One confirmed case and three suspected cases of polio have been reported in Venezuela, the first cases to emerge since polio was eradicated from the country in 1989. There has been laboratory confirmation that a two-year-old child has developed the disease. The Venezuelan Society for Public Health has reported that three additional children are suffering from acute flaccid paralysis and are suspected to have polio as well. All four children are living in the community of La Playita del Volcán, in the remote eastern state of Delta Amacuro [1].
Polio, short for poliomyelitis, is a debilitating and highly infectious disease caused by the poliovirus, which occurs predominantly in young children. It is spread through the fecal-oral route, and can cause symptoms such as fever, fatigue, headache, vomiting, and pain in the limbs. In severe cases, the virus can invade the nervous system, causing paralysis. According to the World Health Organization (WHO), one in 200 polio infections leads to irreversible paralysis [2].
There is no cure for polio but it can be prevented with a vaccine, of which there are two varieties. Inactivated polio vaccine (IPV) is an intramuscular shot given in the arm or leg. The other option, oral polio vaccine (OPV) is used widely due to its low cost and ease of administration. In order to be most effective, children should get four doses of the vaccine [3]. None of the confirmed or suspected cases in the Delta Amacuro region had been vaccinated.
This outbreak of polio comes at a highly unstable time for Venezuela. The country is in the midst of a public health crisis, with outbreaks of measles, malaria, diphtheria and tuberculosis, a result of the political and socioeconomic turmoil which began in 2012. There has been a complete breakdown in infrastructure, with shortages of food, water, electricity and medical supplies [4].
Delta Amacuro is one of the poorest states in Venezuela, with most of its population having to travel several hours by boat to reach the closest medical center. According to a local source, the community in Delta Amacuro is apathetic to the outbreak of polio. Many think of it as equivalent to a disease like malaria, unaware of the gravity of its symptoms [5]. Delta Amacuro is also the state with the largest coverage gap for all types of immunizations. The polio vaccine coverage in the region was only at 67 percent at the time the cases were reported [1].
Low vaccine coverage is also a growing nationwide issue. According to Manuela Bolivar, a member of parliament in Venezuela, “the government is not approving the money for the vaccines” [1]. Low vaccination rates are partially to blame for a resurgence of diphtheria and measles in the country, in addition to polio [5]. Long before this humanitarian crisis in Venezuela, the country was a leader in Latin America for its free immunization programs. Now, many hospitals in the country do not have any type of vaccine available. In order to contain the polio outbreak, the government will have to act quickly to immunize its population and improve overall health and living conditions.
Sources:
[2] http://www.who.int/en/news-room/fact-sheets/detail/poliomyelitis
[3] https://www.cdc.gov/vaccines/vpd/polio/index.html
[4] https://wwwnc.cdc.gov/travel/notices/warning/health-infrastructure-breakdown-venezuela
[5] https://www.cnn.com/2018/06/11/health/venezuela-polio-who/index.html
