| New York Times | - |
Syria's
polio outbreak has now officially spread to Iraq, the first neighbor of
the war-ravaged country to be hit by the crippling virus despite an
ambitious Middle East inoculation effort, and global health officials
warned Monday that dozens of ...
Polio Spreads From Syria to Iraq, Causing Worries
Syria’s
polio outbreak has now officially spread to Iraq, the first neighbor of
the war-ravaged country to be hit by the crippling virus despite an
ambitious Middle East inoculation effort, and global health officials
warned Monday that dozens of vulnerable Iraqi children could potentially
be infected.
The
transmission of polio, a highly contagious disease that primarily
afflicts children younger than 5 and can lead to partial and sometimes
fatal paralysis, reflects one of the most insidious effects of the
three-year-old Syria conflict, which has sent millions of refugees
across the country’s borders and severely undermined its public health
system.
For
Iraq, the outbreak is the first time in 14 years that polio has
appeared; the disease was absent even during the 2003-2011 war that
began with the American-led invasion to topple Saddam Hussein.
World
Health Organization officials said the first Iraqi polio case, that of a
6-month-old boy in Baghdad, was confirmed on March 30 by Iraq’s
Ministry of Health and had the same genetic fingerprint as the virus
that paralyzed 27 children in eastern Syria in October — both having
originated in Pakistan, one of the few countries in the world where
polio has not been eradicated. The Polio Global Eradication Initiative, a
partnership that includes the W.H.O., reported two new Syria cases last week — in Aleppo and Hama, far from the original outbreak area.
Christopher
Maher, the eastern Mediterranean manager of the W.H.O.’s Polio
Eradication and Emergency Support unit, said that Iraqi officials had
been immunizing children protectively since the Syria outbreak began,
and that in light of the first confirmed case in their home country they
were now expediting another scheduled round of vaccinations.
“At
the moment, they’re madly preparing their response plan,” Mr. Maher
said in a telephone interview. It takes multiple rounds of vaccine,
taken orally, to immunize a child.
Iraq
has an estimated five million children under the age of 5. While
estimates vary on the number of infections for every confirmed case, and
not all children develop symptoms, Mr. Maher said, “in all likelihood
it would be dozens — you’ve got to assume there’s some extension of the
transmission.”
The W.H.O. and Unicef said in a joint statement
on Sunday that Iraq’s expedited polio response was part of a broader
vaccination effort in the region, with the goal of reaching more than 20
million children this week. Lebanon and Turkey will participate later
this month, and Jordan and the Palestinian territories will be part of
future vaccination rounds, said Juliette S. Touma, a spokeswoman for
Unicef’s regional office in Amman, Jordan.
“The
recent detection of a polio case in Iraq after a 14-year absence is a
reminder of the risk currently facing children throughout the region,”
Maria Calivis, the Unicef regional director for the Middle East and
North Africa, said in the statement. “It is now even more imperative to
boost routine immunizations to reach every child multiple times and do
whatever we can to vaccinate children we could not reach in previous
rounds.”
The
statement acknowledged that the effort had “yet to reach especially
vulnerable groups such as children who are on the move fleeing violence
from Syria or those living in the midst of active conflict.”
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Some
rights advocates and public health experts have criticized the W.H.O.
and other United Nations agencies for adopting an accommodating policy
toward President Bashar al-Assad of Syria, who they contend has
deliberately withheld inoculations against polio and other contagious
diseases to insurgent-controlled areas.
Dr.
Annie Sparrow, a pediatrician and deputy director of human rights at
the Icahn School of Medicine at Mount Sinai in New York, said in a study published in February that
the polio outbreak in Syria was far more widespread than just the cases
reported by the W.H.O. The health organization has disputed her
findings.
Dr.
Sparrow said in a telephone interview on Monday that the most recent
polio news from Iraq and Syria was both expected and alarming. “It
should signal an absolute failure of the global eradication effort,” she
said.
Mr.
Assad’s forces, she said, “have been bombing the heck out of the people
of Aleppo instead of vaccinating them, which is what they should be
doing.”
While
Mr. Maher said the spread to Iraq was not in itself surprising, health
officials were uncertain about its precise path to Baghdad, where the
victim had no obvious contact with possible carriers from Syria, most of
them refugees concentrated near Iraq’s border with Syria.
“It’s
great if you have clear-cut chain of transmission so you can easily see
how this would happen — maybe a refugee child,” he said. “But where you
would expect to see the virus would have been in the northwest, and not
down in Baghdad.”
At
the same time, he said, the confirmed case reflected the ability of the
polio virus to find vulnerable victims, touching a child who had been
part of “a pocket of under-immunized children in the community.”
Ms.
Touma said the inoculation effort in Syria had made progress but was
still failing to regularly reach an estimated 323,000 Syrian children at
the highest risk of contracting polio, in areas of fighting or
restricted access.
“The
trick with polio is that we can’t give up, we have to do multiple
inoculations continuously and as wide as possible,” she said.
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