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British medical services reported the detection of the polio virus in London’s sewage. This is the first case of the virus in Europe this year, but polio is reported every week in countries in Asia and Africa. After a temporary silence a few years ago, polio infections began to rise again.
- Polio is a dangerous viral infectious disease that can lead to muscle paralysis, damage to the nervous system, permanent disability, and even death
- The “wild” polio virus has been almost completely eradicated in the world, recently only in Pakistan, Afghanistan and African countries, not too many cases have been found
- Vaccination is the only way to stop the disease. Were it not for them, then – as estimated by WHO – in the above-mentioned countries there would be up to 200. cases per year
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Polio in London
The UK health department said it was the first time in 40 years that the polio virus (cVDPV2) was detected in the country. It was not a direct detection, but an indirect one. Several samples of the pathogen were found between February and May at London’s Beckton sewage treatment plant. The UK Health Security Agency (UKHSA) reported that genetic sequence testing of the virus showed that “spread to closely related individuals in North and East London” had occurred.
How was it detected? People infected with polio or vaccinated with a live version of the virus emit traces of the pathogen in their faeces, which ends up in the sewage. According to officials, an infected person brought the virus from abroad and then spread it to other people who were not vaccinated.
“The epidemic so far is very small,” explains virologist Angela Rasmussen. – Her outbreak could have taken place in a large family. Further transmission would need a large number of people who have not yet been vaccinated, he adds.
Representatives of the British Ministry of Health reassure that there is no risk of a mass epidemic, as the vast majority of the country’s inhabitants were vaccinated against the virus in their childhood. However, surveillance of wastewater samples has been increased to see exactly where the virus is coming from and to determine if “additional targeted immunization will be needed”.
The last case of polio in the UK was detected in 1984. The country was declared polio free in 2003.
Polio around the world
Virologists point out that the coronavirus pandemic has disrupted vaccination programs in poorer countries where polio is still low.
In 2016, there were only a few dozen cases of polio in four countries around the world. Between 2019 and 2020, the number of polio cases worldwide has tripled, with over a thousand cases reported in nearly 30 countries. Last year, over 600 cases were reported worldwide.
This year’s reports from epidemic services from individual countries each week inform about more cases of the polio virus, mainly in African and Asian countries. In the last few months, it has been detected in Pakistan, Chad, Egypt, Eritrea, Djibouti, Ghana, Nigeria, Niger, and Togo. Democratic Republic of Congo, Mauritania, Mozambique, WKS, Israel and Madagascar. These are usually single cases, sometimes several. Dozens of cases have been detected only in Yemen.
The vast majority of these are viruses of vaccine origin (circulating vaccine-derived polyovirus – cVDPV, cVDPV2 or cVDPV3). «Wild polio viruses (WPV) have recently only been detected in Pakistan (few cases). Malawi (first case in 30 years) and Mozambique (one).
Last year’s information on the detection of several cases of poliomyelitis in Ukraine concerned the cVDPV2 vaccine-derived virus. These were the first cases of polio in the country since 2015.
In the Americas, the last cases of polio were detected in 1991. In Poland, the last wild polio virus appeared in 1984.
Vaccination against polio
The massive vaccination campaign introduced in 1988 reduced the number of cases worldwide by 99%. In 2015, the Global Commission for the Certification of Poliomyelitis Eradication announced the eradication of “wild” polio 2. Type 3 virus (WPV3) was last identified in 2012. However, isolated cases of type 1 infection continue to emerge, most often in Afghanistan, Pakistan and some African countries.
Somalia, one of the world’s poorest countries, was freed from wild polio in 2015. However, the country was affected by the vaccine type of virus (cVDPV2 and cVDPV2) that had been circulating there since 2017. For several years, he led to permanent paralysis and disability of 32 children.
The vaccine-derived poliovirus is still circulating in an environment where the levels of childhood immunization, and therefore immunity, are too low. The reason for this is not only poor access to vaccines, but also the regular movement of people within inaccessible areas of Somalia, as well as to neighboring countries.
This year, a vaccination program was launched in Somalia targeting 3,5 million children under the age of 5. The first round of the campaign took place in March and nearly 95 percent. children in this group received the oral polio vaccine.
This year, no cases of the polio virus have been reported in the country. In 2020, 14 cases of cVDPV2 were detected and three in 2019.
Why is polio so dangerous?
Polio is a highly contagious disease caused by three types of viruses in the enterovirus family. The disease mainly affects children under 5 years of age. It attacks the nervous system and can cause paralysis and even death.
The most dangerous permanent complications of polio are damage to the motor cells of the anterior horns of the spinal cord and cranial nerves, and permanent paralysis of the muscles. The most dangerous are paralysis of the respiratory muscles. Secondary complications result from immobilization and impaired ventilation of the lungs.
Treatment of polio is only possible in cases that are not paralyzed.
The disease is also known, among others under the name of poliomyelitis i Heine-Medin disease.
Polio – symptoms
Often the disease is caused by the polio virus without causing any symptoms. In many cases they are limited to digestive system ailments, fever and headache. Sometimes meningitis is also seen. The most the characteristic and associated symptoms of polio are associated with the paralytic form of the diseasewhich developed in 1-2 percent. sick.
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It contributes to the paralysis of the muscles and, consequently, can lead to paresis, motor disability, paralysis, respiratory failure and even death.
In the course of polio, it is possible to:
- the passage of infection is asymptomatic;
- occurrence of flu-like symptoms – gastrointestinal discomfort, fever, sore throat, headache, stiff neck or back;
- sterile meningitis;
- asymmetrical paralysis of flaccid muscles, especially of the lower limbs, sometimes of the upper limbs, or of the trunk muscles, reduction of muscle tone, weakness or loss of reflexes;
- paresthesia;
- permanent muscle paralysis;
- paralysis of the respiratory muscles and respiratory disorders;
- the result of the disease may be post-polio syndrome that develops over the years.
Polio – treatment
There is no cure for polio, the only disease can be prevented by vaccination. The polio vaccine, given several times in the early years of life, offers protection for life.
Treatment of polio focuses on reducing and relieving symptoms. It consists mainly of rest, physiotherapy, supportive treatment (correction of water and electrolyte disturbances and coagulation disorders) and symptomatic treatment (antipyretic, analgesic and antispasmodic drugs).
Therapy may improve mobility but will not reverse permanent paralysis. Patients who are immobilized for a long time require prophylaxis of thrombo-venous disease and respiratory gymnastics. Patients with paralysis of the respiratory muscles require respiratory support.
According to the calculations of the World Health Organization, if the Global Initiative for Polio Eradication had not been introduced in 1988, more than 18 million people would be paralyzed worldwide as a result of polio.
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