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Polio Spreading

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    Posted: July 02 2018 at 12:42pm

Alarming polio outbreak spreads in Congo, threatening global eradication efforts

By Leslie Roberts

Overshadowed by the Ebola outbreak in the Democratic Republic of the Congo (DRC), another frightening virus is on the loose in that vast, chaotic country: polio. Public health experts have worked for months to stamp out the virus, but it keeps spreading. It has already paralyzed 29 children, and on 21 June a case was reported on the border with Uganda, far outside the known outbreak zone, heightening fears that the virus will sweep across Africa. The DRC is “absolutely” the most worrisome polio outbreak today, says Michel Zaffran, who heads the Global Polio Eradication Initiative (GPEI) at the World Health Organization (WHO) in Geneva, Switzerland.

The outbreak also underscores the latest complication on the bumpy road toward polio eradication. It is caused not by the wild virus hanging on by a thread in Afghanistan, Pakistan, and perhaps Nigeria, but by a rare mutant derived from the weakened live virus in the oral polio vaccine (OPV), which has regained its neurovirulence and the ability to spread. As OPV campaigns have driven the wild virus to near-extinction, these circulating vaccine-derived polioviruses (cVDPVs) have emerged as the greatest threat to polio eradication. If the outbreaks are not stopped quickly, polio scientists warn, they could spiral out of control, setting eradication efforts back years.

“There is an urgency” to stopping these vaccine-derived outbreaks, says epidemiologist Nicholas Grassly of Imperial College London. “It is so much more important than controlling the wild virus.”

Safe and effective, OPV has long been the workhorse of the eradication effort. But a feature that makes the vaccine so powerful can also be a serious downside. For a short time after vaccination, the weakened live virus can spread from person to person, boosting immunity even in those who didn’t receive the polio drops. But in rare instances, in poor countries such as the DRC where many children have not been vaccinated, the virus can continue circulating for years, accumulating mutations until it reverts to its dangerous form. The vast majority of cVDPVs are caused by serotype 2, one of three variants of the virus.


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