Polio campaign targets 7.4 million children

The Myanmar Ministry of Health, with the UN Children’s Fund (UNICEF) and World Health Organization (WHO), will immunise more than seven million children against polio.



"About 7.4 million children under-five will benefit from the campaign," Ye Hla, a consultant for UNICEF’s expanded programme on immunisation told IRIN in Yangon, the former Burmese capital.



The campaign will cover the whole country, including those areas affected by Cyclone Nargis, which struck in the first week of May, leaving almost 140,000 people dead or missing, and affecting more than two million.



Some 46,000 health workers and volunteers will take part in the community-based effort.



The first three-day round will begin on 10 January, followed by a second round on 7 February.



"According to our assessment, there were some children in the hard-to-reach areas who missed our previous polio vaccination due to issues of transport,” a health official from the department of health told IRIN. “However, this year we will try to reach every area," he said.



Special measures must be taken to ensure that no children of mobile populations or vulnerable children in hard-to-reach areas, such as mines, petroleum exploration and logging areas were excluded, he said.



Cases to date












Photo: Lynn Maung/IRIN
Paralysed by polio, this boy's parents failed to have him vaccinated



Myanmar launched its first nationwide anti-polio campaign in 1996 after the detection of four wild polio virus cases in Muse Township along the 2,000km-plus border with China.



Three years later, two wild poliovirus cases were detected in Maungdaw Township and two in Buthhidaung Township in the northern Rakhine state bordering Bangladesh.



In 2000, the virus spread to Kyauktaw and Pauktaw townships where two more cases were isolated.



Myanmar declared itself polio-free in 2003, only to lose that status in 2006 when another case was reported in Pyin Oo Lwin Township in Mandalay Division. In 2007, 10 wild poliovirus cases were detected in Maungdaw and one in Buthidaung townships, with the last positive polio case detected on 15 May 2007.



Myanmar’s Department of Health reported 15 confirmed cases in 2007, while no cases were reported in 2008.



Risk factors



According to the Global Polio Eradication Initiative (PEI), a Geneva-based country support group, under-fives are at high risk of the highly infectious disease, which invades the nervous system and can cause total paralysis in hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.



One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5 to 10 percent die when their breathing muscles become immobilised, it added.



Moreover, the virus can spread rapidly among unimmunised populations. Between 2003 and 2005, 25 previously polio-free countries were re-infected due to imports, WHO reported.



According to the UN health body, polio remains endemic in four countries in the world today: Afghanistan, India, Nigeria and Pakistan.



The wild polio-virus type 1 found in Myanmar represented a local spread of the virus introduced from Bangladesh, which in turn was infected by imports from India in 2006.



"As long as neighbouring countries cannot eradicate polio, Myanmar will be vulnerable to the imported virus," Ye Hla said. "However, we'll make every endeavour to stop virus entry and local spread."



Four-pronged counter-attack



The PEI advocates a four-pronged eradication strategy against polio.



First, routine immunisation at six weeks, 10 weeks and 14 weeks. Full coverage with routine immunisation ensures the continued protection of new birth cohorts of children and maintains the population’s immunity.



In addition, national immunisation days. Third, monitoring where and how the polio virus is circulating or spreading.



The fourth is mopping-up in areas where the virus is endemic or still occurring, routine immunisation coverage is low, and mobile and migrant populations dwell. Such activities are carried out house-to-house, child-to-child, boat-to-boat and mountain-to-mountain, Ye Hla said.



According to WHO, global polio cases have decreased by more than 99 percent since 1988, from an estimated 350 000 cases to 1,997 reported cases in 2006.



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