Europe at 'polio risk' from Syria

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Europe could be at risk from polio following a recent outbreak in Syria, infectious disease experts say.

In the Lancet journal, two doctors in Germany say the cases in Syria - which had been free of wild poliovirus since 1999 - could endanger nearby regions.

They say because only one in 200 people infected develops paralysis it could take a year of "silent transmission" before an outbreak is detected.

In that time hundreds of individuals could be carrying the infection.

Prof Martin Eichner, of the University of Tubingen and Stefan Brockmann, of Reutlingen Regional Public Health Office explain that most European countries use inactivated polio vaccine (IPV) rather than the live oral polio vaccine (OPV), because the latter can, in rare cases, lead to cases of acute flaccid paralysis, the main symptom of polio.


Whilst IPV is highly effective at preventing polio disease, it does not give the same level of protection against the virus as the oral drops, so vaccination coverage needs to be very high. The doctors say that countries with low coverage such as Austria (83%) and Ukraine (74%) risk a sustained outbreak should the virus be introduced via refugees fleeing Syria. Polio vaccine coverage in the UK is at 95%.

The doctors said Israel could also pose a potential polio threat.

Prof Eichner told me: "Wild poliovirus has also been found in sewage in Israel and from samples taken from some symptom-free individuals since February 2013. Although there have been no cases of polio in Israel, tourists could risk bringing the infection to other countries."

Dr Benjamin Neuman, a virologist at the University of Reading, said: "The Syrian outbreak puts Europe at risk because of the way we give vaccines. In parts of the world where it is still possible to catch a wild strain of poliovirus, children are usually vaccinated with a live but genetically weakened poliovirus which gives excellent protection but has a tiny risk of changing back to the more dangerous form.

"However, in parts of the world where polio has been eradicated, like the UK, children are usually given a killed vaccine. It doesn't protect quite as well but it cannot mutate, so it protects reasonably well while preventing polio from being accidentally reintroduced to a country.

He added: "Vaccination is never perfect, so despite being vaccinated, a small percentage of children in the UK would be at risk of contracting polio if they were exposed to the virus. Until the virus is completely extinct, it is essential that we continue to vaccinate our children."

The Department of Health Director of Immunisation, Professor David Salisbury said:

"The UK is well defended against the possibility of importation of polio from outbreaks such as the present one in Syria. Our population has very high coverage of polio vaccination with more than 95% of young children being vaccinated. We have WHO-approved surveillance in place so we can pick up polio if it does start to circulate in the UK."

'Invisible enemy'

Most of the 22 cases of polio-like paralysis in Syria (10 of which have been confirmed as wild poliovirus type) are among children below the age of two who were unimmunised or who had not received all three doses of vaccine.

The World Health Organization warned last month there was a high risk of polio spreading internationally because of the movement of refugees across the region and low immunisation rates in Syria.

Prof Eichner said: "The WHO wants to get rid of polio completely and had got pretty close until recent outbreaks. The fact that most of those infected do not display symptoms but can still spread the disease makes it a very hard virus to get rid of as it is like fighting an invisible enemy."

So far this year 322 cases of wild poliovirus have been confirmed, more than half of them in Somalia.

Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this

    Comment number 456.

    @ 454. cray74 "Those who ignore history are doomed to repeat it."

    That is a good saying, yes, if we ignore the stories of Thalidomide and other Big Pharma scandals, we are doomed to repeat the same mistakes, in fact we are repeating them as the majority of people are getting vaccinated with untested vaccines which have unknown long-term effects; effects for which there is no tracking system.

  • rate this

    Comment number 455.

    To add to the below, the incredibly low % who are paralyzed by Polio were malnourished had no tonsils.

    If you have tonsils you are protected from Polio, that is why the majority of people show no symptoms of Polio; the antibodies to Polio live in the tonsils. Tonsils are part of the lymphoid system that supports the body's immune response

  • rate this

    Comment number 454.

    The article and the comments on it truly seem to support the saying, "Those who ignore history are doomed to repeat it."

  • rate this

    Comment number 453.

    @ 452.bionicbadger

    This is misinformation, in 95% of all polio cases the person has no symptoms at all; they don't even know they've got it. The other 5% of polio cases can be divided into three groups:-

    1. Abortive polio: Mild illness

    2. Non-paralytic polio: As above but with light sensitivity and neck stiffness

    3. Paralytic polio: Majority fully recover, small number left with paralysis

  • rate this

    Comment number 452.

    Health immune systems are important, but do little against viruses such as polio. Even the best-off people -- including a POTUS -- were reduced to cripples by the likes of polio. I hope your healthcare providers are willing to cough up for your iron lung if you choose to descend down the road of backwardsness because of complacency and short-term memory.

  • rate this

    Comment number 451.

    448 concerned "all it would take is a few years of nobody taking vaccines"

    Big Pharma rewrite history, they tell us that vaccines saved us from childhood disease. It's marketing for them; business

    The reality is rather different, death from childhood disease reduced before mass vaccination due to improved nutrition and sanitation. The Immune systems of healthy people are far superior to vaccines

  • rate this

    Comment number 450.

    4 years ago it was the Bird Flu and all sorts of reports of our impending doom. The Swine Flu, Sars and a variety of others. Just the world we now live in....over populated with many living in a germ free world of sprays, soaps, etc., and others living in abject poverty of dirty water, poor nutrition and unsanitary conditions. Too bad there isn't a vaccination preventing stupidity, greed.

  • rate this

    Comment number 449.

    Vigilance is the key word. European health authorities have a task to fulfil. Medical science has advanced so much. No outbreak of polio should ever takes place. A health watchdog is necessary making certain that vaccines are readily available and properly administered by competent medical staff. The outbreak of polio in Syria should be a timely warning. There should be no room for complacency.

  • rate this

    Comment number 448.

    447. David Cohen
    In the first world it's a lot harder to justify the majority of vaccines
    all it would take is a few years of nobody taking vaccines e.g. in the UK for preventable diseases to spread and cause a lot of death/suffering of population.
    You are lucky to even utter those words because your country has successful vaccination program for its citizens over the years.

  • rate this

    Comment number 447.

    It's wrong to be 100% pro-vaccine or 100% anti-vaccine, specific vaccines like Single Measles clearly help in the third world. In the first world it's a lot harder to justify the majority of vaccines, but they get pushed on us as we have more expendible income compared to those in the third world

    Here's an award-winning documentary which gives both sides

  • rate this

    Comment number 446.

    Are you willing to put pharma manufacturers and government health officials in the driver’s seat when it comes to your health or that of your children? Are you willing to trust the words of ad campaigns built on half-truths and questionable research? Are you willing to blindly trust government health officials who get their advice from ‘experts’ with a financial stake in the vaccine game?

  • rate this

    Comment number 445.

    We are told by Pharma that we have to care about Polio because they have vaccines to sell, these vaccines are known (even the WHO admit) to spread Polio

    When 50,000 people are left paralyzed by a vaccine in India (2010), it is kept out of the Western media under the law of 'Responsible Journalism'

    The BBC/Pharma pretend to give us health info but in reality they are marketing dangerous products

  • rate this

    Comment number 444.

    All the more reason to require proof of vaccination against certain diseases of anyone wishing to enter the country for an extended period.

  • rate this

    Comment number 443.

    ..innocent children&general Eu pop. hv nothing 2do w/ govt action
    they vote for &tolerate them..Why shld children of Syria suffer for 'democratic' whim of West?..culmination of 12yr imperial aggression
    Prob. >50% of pop. per EU country DIDN'T vote for govt in power

    Only 12yrs imperial aggression? Seems limited understanding of Eu (& later US) meddling; better figure >100yrs..

  • rate this

    Comment number 442.

    439. HackToff

    Until the civil war Syria, a Muslim country, had a better polio vaccination rate than the UK. 96% to our 95%. It has dropped to 60%, for obvious reason.

    The regions where polio is still present / endemic also happen to be war-torn.

    The Taliban, in Pakistan, have attacked some polio vaccination teams, because the CIA used a polio team as cover for its own agents and got caught.

  • rate this

    Comment number 441.

    @412.RayBoothby more than Eu deserves..meddling in other countries affairs etc

    Hopefully..make gung-ho pro-militarists think about suffering of others in more general sense than war-hungry BBC headline
    No US share of blame for meddling?
    What about uprising countries' own propensity for sectarian conflict - don't blame Europe for medieval-origin Shiite vs Sunni wars

    Agree on pt.2 tho

  • rate this

    Comment number 440.

    Another reason to shut the gates. An they claim we are safer in the EU. These people lie an know we are not, it's a population reduction program planned by the cooperation Bilderberg shadow government an don't worry they have hide out's the will protect them from the evil they have planned. They should be removed now an arrested for crimes against humanity.

  • rate this

    Comment number 439.

    Let me try again to pass moderation of the BBC's thought police.
    There is clear correlation and, as I assert, a causal link between islam and the prevalence of Polio. See; and
    This is germane to the topic in hand as are other atrocious religious practices. Print or be damned BBC.

  • rate this

    Comment number 438.

    why so many refugees->Eu?..better off in country sharing culture eg Saudi etc
    Better benefits
    Freedom frm oppression-> attempts by some to pressure host soc. into same as previous oppressor

    Yemen cldn't cope
    Iran might take Shiites,but not opposition,nor Christians
    Sunni refugee plight prob. suits rich Saudi/Gulf govts as a stick to beat Assad w/,like P/tinian refugee camps vs Israel

  • rate this

    Comment number 437.

    435. Bubonic

    The anti-immunisation brigade would have been telling you in the time of Edward Jenner that vaccinating (vache inating) people with cowpox to protect against smallpox would give you large horns and udders.

    Fact is the decision to vaccinate is always a balanced one, weighing risk from the vaccine against risk from a serious disease. Inactive polio vaccine, is a no-brainer. Do it.


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