Syria’s first polio outbreak in 14 years endangers Middle East
WHO officials warned that there is a significant risk of the highly infectious disease spreading after the cases were confirmed in the eastern province of Deir al-Zour.
The Washington Post
BEIRUT — A cluster of 10 young Syrian children has been infected with polio, the World Health Organization (WHO) said Tuesday, sparking fears of a major regional outbreak amid mass migration and the collapse of Syria’s health services under the pressures of civil war.
WHO officials warned that there is a significant risk of the highly infectious disease spreading after the cases were confirmed in the eastern province of Deir al-Zour. Twelve more children suspected to be suffering from the virus are awaiting test results.
In response to the outbreak, seven countries in the region, including Syria and its neighbors Jordan, Turkey and Lebanon, have announced that they are launching emergency vaccination programs over the next three weeks to cover 20 million children in a six-month period, the WHO said.
The war in Syria has created optimal conditions for the spread of communicable diseases. The country’s health-care system has been devastated by the 2½-yearlong conflict, with routine immunization programs disrupted amid the violence.
Health workers have warned that the unsanitary conditions in which many of the millions of displaced live in are breeding grounds for diseases such as polio, which is spread through contaminated food or water supplies. With as many as 4,000 refugees fleeing the country every day, the risk of the disease spreading is particularly serious.
Destruction of water-treatment plants, electric power plants and other infrastructure has left Syrians “on average with only one-third the daily water” available to them before the conflict, much of it contaminated, U.N. humanitarian chief Valerie Amos said in Washington on Monday.
Doctors and health-care workers have fled the country in massive numbers, Amos said, while those who remain operate under threat and without supplies, as combatants on both sides have taken over or destroyed hospitals.
“It’s the perfect storm into which to drop the polio virus,” said Bruce Aylward, assistant director general for polio and emergencies at the WHO. “It could explode.”
The disease, which usually affects children younger than 5, can cause permanent paralysis within hours. Some cases result in death as breathing muscles freeze up. There is no known cure, and it can be prevented only through immunization. Syria has more than 3 million children in that age group, according to the U.N.
Just one in 200 polio cases result in paralysis, meaning the real number infected in Syria is in the thousands, Aylward said.
“The confirmed cases are just the tip of the iceberg,” said Aylward, who estimates that the regional vaccination effort will cost at least $15 million. “This isn’t a Syrian problem. This is a Middle Eastern problem.”
Twenty-two children in northeastern Deir Ezzour province, near Syria’s border with Iraq, were reported on Oct. 17 to have become paralyzed, and traces of the wild polio virus were found in samples taken from 10 victims, WHO spokesman Oliver Rosenbauer said Tuesday in Geneva.
More than 4,000 Syrians surge daily into neighboring countries to flee the war, according to the U.N. refugee agency. The outbreak in Syria adds to recent discoveries of the polio virus in Israeli sewage systems, setting back the WHO’s $5.5 billion initiative to make the world polio-free by 2018.
Although the incidence of polio has declined by 99 percent since the WHO, the Rotary Foundation and UNICEF launched a global eradication effort in 1988, the final push has proved challenging.
The disease is endemic in just three countries — Pakistan, Nigeria and Afghanistan — down from 125 in the late 1980s. But its presence in those countries risks re-infections elsewhere.
The outbreak in Syria marks the first confirmed cases there in 14 years.
While global cases of polio had dropped to 223 in 2012 from 350,000 in 1988, they rose this year to 301, according to the United Nations agency’s data. Although Nigeria, Pakistan and Afghanistan remained the only countries where polio is endemic, discovery of the virus in Israel earlier this year raised concerns of a possible spread in the Mideast and Europe.