Aging Begins at 30

At War Against Disease

There is a war on and we are winning. The war started in 1988 and is being waged by WHO, UNICEF, the Danish and Norwegian governments, NGOs, Rotary International, local governments and other organizations. The war is against the poliomyelitis virus. There has already been a 96% decrease in cases reported worldwide and the last case in the Western Hemisphere was a 3-year-old boy from Peru in 1991. Southeast Asia now accounts for 70% of the worldwide burden of paralytic poliomyelitis.

The war to eradicate small pox was won in 1979. The war for poliomyelitis eradication by the year 2000 is being fought. Control in Asia has involved vaccinating 83 million children in a single day in China and 88 million in one day in India. National immunization days are planned in 24 countries. Laboratory facilities to confirm cases and surveillance systems to identify them are being developed throughout Asia. Over 150 countries (three-quarters of all countries) now report zero polio cases.

I remember looking after acute polio in the early 1950's but the time will come when parents need have no fear of crippled children and when the $200 million or more spent on polio prevention can be spent on other health priorities. The USA, for example, spends more than $105 million a year on polio vaccine alone. I have looked after elderly polio survivors who, despite major residual paralysis, were able to have meaningful lives, but a few have post-polio syndrome decades after the initial infection. Let's hope that this is truly a thing of the past.

The program is built on high immunization rates with oral poliomyelitis vaccination, introduced in 1961, and careful surveillance to detect acute limp (flaccid) paralysis in all children under age 15 with confirmation by analysis of stool specimens for the virus. There also needs to be a massive response when any wild polio virus is isolated with "mopping up" vaccination campaigns. There is no non-human animal reservoir for polio, but it can survive in sewage for up to three months. Oral polio virus has one rare but significant side effect, vaccine-associated poliomyelitis at a rate of one case for every 2,500,000 vaccinations.

The target is to eradicate poliomyelitis worldwide by the year 2000. The worldwide 85% vaccination rate has to be improved. Worldwide cases of paralytic poliomyelitis have fallen from an estimated 600,000 yearly to 1,200. Global polio eradication will cost $1,000 million. The total cost of eradication could be recovered in savings within a few years of certification that the world is polio free. The disease, however, still exists in West and Central Africa as well as India, Pakistan, Myammer, and in Chechnya. The obstacles to polio eradication include war, civil disturbances, and social and economic change but temporary peace was declared in Angola, Afghanistan, and Ethiopia specifically to complete vaccination campaigns.

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See related Patient Topics Immune System/AIDS, Immunization/Vaccination or Infections.

See related Provider Topics Immune System/AIDS, Immunization/Vaccination or Infections.

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