GENEVA -- The ongoing polio outbreak which originated in northern Nigeria continues to infect new countries, underscoring the threat of a major epidemic across west and central Africa. Epidemiologists from the Global Polio Eradication Initiative have confirmed the re-infection of Guinea and Mali, as well as three new cases in the Darfur region of the Sudan.
Confirmation of one case in Guinea (date of paralysis: 5 June) and two cases in Mali (dates of paralysis: 15 May and 5 July) comes just two weeks after the resumption of polio immunization campaigns in the northern Nigerian state of Kano and re-affirms the need to urgently boost population immunity levels throughout the region. These new cases bring the number of previously polio-free countries to be re-infected since January 2003 to twelve.
Guinea and Mali are outside a ring of countries which conducted synchronized immunization campaigns in February and March, to try to limit the spread of polio from northern Nigeria and Niger. International concerns over the spread of poliovirus from northern Nigeria had prompted a decision by African Union health ministers in May to conduct a series of synchronized mass polio campaigns in 22 countries, including Nigeria and Niger, in October and November 2004. The new cases were reported as preparations for the campaigns, which aim to reach more than 74 million children under the age of five years, intensified. The Global Polio Eradication Initiative warned, however, that preparations for these activities, and additional synchronized rounds in 2005, are being seriously compromised by an ongoing funding gap of $100 million.
Although similar campaigns in 2000 and 2001 had stopped polio transmission in most of these countries, civil unrest in CÃ´te d'Ivoire and the Darfur region of the Sudan will make it particularly challenging to reach every child this year.
To give the upcoming campaigns the best possible chance of success, countries are being urged to step up surveillance for polio, increase routine immunization coverage and engage every level of society to support national immunization days.
The Global Polio Eradication Initiative is spearheaded by the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. The poliovirus is now endemic in only six countries, down from more than 125 when the Global Polio Eradication Initiative was launched in 1988.
The six remaining polio-endemic countries are: Nigeria, India, Pakistan, Niger, Afghanistan and Egypt. As of August 24, 2004, this year there have been 602 cases reported globally, in the following endemic countries: Nigeria (476 cases), India (34), Pakistan (23), Niger (19), Afghanistan (3), Egypt (1); and the following importation countries: Chad (12), CÃ´te d'Ivoire (9), Burkina Faso (6), Benin (6), the Sudan (5), the Central African Republic (3), Mali (2), Guinea (1), Cameroon (1), Botswana (1).
The polio eradication coalition includes governments of countries affected by polio; private sector foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. the World Bank); donor governments (e.g. Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Ireland, Italy, Japan, Luxembourg, the Netherlands, New Zealand, Norway, Portugal, the Russian Federation, the United Kingdom and the United States of America); the European Commission; humanitarian and nongovernmental organizations (e.g. the International Red Cross and Red Crescent societies) and corporate partners (e.g. Aventis Pasteur, De Beers, Wyeth). Volunteers in developing countries play the central role; 20 million have participated in mass immunization campaigns.