Polio cases soar as conflict hampers vaccination campaigns

The number of recorded cases of polio in Cote d'Ivoire shot up to 17 in 2004 from just one the previous year and the real situation on the ground may be worse given that access to the rebel-held north of the country is difficult, Health Minister Albert Mabri Toikeusse said. "Polio has well and truly returned to Cote d'Ivoire," Toikeusse told a press briefing last week. "It's crucial that routine vaccinations resume." Instability in the West African country, which has been partitioned into a government-run south and a rebel-held north since a failed coup more than two years ago, was the main reason behind the disruption of vaccination campaigns, he said. The most recent flare-up in the long-running conflict in early November forced the Health Ministry to postpone two rounds of a national polio immunisation campaign for 5.1 million children planned for November and December. Polio - poliomyelitis - is a highly infectious disease caused by a virus that affects mainly children under three years of age. It invades the nervous system and can cause total paralysis in a matter of hours. Toikeusse said that 15 of the 17 cases reported last year were in the government-run south, but he added that the situation in rebel territory was probably bleaker than the statistics suggested. "We have an epidemiological silence is this part of the country because we haven't be able to collect numbers. We know that the healthcare situation in the centre, the north and the west is disastrous," Toikeusse said. In its 2004 annual report, the United Nations Children's Fund (UNICEF) sounded the alarm that health care in the north was in tatters, with few doctors and nurses and virtually no routine vaccinations. "Cote d'Ivoire, which was polio-free in 2001, is really of great concern because the cases aren't concentrated in one area. So the threat to children is not localised, it's nationwide," Jeff Brez, the spokesman for UNICEF in Abidjan, told IRIN on Tuesday. "We've definitely seen an alarming rise. And the fact that surveillance is so weak, also leads us to wonder whether there are not cases we are not aware of in the north," he added. Key to stopping polio in its tracks are comprehensive and coordinated vaccination campaigns. Cote d'Ivoire borders five countries and populations in the region are mobile, providing fertile conditions for the polio virus to spread. "Cote d'Ivoire is the economic magnet for the sub region. Children are travelling back and forth with their families so the regional aspect of the campaign is crucial," UNICEF's Brez said. The pace at which polio can gain a foothold was brought into focus recently when a 2003 immunisation ban in the northern Nigerian state of Kano helped the virus spread across the wider region in 2004, infecting 12 west and central African countries previously declared polio-free and derailing international health experts' plans to eradicate the disease by the end of the year. Figures from the World Health Organisation show that as of 21 December, Nigeria had 748 cases of polio -- more than two-thirds of polio cases worldwide.