Polio hits Darfur as experts warn of largest epidemic in recent years

Epidemiologists warned on Tuesday that west and central Africa were on the brink of "the largest polio epidemic in recent years", as confirmation was received that the Darfur region of western Sudan had been reinfected. A five-year old child in Darfur was on Monday confirmed to have been paralysed by the same polio virus that was endemic to northern Nigeria, Oliver Rosenbauer, a spokesman for the World Health Organization (WHO) told IRIN. The virus had spread from Nigeria into Chad, which was reinfected in 2003, and into western Sudan, he added. "At the moment there are no other cases in Sudan but we are concerned that the virus could reestablish itself through secondary infections or further importations of the virus as people travel." Since last year, 22 cases had been reported in Chad, Rosenbauer told IRIN. Sudan had been free of polio since 2001 when the last case was found in the south. Available data showed that transmission of the wild poliovirus was continuing to accelerate "at an alarming rate in the region", said a joint press release from UN agencies, Rotary International and the Centre for Disease Control. "In addition to the reinfection of the Sudan, five times as many children in west and central Africa have been paralysed by polio so far in 2004 compared to the same period in 2003." Some 197 children, it added, had been paralysed in Nigeria, following the suspension of polio immunisation campaigns in the north of the country late last year. "The fact that the Sudan is now reinfected is concrete evidence of the need to support a massive immunisation response right across west and central Africa," said communicable disease expert Dr David Heymann, the WHO's Representative for Polio Eradication. Heymann said that the reinfection of Sudan was the latest setback to the strong progress Africa had achieved in eradicating the virus. "At the beginning of 2003, only two countries in sub-Saharan Africa were polio-endemic. Today, however, Africa accounts for nearly 90 percent of the global polio burden, with children now paralysed in 10 previously polio-free countries across the continent." Epidemiologists fear that a major epidemic this autumn, during the polio "high season", could leave thousands of African children paralysed for life, according to the press release. Children were particularly vulnerable in west and central African countries, surrounding Nigeria, as less than half of them were routinely immunised against a series of diseases, including polio, it said. In response to this threat, experts have recommended plans to hold massive, synchronised immunisation campaigns across 22 African countries in October and November, aiming to reach 74 million children. These campaigns could avert a public health tragedy. Recognising that the northern Nigerian state of Kano remains the epicentre of the outbreak, federal and state authorities are working to resolve a local controversy over the safety of the polio vaccine which had led to the suspension of campaigns in that area. In May 2004, Kano state authorities announced that it would soon restart polio immunisation activities. The Global Polio Eradication Initiative is spearheaded by the WHO, Rotary International, the US Centre for Disease Control and Prevention and the UN Children's Fund. The poliovirus is endemic in only six countries, down from over 125 when the Global Polio Eradication Initiative was launched in 1988. The six are: Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan. There is no cure for the virus, which is passed on through contact with contaminated water or stool along the oral-fecal route, but about 10 percent of cases make a complete recovery.