Polio case in Darfur sparks fears of epidemic in west and central Africa



West and central Africa are on the verge of the largest polio epidemic in recent years, warned experts from the Global Polio Eradication Initiative. The warning followed a confirmation on 22 June that a child was paralysed on 20 May by polio in the Darfur region of the Republic of Sudan, a country which has not seen the disease for more than three years.

"There is no question that the virus is spreading at an alarming pace," said Dr David Heymann, WHO Representative for Polio Eradication. "The fact that the Sudan is now re-infected is concrete evidence of the need to support a massive immunization response right across west and central Africa."

Epidemiologists said that the poliovirus in the Sudan shares close genetic links to the virus in northern Nigeria, which has spread through Chad in recent months. According to Heymann, the re-infection of the Sudan represents the latest setback to progress made towards achieving polio eradication in Africa.

"At the beginning of 2003, only two countries in sub-Saharan Africa were polio-endemic. Today, however, Africa accounts for nearly 90% of the global polio burden, with children now paralysed in ten previously polio-free countries across the continent," said Heymann.

Children in west and central African countries will be particularly vulnerable during the polio "high season" this autumn when experts fear a major epidemic. Less than half of children in the region are routinely immunized against polio. Experts from the Global Polio Eradication Initiative, spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention and the United Nations Children's Fund (UNICEF), recommended synchronized immunization campaigns across 22 African countries in October and November 2004 to reach 74 million children.

"These campaigns could avert a public health tragedy," said Carol Bellamy, UNICEF Executive Director. "But to be effective they must have strong, grass-roots support. The first priority should be to increase community participation in polio activities throughout the region."

The northern Nigerian state of Kano is the epicentre of the region's outbreak, resulting in part from a local controversy over the safety of the polio vaccine which had led to the suspension of immunization campaigns earlier in the year. Following an announcement by Kano state authorities in May 2004, however, it is hoped that polio immunization activities in the state will soon recommence. Despite the statement, the local community still needs reassurance, said Bellamy.

According to WHO, responding to this looming epidemic will require an additional US$ 100 million, of which US$ 25 million is urgently required by August for the first campaign.

World Health Organization Genebra - Genebra - Switzerland
E-mail: bulletin@who.int