Bangladesh launches mass immunization campaign after polio re-emerges
By Zafrin Chowdhury
CHANDPUR, Bangladesh, 13 April 2006 – After a five-year absence, polio has re-emerged in Bangladesh, sending a fresh alert and boosting eradication efforts across the country. But the national initiative to stop the crippling waterborne disease came too late for nine-year-old Rahima Akhter in the town of Chandpur.
Rahima woke up one recent morning and could not get out of bed, nor move her limbs. Her mother, Tahmina, wondered whether this was caused by a table accidentally falling on Rahima the day before, or perhaps the cold air in which she played after school.
In the days that followed, Rahima felt intense pain in her body and could not bear to be touched. She barely ate and just lay in bed. Tahmina was constantly with her, turning her from one side to the other, carrying her to the toilet, trying to feed and comfort her.
The Global Specialized Polio Lab in Mumbai, India confirmed the re-emergence of the polio virus P1 on 8 March. “It was the last thing on my mind,” said an aggrieved Tahmina. “I knew of polio but thought Bangladesh had become polio-free.”
Polio remains a threat
Two days before Rahima fell ill, the family had returned home after attending a wedding in Pirojpur district, where the large extended family gathered from all around the country. Experts identified the P1 virus that infected Rahima as a strain found in Uttar Pradesh, India. Some analysts believe the large and porous border shared with India poses a significant threat to Bangladesh with regard to polio.
An infectious waterborne disease, polio can spread rapidly through human faeces. It can affect people of any age, but children under five are the most vulnerable – comprising about 50 per cent of all cases. The virus invades the nervous system and can cause irreversible paralysis within hours, mostly in the legs, and without any sign of prior illness.
Although paralysis is the most acute and visible sign of polio infection, less than 1 per cent of polio infections ever result in paralysis. The World Health Organization (WHO) considers a single confirmed case of polio paralysis as evidence of an epidemic, especially in countries where few cases occur. There is no cure for polio, only prevention through immunization.
Attention, care, and some therapy have led to improvements in Rahima’s condition. Now she can move her hands and feed herself, but her legs have shrivelled and remain numb. She is hopeful that her legs, like her arms, will get better.
“I want to walk again and go to school,” said Rahima, who is a student at the local Madrassah, or religious school. “It is not far from home. My roll number is one as I am at the top of my class. I would like to get a degree, and get a job when I grow up, and support my parents.”
National Immunization Days
Meanwhile, just two miles away from Rahima’s home, 21-year-old Mukta Begum stood in line with her two-year-old son Nayeem at a local health clinic. She was waiting for him to get drops of the oral polio vaccine.
Ms. Begum had heard about Rahima’s case, “Not only does such an incident in our area sadden us, it makes me scared about my own children,” she said. “I realize even more the importance of immunizing my children.”
Bangladesh’s latest polio outbreak has sparked an urgent new effort by the Global Polio Eradication Campaign – a partnership between UNICEF, Rotary International, WHO and the U.S. Centres for Disease Control – working closely with the government. Their ambitious goal is to reach 18 million children under the age of five through three rounds of National Immunization Days on April 16, May 13 and June 11.
Twenty four million doses of vaccine have so far been procured for this effort. A huge communication and social mobilization drive is under way, broadcasting polio immunization messages through the mass media, distribution of printed materials and door-to-door, interpersonal communication targeting parents and caregivers.
UNICEF Representative in Bangladesh Louis Georges Arsenault noted that Bangladesh has come a long way in polio eradication thanks to its relentless efforts.
“This has been one of the best examples of a nation standing as one to immunize its children against the disease,” said Mr. Arsenault. “The central challenge now is to sustain the momentum. For as long as one transmitter of polio virus remains anywhere, all children will be at risk – and until that last child is reached, the task is not completed.”
UNICEF takes pride in its deep involvement in the polio eradication initiative, explained Mr. Arsenault. “We hope that our partners will make a significant and sustained contribution in child survival and health in Bangladesh,” he said.