Polio in Syria

          Polio in Syria

What is Polio? 

Polio is a disease caused by a virus that is spread through oral-fecal transmission. Typically by eating or drinking items contaminated with feces from an infected individual. Most people with polio do not initially feel sick. They may experience minor symptoms, such as a fever, tiredness, nausea, headache, nasal congestion, sore throat, cough, stiffness in the neck and back, and pain in the arms and legs. Most people recover from polio but in some cases, it can lead to permanent crippling of the arms and legs. Although polio has a lower R naught than measles and pertussis, it remains a major public health concern. 

Individual with severe crippling due to polio.

 

Values of R0 of well-known infectious diseases
Disease	Transmission	R0
Measles	Airborne	12–18
Pertussis	Airborne droplet	12–17
Diphtheria	Saliva	6–7
Smallpox	Social contact	5–7
Polio	Fecal-oral route	5–7
Rubella	Airborne droplet	5–7
Mumps	Airborne droplet	4–7
HIV/AIDS	Sexual contact	2–5
SARS	Airborne droplet	2–5
Influenza (1918 pandemic strain)	Airborne

Polio in the United States

The first case of polio was reported in the 19th century and it soon became one of the most dreaded diseases of the 20th century. Through the late 1940's and the early 1950's, 35,000 people were crippled by polio each year. Travel and commerce between affected cities was restricted and public health officials imposed quarantines on not only homes but entire towns. Through the development of vaccine and public health awareness, the disease has since been eradicated from the United States for over 30 years. 

Current Situation

According to the World Health Organization (WHO), 17 cases of polio have been reported in Syria as of November 2013. In March 2011, more than 90% of individuals were vaccinated but due to the civil unrest, immunization rates have dramatically decreased. Although not every individual had been vaccinated, herd immunity helped prevent the spread of the disease. Due to the conflict in the area, less than 68% of individuals are vaccinated, leading to the increase of polio cases. 

Oral polio vaccinations.

Government officials and public health officers have advocated for a vaccine drive but the political unrest and safety concerns pose a threat to both citizens and visitors of Syria. 

The polio outbreak in Syria is a reminder of the power of disease. Before the 2013 outbreak, there were no reported cases of polio in Syria since 1999. Epidemiologists and public health officials are still trying to determine the cause of this outbreak and mode of transmission. Some believe it spread from the Middle East or another African country. 85% of polio cases reported worldwide are found in Africa with the remaining cases isolated in the Middle East. This polio outbreak is an example of the impact that place of residence and the current state of the government can have on an individuals health. The outbreak of polio in Syria is one of the most challenging outbreaks since the eradication of polio. This outbreak exemplifies the damage that disorder in society can have on the infrastructure of a health system.

Syria isn't the only country that has experienced disease outbreak due to violence. Health professionals have been forced to flea certain territories because of civil unrest. This has led to fewer vaccinations, less health education and an increase in disease outbreak. We are faced with the challenging task of maintaining the health of a population in the presence of political dispute.