When the worldwide campaign to eradicate polio was launched in 1988, the disease was circulating freely in 125 countries and some 350,000 people were infected. By the end of 2001, the circulation of the virus had been reduced to 10 developing countries and fewer than 500 cases.
Bob Keegan, acting director of the global immunization division at the Centers for Disease Control and Prevention in Atlanta, Georgia, says: "The global polio eradication initiative has reduced cases by more than 99%. And where in 1988 approximately 1000 children a day were paralyzed from polio virus, now we are looking at, this year, probably less than 1000 for the entire year."
Mr. Keegan says the goal of eliminating polio by 2002 was achieved throughout the Western world. (The last polio case in the United States was recorded in 1979.) But the disease continues to plague some developing countries in Asia and Africa.
"In 2003, we've had the largest number of polio cases reported from Nigeria," says Bob Keegan. "This is a dramatic change from previous years. In previous years, India was the number-one country for reporting polio cases. In fact, in some years they've had as much as 80 percent of the world's burden of polio in India. But this year India seems to have turned the corner and there has been a very sharp reduction in the number of cases from last year in India, and Nigeria is experiencing an epidemic, particularly in its northern states, so that Nigeria now has more cases than India and Nigeria is the number-one country in the world in terms of the number of polio cases being reported this year."
The polio virus lives in the intestines and is spread by contact with fecal material. This is a problem especially in countries with poor sanitation and a shortage of clean drinking water. The virus attacks nerves that control movement and causes paralysis. It usually afflicts children younger than five. In some cases, the disease is fatal and in rare cases patients recover. While polio cannot be cured, it can be prevented with vaccination. In 1988, four international groups - The World Health Organization, UNICEF, Rotary International and the Centers for Disease Control and Prevention - launched a global campaign to rid the world of the disease. Its success has been enormous, but not complete. Recently, polio has begun to spread from northern Nigeria to the neighboring countries of Togo, Burkina Faso, Ghana and Chad.
Dr. Mansur Kabir, Commisioner of Health in the northern Nigerian state of Kano, cites several reasons for the current polio epidemic in his state: "Kano state has a population of over 17 million people tightly packed in a very narrow area. Secondly, there is a lot of poverty in the society, and in addition to that our routine immunization has virtually collapsed. When we looked at our figures for polio routine immunization, we were able to cover maybe 10 to 15% of the children. So you can see that about 80% of our children go without immunization."
Dr. Kabir says the same ratio of children is at risk from other fatal diseases, such as malaria and whooping cough, due to poor nutrition and unsanitary living conditions. Infant mortality is extremely high in the State of Kano. A shortage of funds is the main reason many children escape routine vaccination.
"But I think another reason why we continue to have the wild polio virus is because we have a population that is not educated and that is skeptical about immunization,? says Dr. Kabir. ?A lot of rumors are going around and a lot of children have not been available for immunization because the parents don't believe it is good for their children."
Most of the population in northern Nigeria, including the states of Kano, Zamfara and Kaduna, is Muslim. Last month, when world organizations raced to immunize some 15 million African children at immediate risk of contracting the virus, some conservative Muslim families refused to have their children vaccinated. Rumors that the Western world is trying to wipe out Muslims through HIV infected vaccine, or vaccine that causes infertility, have compelled the Nigerian government to analyze the content of the serum to make sure it is safe.