Guyana heightens polio surveillance after isolated case confirmed in Venezuela

Nov 01, 2018 News

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Guyana is currently one percent shy of achieving the recommended vaccination coverage needed to ward off the re-emergent of polio.

Based on PAHO/WHO statistics, Guyana, and three other territories – Trinidad and Tobago, Bahamas and Antigua and Barbuda – have 94 percent vaccination coverage.

In its polio coverage report, which highlights the state of coverage of 41 countries in the Caribbean and the Americas, a mere nine countries have achieved the PAHO/WHO 95 percent vaccination coverage or higher.

While the Cayman Islands has achieved 95 percent coverage and Costa Rica has 96 percent coverage, Saint Kitts and Nevis and Aruba have both attained 97 percent coverage. The report names Cuba as the territory with 98 percent coverage, while four other countries – Montserrat, Saint Vincent and the Grenadines, Nicaragua and Sint Maarten – top the list with 100 percent coverage.

But Guyana is well on its way to improving its coverage, says Maternal and Child Health Officer, within the Ministry of Public Health, Dr. Oneka Scott. According to Dr. Scott, primary among Guyana’s strategy is heightened surveillance. Through this tactical move, she anticipates that Guyana will be able to quickly detect any evidence of acute flaccid paralysis associated with the disease. This condition is one, which manifests with the sudden onset of weakness in any part of the body of a child younger than 15 years of age.

Poliomyelitis is a highly contagious disease caused by a virus that invades the nervous system, resulting in paralysis in a matter of hours. It mostly affects children under the age of five and is transmitted from person-to-person.

Guyana’s move to heighten surveillance comes on the heels of reports of a case of polio reported in neighbouring territory, Venezuela.  But Dr. Scott, in commenting on that situation, said that while Venezuela had reported a case which was confirmed as polio, that case was not endemic, but rather was vaccine-associated. “That was one isolated case, but we have stepped up our surveillance nevertheless.”

Her message as the public health sector implements measures to safeguard the nation is that “we have to work together for surveillance to be effective; we all have to be looking for people with the symptoms associated with polio.”

Just recently, PAHO/WHO issued an advisory, which urged countries to take immediate action to increase polio vaccination coverage to at least 95 percent, given the fact that a number of countries are below the recommended level.

But according to PAHO/WHO, the Americas have remained free from cases of wild poliovirus for 27 years, with the last case detected on August 23, 1991, in Peru.  The countries of this region were able to eliminate polio by achieving high rates of vaccination coverage of children and through sustained epidemiological surveillance to ensure early detection of any outbreaks.

“The Region of the Americas is polio-free, but as long as even one case of polio exists in any part of the world, we are still at risk,” said Dr. Jarbas Barbosa, Assistant Director of PAHO.

“By achieving and maintaining high vaccination coverage, and by strengthening epidemiological surveillance, we can make the dream of a polio-free future for the world, a reality,” he added.

Since recent reports show that countries are not maintaining the 95 percent vaccination coverage rate required at all levels to prevent polio transmission, this means that some communities are at risk of being unable to prevent an outbreak, should an imported case occur or if there is an emergence of vaccine-derived poliovirus [VDPV].

While there is no cure, the virus is preventable by vaccine. Polio vaccine, given multiple times, can protect a child for life.

In 1975, nearly 6,000 cases of polio were reported in the Region of the Americas, and in 1991, the last six cases were detected. Three years later, in 1994, the disease was formally declared eliminated from the Region. Since then, no child has been paralyzed by wild poliovirus in the Americas.

As the first region of the world to eliminate polio, the Americas, supported by PAHO, has led the way toward a world free from the disease.

PAHO is currently working with countries to ensure that every year more than 95 percent of children under the age of one are vaccinated against polio in every municipality in the countries of the Americas. Efforts are also focused on increased monitoring of cases of acute flaccid paralysis, and on meeting the requirements of the Global Polio Eradication Initiative, the Polio Eradication and Endgame Strategic Plan, and the Global Polio Eradication Certification Commission.

While polio cases have decreased worldwide by over 99 percent since 1988, from over 350,000 estimated cases to just 19 reported cases as of October this year, the threat will remain active once a single case exists, PAHO/WHO says.  This was emphasised by Cuauhtémoc Ruiz Matus, Head of the Comprehensive Family Immunization Unit at PAHO.

“There is no place for complacency when it comes to keeping the Americas polio-free,” said Matus.  He added, “Vaccination coverage rates must be increased immediately in order to protect the children of our Region from this deadly disease [because] as long as polio exists anywhere, it is a threat to children everywhere.”

The poliovirus can easily be imported into a polio-free country and can spread rapidly amongst unimmunized populations, which is why maintaining a high rate of vaccination coverage is so important.

However, today the world is closer than ever to achieving the goal of eradicating polio. Four of the six WHO regions have been certified as polio-free, and only one of the three types of wild poliovirus [type 1] continue to circulate in the world.

The hard work that has resulted in these achievements was led by the Global Polio Eradication Initiative, headed by WHO, Rotary International, the United States Centers for Disease Control and Prevention (CDC), UNICEF, and the Bill and Melinda Gates Foundation, in addition to the commitment and efforts from the countries themselves.

According to PAHO/WHO, global polio eradication will mean a disease-free world for future generations, as well as economic savings of between $40 billion and $50 billion. However, failing to meet the target of eradication would result in a re-emergence of the disease, with an estimated 200,000 cases every year around the world.

“With everyone’s commitment, poliomyelitis will be the first disease to be eradicated in the 21st century,” said Dr. Barbosa. “We must all take action now to protect our children.”

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