Rotrians updated on polio eradication program

By Staff, 08/13/19 1:49 PM

PRESCOTT – Dr. Jennifer Dillaha, medical director for the Arkansas Department of Health’s immunization program, updated the Prescott Rotary Club on efforts to eradicate polio.

One of Rotary’s goals is to get rid of polio in the world. Dr. Dillaha reminded the club polio is highly contagious, can cause paralysis and death. It’s a viral disease that can be contracted by contact with fecal matter or through the air. However, she pointed out not everyone who gets polio winds up paralyzed. At times, she said, most people only think they have a bad cold or the flu when they’re infected. Only one in 200 who get polio are paralyzed.

The problem, she continued, is polio can be spread and not be recognized because it doesn’t always present with symptoms. The first outbreak in Arkansas was in 1936 when 334 cases were found. The Arkansas Legislature established what became the Department of Human Services to help combat the disease in children. The state’s worst outbreak occurred in 1949 with 992 cases. Those, Dillaha said, were scary times, as strict curfews were imposed on children. Children weren’t allowed to play in public pools or venture more than a few blocks from their home. The biggest outbreak nationally, she said, occurred in 1952.

The last case in Arkansas was diagnosed in 1973, and in 1979 in the United States. It was eradicated in the Western Hemisphere by 1991, she said.

The first line of defense came in 1952 with the development of the Salk vaccine which was initially tested on 1.8 million children. This vaccine was primarily given as drops on a sugar cube. The vaccine was officially licensed in 1965. The second vaccine developed is the Sabin vaccine, an injection, she said.

Dillaha told the club members there are three types of polio, Type I, II and III. All types are included in the vaccines. The drops were initially preferred because they were much cheaper than the vaccine and also surpress replication of the “wild” virus in the digestion system, whereas the injected vaccine is eliminated from the body in the stool. The downside of the vaccine, she added, is the virus mutates and can end up causing nerve damage and paralysis.

“It’s important to keep the immunization rate high,” she said. She reminded the group in the 1980s Rotary International (RI) went through a shift where it was decided all clubs should work together and have a global impact on things. To do this, RI started the 3-H program, Health, Hunger and Humanity, with a chairman for each “H”.

A feasibility study was done in 1979 concerning polio when RI took $750,000 of polio vaccine to the Philippines to immunize children. It proved to be successful and overall $6.3 million was spent in the island nation. From there RI did this project for five other countries.

Eradicating polio became the focus for Rotary International. It’s worked to get vaccine to children in all 166 nations in the world and succeeded in doing this in 1988. However, there have been problems as some groups, such as the Taliban, began spreading disinformation about the vaccines, claiming they were designed to sterilize people. Dillaha said in some instances vaccine repositories have been blown up and volunteer workers killed.

Eradicating polio is an expensive initiative, she said. RI has contributed $1.8 billion over the years, with other countries adding another $9 billion. Polio, she continued, can be eradicated as it’s only found in humans, just like the measles. Vaccines are effective against all types of polio.

Currently, she added, there are three countries where polio hasn’t been eliminated and one, Nigeria, could come off the list soon. The other nations are Pakistan and Afghanistan. Dillaha said anyone crossing the border between Pakistan and Afghanistan is automatically vaccinated. Type II polio, she told the club, hasn’t been seen since 1992 and is considered gone. Type III hasn’t been seen in several years and may soon be removed from the list.

The biggest problem in getting the vaccine where it’s needed, she said, is the infrastructure of many countries. At last count 60 cases have been identified this year worldwide, but there have been outbreaks in 12 countries, with 13 key countries considered to be at risk.