Polio in Ivory Coast Started in Nigeria, Tests Confirm

Laboratory tests have confirmed that Nigeria was the source of the virus that caused a case of polio in Ivory Coast, the director of the World Health Organization’s polio eradication program said here on Sunday.

Laboratory tests have confirmed that Nigeria was the source of the virus that caused a case of polio in Ivory Coast, the director of the World Health Organization’s polio eradication program said here on Sunday.Ivory Coast is the eighth previously polio-free country in Africa where the crippling disease has reappeared in recent months. Its last polio case was reported in July 2000.Nigeria is believed to have also exported the infections to the seven other previously polio-free African countries: Benin, Burkina Faso, Cameroon, the Central African Republic, Ghana, Togo and Chad. The World Health Organization says the exported cases and continued opposition to polio vaccination by religious and political leaders in the northern states of Nigeria are jeopardizing its efforts to eradicate polio by the end of this year.But Dr. David L. Heymann, the director of the polio eradication program, expressed optimism at the opening of the Fourth International Conference on Emerging Infectious Diseases and in interviews that the disease would be eradicated by early next year at the latest. If that happens, polio and smallpox will be the only naturally occurring diseases to be wiped out.Success depends largely on how northern Nigerian officials interpret the findings of laboratory tests of the polio vaccine now being completed in India, Dr. Heymann said.Opposition from religious and political leaders in the north of Nigeria has forced the suspension of an immunization program being conducted in Nigeria and other countries in Africa where polio is endemic or has been spread in recent months. Hundreds of thousands of volunteers bearing droppers of vaccine fanned out across those countries in an emergency program synchronized by the World Health Organization. The program aims to vaccinate 63 million children under the age of 5.Nigeria is Africa’s most populous country. Critics of vaccination in the north of the country have charged that polio vaccine makes girls infertile and that the health organization and Western countries are using it to reduce the Muslim population. The organization, a United Nations agency based in Geneva, has rejected the charges.Dr. Heymann said the vaccine being used in Nigeria and elsewhere in Africa was the same one that reduced the incidence of paralytic polio to less than 758 cases in 2003. Nigeria accounted for 347 of those cases.When the health organization began the program in 1988, there were 1,000 cases a day, Dr. Heymann said. Polio can spread readily as long as there is a single case anywhere.Dr. Heymann said Unicef bought the polio vaccine and used only a product that met specifications approved by expert committees appointed by United Nations agencies.Nigeria sent the vaccine to South Africa for testing. Although the tests found no elements of hormones or infectious agents other than the Sabin polio virus used in the oral vaccine, Dr. Heymann said, they did not satisfy the critics. So a second set of tests is being performed in India. The Nigerian government has also sent a 23-member team, including Islamic scholars, to India and Indonesia to discuss concerns about the vaccine, Dr. Heymann said.A problem, he said, appears to be results from one test that some Muslim officials have interpreted as showing female hormones in the vaccine. He said the findings were nonspecific and not a true indication of the presence of hormones.Islamic countries elsewhere in the world have vaccinated against polio, including Nigeria’s neighbor Niger, a largely Muslim country, which led a vigorous vaccination program last week, Dr. Heymann said. In January, health ministers from six countries where polio is now spreading said they would intensify efforts to immunize 250 million children against the disease by the end of this year. To meet the goal, Dr. Heymann said, “it’s clear the solutions have to come from Nigeria.”For the first time, Dr. Heymann said, there are more countries where polio has reappeared after it was eliminated than countries where it remains endemic.The countries with endemic polio are Afghanistan, Egypt, India, Niger, Nigeria and Pakistan.(Source: New York Times Health News, Feb 2004)