6230: Polio Outbreak in Dominican Republic, Haiti (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: nozier <nozier@tradewind.net>

  Thursday December 14 1:26 PM ET
   Polio Outbreak in Dominican Republic, Haiti
   By Merritt McKinney

      NEW YORK (Reuters Health) - A recent outbreak of 14 cases of polio
in
      the Dominican Republic and Haiti appears to be due to a mutated
version of
      the virus used in oral polio vaccine, according to the Pan
American Health
      Organization (PAHO).
      The oral polio vaccine contains a weakened virus and is very
effective at protecting against the crippling  disease. However, in
areas where vaccination rates are low, the virus may circulate in the
population. In this   case, the virus appears to have had time to
mutate, and regain its ability to cause disease. Wild strains of
poliovirus have not circulated in the Western Hemisphere since 1991.
This is only the second time that such an outbreak has occurred. The
first occurred in Egypt, in which a vaccine-like virus circulated in the
population between 1983 and 1993, causing 30 cases of the disease.
      To combat the outbreak, both the Dominican Republic and Haiti are
launching a massive vaccination campaign   using the oral polio vaccine.
All 14 cases occurred in unvaccinated or only partially vaccinated
people. The outbreak is concentrated in a poor region of the Dominican
Republic where vaccine coverage--the  percentage of the population that
has received full immunization--is low, Dr. Socorro Gross, the
representative  of the PAHO and the World Health Organization (news -
web sites) in the Dominican Republic, told Reuters

      Health in an interview.

      This low coverage may have allowed the virus to circulate and
mutate for the past 2 years, she said. Of the 18 suspected cases, 14 are
``clinically compatible'' with polio. One laboratory-confirmed case has
occurred in   Haiti. The countries share the island of Hispaniola.
Officials in the Dominican Republic have already taken the first step
towards controlling the outbreak by  immunizing the population in the
city and surrounding area where all but one case occurred, Gross said.
Then on December 15th, all children under 5 years of age throughout the
Dominican Republic--nearly 1.2  million children--will be offered the
first dose of the oral polio vaccine, she said. The second and third
doses
      will be given in February and April, she said. According to Gross,
officials hope to achieve at least 85%  coverage in each of the three
rounds of vaccination.  A similar effort in Haiti will begin in January,
she said. Travelers to the Dominican Republic and Haiti should ``make
certain they are fully immunized against polio,'' according to PAHO.
  The recent outbreak shows that vaccination programs should not be
abandoned once polio is eradicated or  eliminated in a country, Gross
noted. She pointed out that the last reported case of polio in the
Dominican  Republic occurred in 1985.
 Dr. D. A. Henderson, a PAHO official who headed the global smallpox
eradication program, agreed that no  country should let down its guard
against polio.
  ``The lesson is clear,'' he said in a PAHO statement. ``We must keep
vaccination coverage high until we get to  the zero point of stopping
polio transmission, we must undertake additional studies and we must
keep everyone  updated on this situation.''
      From 1988 to 1999, worldwide cases of polio dropped 95%, from
350,000 to 7,094, due to widespread use of the polio vaccine.