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World Health Organization seeks eradication of polio by 2005

( 2003-07-30 10:54) (The New York Times)

WHO aims at eradicating polio by 2005, and that "is a doable job" provided that money is available to sustain the effort, said the agency's director general, Dr Jong Wook Lee.

So far this year, only 235 cases of paralytic polio have been reported in the world, nearly all from India, Nigeria and Pakistan.

But as long as a single case exists anywhere, the infectious disease can surge within a country and be exported elsewhere, said Dr. David L. Heymann, the epidemiologist Dr. Lee has put in charge of meeting the goal. Dr. Heymann led the WHO team that controlled the epidemic of SARS.

The risk of the virus getting loose is one reason why WHO has asked countries to conduct inventories to determine which of their laboratories have polio virus in freezers. So far 80 countries have provided such lists to WHO.

Two countries Oman and Vietnam have destroyed all known stocks of the virus there.

Some laboratories in eight other countries have destroyed their stocks, even though WHO has not required that step. The eight countries are Albania, Bahrain, Cambodia, Hong Kong, Mongolia, Morocco, New Zealand and Singapore.

Even if WHO succeeds in stopping transmission of polio, countries are expected to continue polio immunization for some time to protect against virus that may be lurking undetected somewhere. Since polio virus is needed to manufacture the vaccine, a number of countries will need to maintain stocks of polio virus, Dr. Heymann said in an interview.

WHO is encouraging laboratories to destroy stocks of polio virus unless they are conducting top priority scientific projects or have a clear scientific reason for keeping the virus.

Also, to help prevent accidental infection or escape of the virus, WHO is encouraging scientists to work with polio only in laboratories that are rated as P-3, the second strictest of the four levels of bio-security.

Chris Wolff, a member of Dr. Heymann's team, said that in asking countries for an inventory, "WHO is trying to make the laboratory community aware of the implications of holding stocks of polio virus."

"Most scientists realize the implication and are taking this situation very seriously," said Mr. Wolff, who coordinates efforts to contain the virus for WHO's polio eradication team.

Dr Bruce Aylward, another polio expert at WHO, said that obtaining reliable inventories "is proving to be a big logistical challenge but very definitely a manageable one."

Dr Heymann said that because WHO has no power to investigate laboratories in countries, it has to take the word of health ministers. So there is no way to be sure that scientists have inadvertently overlooked specimens containing polio virus or that they have lied.

The 235-case total reported so far this year is the second lowest for the comparable period of any year, and seems to be dropping rapidly, Dr Lee said.

The fewest cases were the 101 reported in 2001. Last year, the polio eradication program suffered a serious setback when the worldwide total rose to 1,918, up from 483 in 2001. The surge resulted from a large outbreak in Uttar Pradesh in India. Cases spread to other states, including Gujarat, Rajasthan and West Bengal.

In the last four years, polio has been exported 12 times into areas that had been polio-free, Dr Heymann said. Five of the exports came from India.

Of this year's cases, three were exported to Ghana and one to Lebanon.

Dr Aylward exhorted government leaders in polio-affected countries to fully back the extensive immunization programs. "What we need now in polio eradication is to see the full engagement of" political, religious and community leaders at national, local and regional levels, Dr. Aylward said.

The 235 cases this year represent a 99 percent reduction from 350,000 cases in 125 countries when WHO undertook the polio eradication program in 1988. So far it has cost $3 billion of support from WHO, Unicef, then Centers for Disease Control and Prevention in Atlanta and Rotary International.

 
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