Polio: Walk the line

The existence of polio in Pakistan is a ticking time bomb but can be prevented.

Poliomyelitis or Polio is an infectious virus that invades the body’s nervous system and can cause irreversible paralysis in a matter of hours. The virus enters through the mouth or via inhalation through the respiratory tract and multiplies in the intestines. Children under the age of five are most vulnerable to this infection as it invades the nervous system, rendering it dysfunctional.

Symptoms

• The initial symptoms can be anything from fever, fatigue, and vomiting.

• It also causes stiffness in the legs, neck and limbs.

• One in every 200 infected individuals is paralysed and five to ten percent of paralysed individuals die as their breathing muscles are immobilised.

Numbers speak

• Pakistan, along with Nigeria and Afghanistan is one of the three countries that are still struggling with the deadly polio virus.

• The total number of naturally occurring wild polio virus in 2013 was 93 while 9 cases have been reported in 2014 so far.

• The total number of vaccine deprived polio cases in Pakistan was 45 for 2013 and one in 2014 so far.

• North Waziristan is the district with the largest number of children being paralysed by poliovirus in the world.

• As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200,000 new cases every year, within 10 years, all over the world.

• The complete eradication of polio will save at least $50 billion over the next 20 years, mostly in low-income countries. Most importantly, this will mean that no child will ever need to suffer lifelong paralysis because of a preventable infection.

Preventions and precautions

The only way to prevent this infection is through polio vaccine or drops which are given to children at two months, four months, six to 18 months and at four to six years. Once caught, the infection is not curable.

“There are two types of vaccines available, the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV),”says Dr Anwar, medical supint at the Police Hospital, Karachi. “Precautions must be taken by those who have developed allergic reactions to prior vaccines and those who have lower immunity to diseases.”

A child’s dose of IPV may be delayed or may not be given at all if the child has a known severe allergy to the antibiotics neomycin, streptomycin, or polymyxin B. A child who has had a life-threatening reaction to a previous IPV should also not receive another one.

However, if the child is unwell on the date for the vaccine, then it must be rescheduled but no dosage should be missed.

Side effects

“In case of fever and pain, medicines to relieve the condition can be given by the polio administering personnel,” says Dr Anwar. There may be other slight side effects like redness at the injection site, vomiting, decreased appetite and pain and tenderness with low fever.

Side effects that should be reported as soon as possible are:

• Limp, pale or less alert child

• Difficulty in breathing, shortness of breath or wheezing

• Difficulty in swallowing

• High fever (103°F or more)

• Inconsolable crying for three hours or more

• Seizures (convulsions)

• Severe skin rash, hives or itching

• Swelling of the eyes or face

• Unusual sleepiness

Published in The Express Tribune, Sunday Magazine, February 16^th,  2014.