Nigeria Is On The Verge Of Bidding Goodbye To Polio

Feb 12, 2015
Originally published on February 13, 2015 6:29 pm

Nigeria, Pakistan and Afghanistan are the three countries where polio transmission has never been brought to a halt.

Now Nigeria may be leaving this unfortunate club.

In 2006 the West African nation recorded more than 1,000 cases of polio-induced paralysis. Last year it had only six; the most recent was in July.

"This I believe is the first time in history that they've gone this long without having a case," says Gregory Armstrong, chief of the polio eradication branch at the Centers for Disease Control and Prevention.

If polio really has been stopped in Nigeria it would be a major step forward in the global effort to drive the virus in to extinction.

"Nigeria has been the source of polio throughout much of Africa over the last ten years or so," Armstrong says.

But six months is not enough time to tell if polio has really been wiped out in Nigeria.

First, the polio virus is hard to track. The fact that there've been no recorded cases of polio paralysis does not mean the virus is gone. Someone could be infected with polio and be spreading the disease yet not showing any symptoms.

"It's only in [fewer] than 1 in 200 cases that it actually causes paralysis. that it causes polio myelitis," says Armstrong. "So the vast majority of infections are not visible to us."

The other major problem for polio eradication in Nigeria are the Islamic militants Boko Haram. Just as the Taliban has disrupted efforts against polio in Pakistan, Boko Haram has denounced vaccinations and made it nearly impossible to vaccinate kids in parts of Northern Nigeria.

Borrowing a tactic from the polio campaign in Pakistan, vaccinators in Nigeria set up checkpoints on major roadways and try to immunize children as they enter or leave areas dominated by Boko Haram.

They call the technique "hit and run." When there's no fighting or signs of the Islamic militants, health teams rush in, do a one-day immunization campaign, then quickly depart.

The World Health Organization's representative to Nigeria, Rui Gama Vaz, says the overall immuniziation strategy is working.

"Six months is an important milestone," Vaz says. "But it's clear that we have a lot of challenges ahead."

One of them is politics. Polio immunization drives had been on hold due to the presidential elections scheduled for this weekend. The idea was that once things settled, the vaccination campaigns would ramp up again. But now the Nigerian election commission has postponed the vote for another six weeks, so it's unclear when the next national immunization campaign will happen.

But health officials in Nigeria say they are committed to pushing forward with the polio eradication drive.

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RACHEL MARTIN, HOST:

Ebola has dominated headlines the last several months, but there's been good news in the global effort to wipe out another highly contagious virus, polio. Nigeria hasn't reported a single case of the crippling disease in more than six months. It's one of three countries in the world where polio transmission has never been fully stopped. Health officials are guardedly optimistic that polio could finally become a disease of the past. But as NPR's Jason Beaubien reports, completely eradicating the polio virus remains a big challenge.

JASON BEAUBIEN, BYLINE: Every country in Africa has managed to stop the ongoing circulation of polio except for Nigeria. There have been sporadic outbreaks on the continent over the last few years, but most were linked back to polio virus imported from Nigeria.

GREGORY ARMSTRONG: Stopping polio in Nigeria has always been the key to getting Africa polio-free.

BEAUBIEN: Gregory Armstrong is the chief of the polio eradication branch at the Centers for Disease Control and Prevention. He's worked extensively on polio in Nigeria. In 2006, the West African nation recorded more than 1,000 cases of polio-induced paralysis. Last year it had only six, and the most recent one was back in July.

ARMSTRONG: This, I believe, is the first time in history that they've gone this long without having a case.

BEAUBIEN: Currently, polio remains endemic in just two places on the globe - Nigeria and the Afghan-Pakistan border. If polio really has been stopped in Nigeria, it would be a major step forward in the global effort to drive the virus into extinction.

ARMSTRONG: Nigeria has been the source of polio throughout much of Africa for the last 10 years or so.

BEAUBIEN: Armstrong adds, however, that six months is not enough time to tell if polio really has been wiped out in Nigeria. First, the polio virus is hard to track. The fact that there've been no recorded cases of polio paralysis does not mean the virus is gone. Someone could be infected with polio, could be spreading the disease, but not showing any symptoms.

ARMSTRONG: It's only in less than 1 in 200 cases that it actually causes paralysis, that it actually causes poliomyelitis. And so the vast majority of infections that are out there are not visible to us.

BEAUBIEN: The other major problem for polio eradication in Nigeria is the insurgency by the Islamic militants Boko Haram. Just as the Taliban have disrupted efforts against polio in Pakistan, Boko Haram has made it nearly impossible to vaccinate kids in parts of northern Nigeria. Borrowing a tactic from the polio campaign in Pakistan, vaccinators in Nigeria set up checkpoints on the major roadways and try to immunize children as they enter or leave areas dominated by Boko Haram. They call the technique hit and run. When there's no fighting or signs of the Islamic militants, the health teams rush in, do a one-day immunization campaign and then run away. The World Health Organization's representative to Nigeria, Rui Gama Vaz, speaking from Abuja, says the overall strategy is working.

RUI GAMA VAZ: Six months is a milestone. It's an important milestone. But we are clear that we still have a lot of challenge ahead of us.

BEAUBIEN: And one of those challenges is politics. Polio immunization drives had been on hold due to security concerns around the presidential elections, which were scheduled for this weekend. The idea was once things settled down, the polio vaccination campaigns would ramp up again. But now the Nigerian election commission postponed the vote for another six weeks. It's unclear when the next national immunization campaign will happen. Health officials in Nigeria however, say they're committed to pushing forward with the polio eradication drive. Jason Beaubien, NPR News. Transcript provided by NPR, Copyright NPR.