Polio in Bangladesh
Dr Wrishi Raphael
Bangladesh along with 10 other countries of WHO South-East Asia Region was certified polio-free in 2014 by an independent commission under the WHO certification process. South-East Asia Region is home to a quarter of the worlds population.
This is the fourth of six WHO Regions to be certified, marking an important step towards global polio eradication.
With this step, 80% of the worlds population now lives in certified polio-free regions according to a WHO press release.
According to WHO, only 2% of Bangladeshi children under 5 years old were immunized before 1985, but this number jumped to 60% within 10 years following the introduction of routine immunizations in 1985. This was the time when more and more people became confident of the positive impact of vaccines on their childrens welfare. The motivation of parents and caregivers for child vaccination made polio immunization events more popular and successful. The country has to date observed 21 National Immunization Days for polio; the one in January 2014 reached confirmed coverage of 100%.
The secondary benefit of vaccination, however, is herd immunity, also known as community immunity. Herd immunity refers to the protection offered to everyone in a community by high vaccination rates.
With enough people immunized against a given disease, its difficult for the disease to gain a foothold in the community. Unfortunately, Bangladesh became yet another reminder that polio respects no borders when the disease re-emerged in Bangladesh via importation from neighboring India in early 2006. After 6 months of extensive operations, which included 6 rounds of special immunization days and mop-ups, polio was, once again, eradicated by November 2006.
Our country is now a place where people of various nationalities have started to come for work or tourism.
Since this trend is not likely to change unless we are once again jolted by overwhelming political crisis, its good for medical personnel to stay acquainted with our old foe, just in case mop up operations like the one we had in 2006 becomes a necessity.
Although polio can cause paralysis and death, the vast majority of people who are infected with the poliovirus dont become sick and are never aware theyve been infected with polio.
Nonparalytic polio
Some people who develop symptoms from the poliovirus contract nonparalytic polio a type of polio that doesnt lead to paralysis (abortive polio). This usually causes the same mild, flu-like signs and symptoms typical of other viral illnesses.
Signs and symptoms, which generally last one to 10 days, include, fever, sore throat, headache, vomiting and muscle weakness or tenderness and meningitis
Paralytic polio
In rare cases, poliovirus infection leads to paralytic polio, the most serious form of the disease. Paralytic polio has several types, based on the part of your body thats affected your spinal cord (spinal polio), your brainstem (bulbar polio) or both (bulbospinal polio). Within a week, however, signs and symptoms specific to paralytic polio appear, including; loss of reflexes, severe muscle aches or weakness, loose and floppy limbs (flaccid paralysis), often worse on one side of the body
Post-polio syndrome
Post-polio syndrome is a cluster of disabling signs and symptoms that affect some people several years an average of 35 years after they had polio and require long term therapy and rehabilitation.
Treatment
Management of polio is mostly symptomatic. It comprises of the following;
rest, painkillers to relieve headaches, muscle aches, and muscle spasms.
antibiotics for urinary tract infections.
portable ventilators to help with breathing.
physical therapy and/or corrective braces to help with walking.
heating pads or warm towels to ease muscle aches and spasms.
The writer can be reached at:
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