POLIO cases drop as eradication effort moves into final stretch

Saturday, May 19th 2001, 12:00 am
By: News On 6

GENEVA (AP) _ The worldwide prevalence of polio has hit an unprecedented low, with the number of cases cut in half between 1999 and 2000, World Health Organization scientists said Friday.

As a result of an intense push to eradicate the last remnants of the crippling disease, the number of countries where polio is endemic plummeted to 20 from 50.

``We have forecast that by the end of this year, less than 10 countries will remain endemic for polio virus and within two years, we will be down to zero,'' said Dr. Bjorn Melgaard, director of vaccines and biologicals at WHO.

``We already may have eradicated one of the three virus types causing polio,'' Melgaard said. The type II polio virus was last detected in October 1999. After a year of silence, a virus type is usually considered to have died out, experts say.

Type II is far more likely to lead to paralysis than other polio virus types, said Dr. Bruce Aylward, coordinator of WHO's polio program. While the other two types give polio-infected children a one in 1,000 and one in 200 chance of becoming paralyzed, type II paralyzes about one in 100 children it infects, he said.

The eradication initiative is a joint project of WHO, the U.N. Children's Fund, Rotary International and the U.S. Centers for Disease Control and Prevention. It aims to certify the world polio-free by 2005.

The effort, launched in 1988, was intensified in 1999. The number of WHO staff working in polio-stricken countries swelled from 200 in 1999 to about 1,600 in 2000. There were more national immunization days and health workers went door-to-door with vaccines.

Polio is a highly infectious disease that usually strikes children under 5. It damages the spinal cord and brain, causing paralysis and sometimes death. It is transmitted by ingesting food or water contaminated by fecal matter of an infected person.

Since the effort to eradicate polio began, cases have fallen from 350,000 in 1988 to 2,870 in 2000, a reduction of 99 percent.

Success is particularly apparent in India, historically one of the worst places for polio.

``In India, we are certainly very, very close,'' Melgaard said. ``In 1998 nearly 2,000 cases were identified, basically all over the country. In 1999 this got more concentrated to the very populous states. In 2000, only 265 cases were reported and so far this year, with an extremely top-notch surveillance system, only 10 cases have been reported.''

However, WHO officials said it will take another $400 million to stamp out the disease, which still lurks in Southeast Asia, the eastern Mediterranean and Africa.

On Thursday, WHO officials disclosed the first polio cases in Europe since 1998, both in Bulgaria. One victim, a 13-month-old baby, was diagnosed in April and the other, a 2-year-old girl who suffered paralysis of both legs and her left arm, was identified on Tuesday. Both children are members of Roma, or Gypsy, communities.

A vaccination campaign announced after the cases were disclosed was delayed Friday because there were no vaccines in the country. A Bulgarian Health Ministry official said about 800,000 doses of polio vaccine were due to be imported within days.

``The funding gap is the most critical inhibitor to a successful eradication at this point in time,'' Melgaard said.

One of the major challenges is to reach children in war-torn countries. On Friday, the office of the U.N. Coordinator for Afghanistan called for a cease-fire in Afghanistan to allow the next polio campaign to go forward over the weekend. About 5.7 million Afghan children have yet to be vaccinated, officials said.

Once the world has been declared free of polio, experts must then decide how and when to stop vaccinating children.