6249: Polio campaign in DR (implications for Haiti) (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: Greg Chamberlain <GregChamberlain@compuserve.com>

   By SUSANNAH A. NESMITH

   SANTO DOMINGO, Dec 16 (AP) -- Volunteers went from house to house in
poor neighborhoods Saturday, vaccinating children against polio in the wake
of an outbreak here that has left at least six children paralyzed and
alarmed health officials.
   "Tomorrow, I need to be able to grab a child on the street, any child
under 5 years old, and ask his mother if he was vaccinated, and she's going
to tell me yes," said Jose Beltre, the volunteer coordinator in La Cienega,
a squatter neighborhood in the center of the capital.
   "We have to get everyone," he told a group of 15 volunteers before they
set out, armed with thermoses of the oral vaccine and chalk to mark the
houses they had visited.
   Health care experts thought polio was eliminated from the Western
Hemisphere in 1991, when the last case was reported in Peru. Then in
November, an unusual strain of the virus appeared, first in the remote
mountain town of Constanza. Six cases have been confirmed in the Dominican
Republic and a seventh has been reported in neighboring Haiti.
   The countries have 8 million people each and share the island of
Hispaniola.
   In response to the outbreak, health officials in the Dominican Republic
launched the three-day vaccination campaign Friday. The goal is to
vaccinate 2 million children either at stations or by sending volunteers
house to house in poorer and remote areas.
   Experts from the Pan American Health Organization say the outbreak was
caused not by the wild virus, but by an unusual mutation of the vaccine.
   The oral vaccine, a relatively safe form of the live virus, is preferred
in part because it is contagious and can give what experts call "herd
immunity." But that only works if most children are vaccinated directly. If
too many children are left unvaccinated, the virus can circulate in the
population long enough to mutate back into a virulent strain, as apparently
happened here.
   None of the children who contracted the virus had been vaccinated, PAHO
officials say. The only other similar outbreak occurred in Egypt in the
1980s, when 30 people contracted the disease.
   Polio is a crippling and sometimes fatal disease that attacks the
central nervous system and usually strikes children younger than 5. Fewer
than 7,100 cases were reported worldwide last year, confined to Africa and
Asia.
   A handful of mothers lined up Saturday morning at the clinic in La
Cienega. A few others followed the teams around, waiting for them to reach
their homes.
   "I get every vaccine they'll give me for him," said Maria Altagracia, as
she waited for the team to reach her house, and her 2-year-old son Jose.
"The children all get so sick here, but a lot of that is because the
mothers neglect them."
   The volunteers picked their way through garbage strewn alleys, knocking
on doors and wandering through houses looking for children.
   Coordinating the vaccinations was complicated. The vaccine has to be
kept on ice and must be given to at least 80 percent of the children to
prevent the mutation. A safer injected vaccine that can't mutate isn't used
here because it's more expensive, it has to be given by professionals and
it doesn't offer the herd immunity effect.