Wed, 04 May 2005

Polio makes resurgence in Indonesia

The Jakarta Post, Jakarta

Indonesia has detected its first cases of polio in more than 10 years and health officials are urging the government to launch an aggressive vaccination campaign to keep the disease from spreading.

The Ministry of Health's polio surveillance team reported that two 20-month-old toddlers in Sukabumi, West Java, had polio. The team had received six reports of acute flaccid paralysis in children in the area and followed up the reports by taking specimens and running laboratory tests.

"The virus found in the area is not indigenous, it is imported," World Health Organization medical officer Bardan Jung Rana, who investigated the case, told The Jakarta Post on Tuesday.

"It means that the infected children had contact with people who acted as carriers after the virus had entered the country and became widespread," he said.

Immediately after the findings were confirmed, the ministry conducted a door-to-door vaccination campaign for children under the age of five in the area, as well as in four surrounding villages.

"We will proceed with immunization programs for children under the age of five in West Java, Banten and Jakarta," Minister of Health Siti Fadilah Supari said in a press release. The program is expected to last until June and cover some five million children.

Indonesia is the latest former polio-free country to see a reemergence of the disease. In 2004, the WHO recorded 119 cases of paralytic polio in 15 former polio-free countries.

The health organization said on its website that the virus had spread from northern Nigeria, a country that was not declared polio-free.

According to a foreign newswire, the polio strain then spread to Saudi Arabia and Ethiopia, but vaccination campaigns averted major outbreaks in those countries.

The virus also spread to other African and Middle Eastern countries -- Benin, Chad, Cameroon, Botswana, Burkina Faso, Central African Republic, Ghana, Guinea, Mali, Togo and Yemen.

Indonesia was declared polio-free in 1995 although it continued to carry out vaccination programs for children until 2002. The Ministry of Health also set up a polio surveillance team to monitor cases of acute flaccid paralysis in children under the age of 15, which are frequently caused by polio.

Poliomyelitis, commonly known as polio, is a highly infectious viral disease that invades the nervous system and can cause total paralysis and death.

The virus enters the body through the mouth and multiplies in the intestines. After initial infection, the virus is shed intermittently in feces for several weeks. During that period, the virus can spread rapidly through a community.

According to the WHO, one in 200 infections leads to irreversible paralysis, usually in the legs. As of April 2005, the organization reported 1,267 global cases of polio, 792 of those in Nigeria. The virus can strike at any age, but statistics shows that 50 percent of infected individuals are children under the age of three.

Transmission of the virus by immune and partially immune adults and children is possible, and is more likely to occur in countries where sanitation systems are substandard.

"The world will hardly ever be free from polio," Bardan said. "That's what makes immunization important." (003)