Two new cases of polio were confirmed to have paralyzed a 15-month-old boy and a 2-year-old girl in Nigeria, the World Health Organization announced on Thursday. The cases were the first reported in the region in two years. They came as a major blow toward global eradication efforts, sparked fear of an outbreak, and ignited an emergency vaccination effort in a region where the fundamentalist Islamist militant group Boko Haram has made it difficult to combat the disease.
“We’re anticipating that there may well be more than two cases,” Stephen Cochi, a senior polio program scientist at the Centers for Disease Control and Prevention, told STAT News. “We have to be prepared for additional cases and perhaps the possibility that there’s a larger geographic extent to this outbreak.”
More from the science publication:
The cases were found in Borno, a state in northeastern Nigeria. The Islamic extremist group Boko Haram is active in Borno, and the instability in the region has meant as many as a half-million children have been out of the reach of polio vaccination efforts for the past two years, Cochi said.
Often in conflict zones the polio program has been able to negotiate so-called days of tranquility, where combatants put down their arms to allow for the vaccination of children. That has not been possible in Borno.
“Boko Haram is so demonstrably anti-Western in every way, shape, and form, whether it’s education or health care, that there’s no negotiating days of tranquility with Boko Haram,’’ Cochi said.
Only an estimated 1 in 200 cases of polio lead to paralysis, which means that there are likely more infections yet to be discovered. In order to combat the disease, an emergency vaccination campaign will try to target 1 million children starting as early as next week and could ultimately cover 5 million children across the region.
The logistics of the campaign will continue to prove difficult, however, because of Boko Haram. Michel Zaffran, director of polio eradication for the World Health Organization, told Time that his group would use a “hit-and-run” strategy to try to quickly move in and out of the affected areas.
“This is when we sent the vaccination teams in a very quick manner to access the children,” he explained. “It is very tricky in some areas but in the past we have been able to use it.”
As NPR reported, the news comes just as it seemed polio might be eradicated for good and in a place that had been “the Achilles’ heel of polio eradication in Africa” in the past:
Prior to this week the polio virus appeared to be on the verge of defeat: Afghanistan and Pakistan were the only countries reporting ongoing transmission of the virus. Including these two children who’ve been paralyzed in Nigeria there’ve been only 21 polio cases reported anywhere in the world this year.
A decade and a half ago, religious leaders in some parts of Nigeria actively denounced polio vaccination as part of a Western plot to sterilize Muslim children.
Even as other nations on the continent wiped out polio, Nigeria served as reservoir where the virus survived, sparking outbreaks throughout West Africa as travelers moved throughout the region.
Just 4 years ago Nigeria accounted for more than half of all the polio cases reported worldwide—122 of the 223 global cases in 2012. Up until this week it appeared that Nigeria had successfully eliminated polio and was on track to be declared polio-free by the WHO next summer. It takes 3 years without a case to be eligible for the designation.
In 1988, when the Global Polio Eradication Initiative was set up by a number of major disease control and charity organizations, more than 125 countries had cases of polio. After that number dropped to two countries, it’s now back up to three and terrorism is largely to blame.