Polio outbreak reported in southern Madagascar

The Malagasy government and its UN partners are to launch a door-to door immunisation campaign after two cases of polio were reported in southern Madagascar in the last few weeks. Oliver Rosenbauer, a spokesman for the polio eradication initiative of the World Health Organisation (WHO), confirmed that the cases were "vaccine-derived" and had been contracted from the weak live polio virus in the oral vaccine given to children. "These cases are very rare," he pointed out. The Ministry of Health, WHO and the UN Children's Fund (UNICEF) have intensified medical surveillance in the southern province of Toliara and neighbouring districts. "We will be conducting a door-to-door campaign in 27 districts," said Barbara Bentein, UNICEF's resident representative. "Madagascar was going to qualify for polio-free status," she commented. The last polio outbreak in Madagascar was reported in 2002. At an inter-agency coordinating committee meeting earlier this week, the government and its UN partners decided to hold national immunisation days in the next two months, covering at least 600,000 children aged under five in Toliara's 21 districts as well as six other districts bordering the province. Five cases of acute flaccid paralysis, "associated with strains of polio virus derived from oral polio vaccine", were reported in southern Madagascar in 2001/02, according to the L'Institut Pasteur in Paris. Although no case of the disease due to a wild polio virus has been detected in Madagascar since 1997, L'Institut Pasteur researchers said those associated with the virus derived from the oral vaccine made eradication "more complex", and had an implication for vaccination campaigns. Rosenbauer said because of the possible - though remote - threat of contracting polio from the vaccine, it was WHO's policy that "eventually all polio vaccines will be stopped, once the disease has been eradicated".