Sudan polio threatens Uganda

Aug 12, 2001

POLIO has broken out in southern Sudan, threatening Uganda’s four-year-long freedom from the disease.

By Charles Wendo POLIO has broken out in southern Sudan, threatening Uganda’s four-year-long freedom from the disease. Health ministry officials say they are stepping up surveillance since there is a high risk of the disease spilling into Uganda. Reports from the World Health Organisation (WHO) say a two-year-old girl in Ruweng County of southern Sudan became paralysed in April this year. In June, aid workers collected her stool sample and flew it to a reference laboratory in South Africa for testing. On July 20, the laboratory confirmed polio. Experts fear that during the past few months the disease could have spread widely due to poor hygiene and lack of routine immunisation in the war-ravaged area. According to WHO, Southern Sudan has the world’s lowest polio immunisation coverage. Mass polio immunisation efforts covered Ruweng only in 1999 and 2000. News agencies quote the head of WHO’s polio eradication programme in Sudan, Jeff Partridge, as saying that thousands of children in the area might already be infected. Dr. Issa Makumbi, Manager of the Uganda National Expanded Programme on Immunisation (UNEPI), says that although Ruweng is 300km from the Ugandan border, there is a high risk of the disease spilling over. He says that for every child cited lame with polio, there are about 200 others. “This contagious disease is never far from you. It could be an hour’s drive or a 30-minute flight. It is a threat. We must be vigilant,” he says. Polio, a virus disease, affects mostly children and causes lameness. The only source of the virus is the faeces of infected people. In areas where people strew faeces in the environment, the virus in faeces from an infected child can contaminate wells or streams. Then children who drink such water unboiled become infected with polio. In addition to untreated drinking water, the virus also spreads through direct contact, especially among children, whose hands are often contaminated. Makumbi says the mass immunisation conducted over the weekend came in handy to provide extra protection to children along the border areas. More than two million children aged five and below were due to be immunised over the weekend in 26 districts including all those along the border areas. The next round of immunisation is on September 15 and 16. Makumbi says that in addition to the immunisation, disease intelligence and investigation teams would be on alert and have extra vigilance in northern Uganda. “We are going to strengthen our disease intelligence system to see that the disease does not cross over. If polio came into a house it can spread into the community within no time,” he says. Dr Walker Oladapo, the WHO representative to Uganda says he trusts Uganda’s polio surveillance network will be able to monitor the Sudanese outbreak and keep it at bay. “Within 48 hours of any suspected polio case being seen, samples are taken to the Uganda Virus Research Institute for testing. We have a process where by all cases of acute paralysis flaccid (suspected polio) are reported,” he says. He adds, “Therefore even if there is wild polio in the Sudan, the surveillance system in Uganda is able to cope with it.” He says it is because of such occurrence of polio in Sudan and possibly Congo, that Uganda has to continue mass polio immunisation along the borders though the disease has not been detected anywhere in the country since 1996. Experts fear that controlling the Ruweng polio outbreak might be complicated by fighting between rebels of the Sudanese People’s Liberation Army (SPLA) headed by Col John Garang, and Sudanese government forces in the area. The United Nations has appealed for a cease-fire in southern Sudan so that development workers can investigate the outbreak and implement control measures. The last known case of polio in Uganda was a 13-month old boy in Mukono in 1996. The absence of polio since then has been attributed to the mass polio immunisation dubbed national immunisation days (NIDS). Walker says that though Uganda has not had polio for such a long time, the country can not yet be declared polio-free. He says the borders are porous and some of the neighbouring countries still have polio. “Uganda has done very well and we want to keep polio cases at zero. If we are also able to get zero cases in the countries surrounding Uganda then we can stop (polio immunisation). So long as the African region has not been declared polio-free, we shall continue,” he says.

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