus to near-extinction, these circulating vaccine-derived polioviruses (cVDPVs) have emerged as the greatest threat to polio eradication. If the outbreaks are not stopped quickly, polio scientists warn, they could spiral out of control, setting eradication efforts back years.

“There is an urgency” to stopping these vaccine-derived outbreaks, says epidemiologist Nicholas Grassly of Imperial College London. “It is so much more important than controlling the wild virus.”...

The country and its international partners targeted mOPV2 campaigns to eight health districts deemed at highest risk—the minimum, experts thought, to get the maximum effect. But vaccination campaigns in the DRC, with its remote villages, crumbling infrastructure, and weak health system, are tough. They failed to reach enough children. The Haut-Lomami virus broke through, spreading south to Tanganyika and then Haut-Katanga...

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Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (www.dgroups.info), which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org