Polio outbreak in Ukraine: consequences and lessons

BY AVA TORJANI

Beginning September 2015, two cases of polio were reported in southwestern Ukraine, paralyzing a 4-year old and 10-month old, according to the Global Polio Eradication Initiative. After its first occurrence in Europe over the last five years, polio has stirred significant distress amongst healthcare officials and the Ukraine government due to the alarmingly low population of vaccinated children, which is currently at fifty percent. The World Health Organization (WHO) has urged Ukraine to declare a state of emergency in order to avoid further spread of the disease to bordering countries including Romania, Hungary, Poland, and Slovakia.

Polio is a highly infectious disease caused by poliovirus, which can be transmitted from person to person via ingestion of infected feces. It predominantly affects children under the age of five and is characterized by symptoms of fever, headache, and vomiting. Initially replicating in the intestine, the virus can invade the immune system and cause paralysis.

Thankfully, several vaccines against polio exist. So how exactly did this menacing disease reappear? The vaccine itself contains a weakened form of the virus, which boosts our immune system so that we can fight off the real virus if we ever catch it. However, the weakened virus may undergo mutation and grow stronger—a problem for those who are not vaccinated, but not for those who are.

Up until now, there have been no new reported cases of Polio, according to the Global Polio Eradication Initiative. However, the World Health Organization is still urging Ukraine to declare a state of emergency for several reasons. Firstly, there is no cure to polio, which makes it very difficult to treat successfully if contracted. Also, an outbreak can have devastating consequences due to the large number of countries bordering Ukraine.

As a result—with the aid of WHO, CDC, UNICEF, Gates Foundation and Rotary International—the Ukrainian government launched a polio vaccine campaign in October, whose initial goal was to vaccinate ninety percent of children aged five and under. Unfortunately, only sixty percent of these children were vaccinated by early November.

What is obstructing the campaign’s path towards this goal?

The most significant explanation corresponds to anti-vaccination attitudes amongst Ukrainians, in particular a Ukrainian lobby group that claims the vaccines against polio are unsafe and should be destroyed. In addition, the majority of parents are not well informed about the disease, with only eighteen percent of Ukrainian mothers knowing that polio is actually dangerous. Physicians are also liable to the potential consequences of vaccines and are therefore reluctant to administer them; if a child dies within thirty days of receiving the vaccine, it is considered as the sole cause of death. In Ukraine, the physician who administered the vaccine can consequently have their license suspended or can be sent to jail. However, the driving reason for low immunization rates for polio is the insufficient supply of its vaccines. According to the Global Alliance Vaccine Initiative, Ukraine buys these vaccines locally rather than internationally, which means that the supply is generally low and the costs are accordingly much higher.

These obstructions are yet another driving reason for WHO’s insistence that Ukraine declares a state of emergency. “The declaration would mobilize other government divisions to support the vaccination campaign,” claims Oliver Rosenbauer, a spokesperson for the WHO polio eradication program. Nevertheless, the vaccine campaign has created a greater public awareness of the importance of immunizing against polio and other infectious diseases.

Although it’s a costly lesson, this incident teaches us all about the importance of public health awareness for diseases, their treatments and their cures. The optimistic outlook of this incident focuses on the long-term goal of improving Ukraine’s immunization system in order to prevent future outbreaks of disease.

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