November 14, 2006

In-depth- Nigeria Polio


In-depth- Nigeria Polio

Poliomyelitis (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. It can strike at any age, but mainly affects children under five years through contaminated drinking water.
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. One in 200 infections leads to irreversible paralysis (usually in the legs). Amongst those paralysed, 5%-10% die when their breathing muscles become immobilized. Although polio paralysis is the most visible sign of polio infection, fewer than 1% of polio infections ever result in paralysis.
Poliovirus can spread widely before cases of paralysis are seen. Poliovirus can travel from
village to village and country to country, through un-immunized children. One unimmunized child
can leave tens or hundreds more paralysed for life. While polio exists anywhere, children
everywhere are at risk. As most people infected with poliovirus have no signs of illness, they are
never aware they have been infected. After initial infection with poliovirus, the virus is shed
intermittently in faeces (excrement) for several weeks. During that time, polio can spread rapidly
through the community.
Global goal of eradicating polio
■ In 1988, the World Health Assembly, the annual meeting of the ministers of health from all
members of the World Health Organization, including Nigeria, voted to eradicate polio and
launched the Global Polio Eradication Initiative. The goal was to ensure that no child would ever
again know the crippling effects of polio.
Biggest health initiative ever
■ The Global Polio Eradication Initiative is the largest public health initiative the world has ever
known. As a result of this Initiative, by late-2003 polio had been eliminated from all but 6 countries
and fewer than 1000 children had been paralysed by the disease during that year. The Initiative
spearheaded by the World Health Organization, Rotary International, US Centers for Disease
Control and Prevention and UNICEF, is a unique collaboration of governments, international
organizations the private sector, civil society and over 20 million volunteers. More notably, nearly
five million children were walking who would otherwise have been paralysed by polio and 1.25
million childhood deaths had been averted by distributing vitamin A during polio immunization
Kicking polio out of Nigeria
■ In 1996, Africa leaders, including Nigeria, together launched an enormous effort to improve the health of the children across the continent, and united to eradicate polio from the continent for good. Together

the (then) Organization for African Unity pledged its own destiny and determination to make Africa free of polio. In 1996, polio was rampant in at least 41 African countries. Tragically as many as 75,000 African children were paralyzed every year. Since then tremendous progress has been made towards eradicating polio from Nigeria. In fact, until 2002, many states in the south of Nigeria were largely polio-free.
■ Investing in polio helps address other health programmes in Nigeria
Nigeria has made a huge investment in protecting its children from polio. Until we finish the job, this investment is under threat. Polio does not respect borders - country, state or even village. Polio anywhere is a threat to children everywhere. It is easy to forget that polio once crippled over
1000 children every day. We are now on the brink of eradicating this crippling disease globally. But if we stop our efforts now, we will again see a resurgence of polio across Nigeria.
Nigeria's polio eradication programme is reaching out to more children in more LGAs, districts and communities, more often than any other programme. In fact it is providing the basis for
other national public health efforts - including the surveillance of diseases, improvement in vitamin A status, and response to other disease outbreaks. This focus on the health of all people contributes to equity and national development. As the national capacity to promote public health
increases with success in eradicating polio, efforts can be extended to other priority conditions – such as measles, malaria and HIV/AIDS.
■ What will it take to eradicate polio?
Engaging everyone to reach every child – from the head of state, local religious leaders and
traditional leaders, media, health workers, teachers, vaccinators and most importantly
parents. Rebuilding trust in polio immunization at the community level. Strengthening routine immunization - the best prevention against polio. Boosting surveillance to immediately detect
and respond to poliovirus. Focusing on the very young – protecting newborns who are often missed during campaigns.
National Immunization Days in Nigeria
Did you know what is involved in a 4-day immunization campaign in Nigeria? Here are just some of the basic
■ 138,220 vaccinators
■ 27, 644 supervisors, with 13,822 vehicles (cars, motorcycles, mopeds, bicycles, boats, whatever it takes to reach every child)
■ 3,200 community mobilizers visiting homes and addressing parent’s concerns in the high risk northern
■ 45 million doses of polio vaccine, carried around the country in 83,000 Kick Polio Out of Nigeria vaccine carriers
■ 498,000 ice-packs to keep all doses of polio vaccine cold despite the hot Nigerian temperatures
■ All children under five years of age immunized in just 4 days!
■ The commitment and support of everyone in Nigeria

Nigeria—The polio facts at a glance
The maps show that poliovirus can travel from state to state and village to village and country to
country through un-immunized children.
■ Rapid progress continues to be made towards polio eradication in Nigeria.
■ The number of polio cases to date in 2005, while still substantial at 52, is nearly 50% of
that for the same period in 2004.
■ This progress reflects the engagement of political, traditional and religious leaders at the federal, state, LGA and ward levels and the full support of a strong partnership.
■ As of 6 May, Nigeria has 78 confirmed cases of wild poliovirus in 2005, in 18 states. This
compares to 125 cases in 25 states in the same period in 2004.The number of Nigerian
children crippled by polio increased from 355 (total) in 2003 to 792 cases in 2004.
■ Although the number of confirmed poliovirus cases continues to increase, there has been a
downward trend in the number of cases since May 2004.
■ Nigeria accounted for 63% of the total number of poliovirus cases reported globally in 2004.
■ Currently 70% of Nigeria’s poliovirus cases are children below 3 yrs of age and 67% have
received less than 3 doses of OPV.
■ 6 States in the northwest - Kano, Kaduna, Sokoto, Zamfara, Kebbi, and Jigawa account
for 73% of the total number of children paralysed by polio.
■ There has been a downward trend in the number of cases since May 2004. This
indicates a degree of control of the infection in the southern states, along with the impact of
resumed immunization in the north.

Putting Polio Eradication in Nigeria in a global context
Poliovirus can travel from village to village and country to country, through unimmunized children. One un-immunized child can leave tens or hundreds more paralysed for life. African countries are increasingly vulnerable to importations of poliovirus linked to Nigeria. While polio exists anywhere, children everywhere are at risk of infection. 16 previously polio-free countries, most recently Ethiopia, Saudi Arabia, Indonesia and Yemen have been re-infected.
Figures at a glance
As of 6 May, 78 Nigerian children have been paralysed by polio in 2005. This compares to 125
during the same period in 2004. 792 Nigerian children were paralysed by polio in 2004.
1266 children globally were paralysed by polio in 2004 (as of 25 March 2005).
List of countries for synchroNIDs: Benin, Burkina-Faso, Cameroon, Cap Verde, Central
African Republic, Chad, Congo-Brazzaville, Cote d’Ivoire, Democratic Republic of Congo, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Guinea- Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Sudan, Togo. Polio affected countries Endemic: Niger, Nigeria (note that Egypt is also polio-endemic) Countries with re-established transmission:
Sudan, Central African Republic, Côte d'Ivoire, Chad, Burkina Faso and Mali Re-infected: Benin, Botswana, Cameroon, Ethiopia, Ghana, Guinea, Indonesia, Saudi Arabia, Togo and Yemen.
At risk: Cape Verde, the Democratic Republic of Congo, Equatorial Guinea, Gabon, Gambia, Guinea, Guinea-Bissau, Liberia, Mauritania, Senegal & Sierra Leone.