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September 2008
Vol. 18, No. 9
Global ID
Polio Resurges in Nigeria After a Promising Year

After making significant gains last year, Nigeria is currently undergoing a major outbreak of polio. In a setback to the global polio eradication campaign, more than 670 cases of the paralyzing disease have been reported as of Sept. 23, compared to 285 cases in all of 2007, according to the latest figures from the Global Polio Eradication Initiative.

Nigeria is one of just four countries that have never interrupted transmission of the polio virus. ( India, Pakistan, and Afghanistan are the other three.) Several northern Nigerian states halted mass vaccination campaigns in April 2003 following an outbreak of rumors that the vaccine was unsafe. Vaccination resumed in July of 2004, but case counts continued to soar, peaking at 1,122 in 2006. Between 2003 and 2006, virus imported from Nigeria re-infected 20 previously polio-free countries and spread as far as Indonesia. Recent cases in Chad, Benin, Niger, and Burkina Faso also have been traced back to Nigeria.

Stepped-up efforts improved vaccination rates in Nigeria in 2006 and 2007. Routine polio immunization rates went up from a nationwide average of 32 percent in 2005 to 62 percent in 2007. But the northern states, where polio is most common, continued to be on the low end of the scale, with routine coverage in some local areas dipping below 30 percent.

Many residents in areas with low vaccination rates complain that the government expends extraordinary effort on polio eradication while malaria and other diseases take a much heavier toll. In an effort to address these complaints, “Immunization Plus Days” began in May 2006, giving away insecticide-treated bed nets, de-worming medications, and other vaccines during mass polio immunization campaigns.

Following these efforts, the estimated number of unvaccinated children fell somewhat in the high-incidence northern states, from 45 percent in early 2006 to 30 percent in early 2007. But it has not been enough to prevent the latest outbreak, or to curb an ongoing outbreak of vaccine-derived poliovirus.

The World Health Assembly took the unusual step in May of singling out Nigeria for the spread of polio beyond its borders. The government has responded with new commitments to improve immunization activities.
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