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Indonesia fights polio after first case in a decade

Public HealthMay 03, 05

An 18-month-old infant in Indonesia has contracted polio, the first case in the country in a decade and a fresh setback to the global drive to eradicate the disease, the World Health Organisation and Jakarta said on Tuesday.

Several other cases of paralysis in the same village in the province of West Java are under investigation, WHO spokesman Oliver Rosenbauer told Reuters.

A top Indonesian health official said a drive would be launched later this month to vaccinate more than five million children on the main island of Java within two months.

The polio case was found last month in a village near the city of Sukabumi and health officials have since vaccinated 4,000 children in the area, said Umar Fahmi, director general of communicable diseases eradication at the Health Ministry.

“We have taken samples from 115 children with a history of contact with the case and 13 of them turned out positive in carrying the virus,” Fahmi told Reuters by telephone from the West Java capital of Bandung.

He said those 13 children had not yet developed polio, a viral disease of the brain and spinal cord that can cause irreversible paralysis in a matter of hours.

Fahmi said the vaccination drive would be expanded if indications of other cases surfaced on neighbouring islands.

Indonesia is the world’s largest archipelago, with more than 17,000 islands. Its last polio case was reported in 1995.

The polio virus, which mainly strikes children under the age of five, is endemic in three Asian countries - Afghanistan, India and Pakistan.

But WHO officials in Geneva said the strain detected in Indonesia seemed to have come from the Red Sea area, where cases were recently found in Yemen and Sudan. The Red Sea virus originated in west Africa.

“We expect that it is an importation ... from the Red Sea area,” said WHO spokeswoman Christine McNab. “It looks like a virus from that origin (Red Sea) that can be traced back to west Africa.”

EPIDEMIC

The WHO’s campaign to halt transmission worldwide by the end of 2005 was dealt a severe blow in mid-2003 when Nigeria’s Kano state banned vaccines because Muslim elders said they were part of a Western plot to spread HIV and infertility.

Immunisation resumed last July, but the 10-month ban helped the virus reach epidemic proportions on the African continent.

Indonesia is the 16th previously polio-free country to be reinfected in the past two years, including 13 in Africa, according to the United Nations health agency.

On Friday, the WHO said that a polio epidemic had broken out in Yemen, infecting 22 children.

No fresh cases have been reported in Yemen, but genetic analysis of the virus has revealed that the outbreak is linked to neighbouring Sudan, Rosenbauer said.

Indonesia is the world’s most populous Muslim nation but government-led polio campaigns are popular, and Fahmi said clerics “do not see it as a problem.”

More than 70 percent of Indonesian children under one year have been routinely immunised. But a rate at less than 90 percent leaves a population at risk of an outbreak, experts say.

Indonesia does not have an emergency plan in place, according to the United Nations-led global polio eradication movement.

There were 1,267 cases of polio worldwide in 2004, up from 784 the previous year, according to the Geneva-based WHO, which says that it is short of funds to complete its immunisation campaign this year and continue it in 2006.

McNab said that the U.N. health agency still needed $50 million out of the $620 million sought for 2005, and a further $200 million for next year.



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