Massive immunisation as polio hits Namibia

Shangula had earlier in the week announced that the government planned to immunise its population of 1.8 million people against wild type polio which had suddenly hit the country killing seven people and prompting the hospitalisation of 11 others He said the monovalent Oral Polio Vaccine (mOPV) was not available in the country and that the people that had so far been immunised, including hordes of health workers, had been given the wrong vaccine and must be immunised again. “The mOPV vaccine is currently not available in Namibia, but is being airlifted into Namibia by UNICEF suppliers and is expected to arrive in the country on June 16 2006,” he said. Namibians from all walks of life and of all ages had begun showing up at the country’s health facilities for immunisation after government said it was imperative for people to get polio vaccinations on Tuesday. However, Shangula later in the week said the immunisation that people were getting from the hospitals was the wrong one. “Vaccination of people with trivalent Oral Polio Vaccine (tOPV) must cease immediately. This vaccine is reserved for National Immunisation Campaigns among children under five years. The administration of tOPV reduces the likelihood that the recipient will have appropriate immunological response to the mOPV that will be administered,” he said, adding that the virus that was circulating was the Indian type, which was isolated in Angola last year and he was not sure he how it was introduced in Namibia. The government has said it needs about N$27 million to carry out the immunisation campaign for the entire population. Shangula said the wild polio virus type 1 disease constituted an emergency case for the country that required concerted efforts with all cooperating partners (World Health Organisation and UNICEF). So far 34 people have been affected. “Availability of logistics will decide how quickly the mass immunisation campaign will start. We are requesting the public to remain calm and to co-operate because we now know the cause of the outbreak. We are targeting two million people,” he said. Shangula said it was imperative for “everybody to be vaccinated again” because there is no “specific treatment but only symptomatic and supportive treatment and recovery takes time.” He added that those that died from the disease did so as a result of complications involving the muscles that allow a person to breathe being affected. He said the National Health Emergency Preparedness and Management Committee, which is a coordinating body in all emergencies and disease outbreaks in the country, had immediately been activated. This committee has the task of coming up with a budget for the immunisation campaign and identifying the places that people can go to get immunised. “These places for immunisation will not only be hospitals or clinics but any places that can enable the ministry to reach the maximum number of people,” he said. Shangual announced also that the mass vaccination campaign will start on June 21st 2006, simultaneously in the whole country. The schedule for vaccinations is as follows: 1. Round One: 21st – 23rd June 2006 2. Round Two: 18th – 20th July 2006 3. Round Three: 20th – 24th August 2006. “However the last round will only be for children under five years and shall include polio and measles vaccination as well as Vit A supplementation,” he said. He said polio had last affected Namibia in 1995 and after that; the country has had no polio case until May this year. “The first suspected case of acute paralytic disease was admitted on the 10th May, 2006 at Katutura Hospital. The second case was admitted on the 26th May at the Roman Catholic Hospital. The next case was admitted on the 28th May 2006 at Katutura Hospital. Subsequently a total of 38 suspected cases were reported as of the 6th May, 2006. Four patients were later discounted as suffering from other conditions and not from acute paralytic diseases. The total number is 34,” he said. Shangula said they would communicate with the Southern African Development Community sub committee dealing with emergency preparedness and responses about the wild type polio in Namibia so that all neighbouring countries can be on the look out for the disease. “Neighbouring countries will need to do immunisation campaigns in the borders so that there is no spill over. We expect to contain the disease very quickly especially since we are targeting the whole population. Our immunisation campaigns can reach about 80 to 99 per cent of the population and sometimes we go over 100 percent because people from neighbouring countries come into Namibia to be immunised,” he said. The disease manifests itself through back pain, headache, neckache, and fever, weakness of lower limbs, vomiting, paralysis, epigastric pain, chest pain and diarrhea. It also affects people of all age groups. In Namibia, those affected are tabulated as follows: Age Group in Years Number of Cases Less than 5 years 1 5-9 1 10-14 1 15-19 2 20-24 3 24-29 12 30-34 4 35-39 2 40-44 1 76 years 1 Shangula said the source of the disease is not yet known but they suspect that poor sanitation played a part. “It is a question of sanitation. This disease is found in faeces and when it rains or water passes through and the faeces are carried off into drinking water, you find people getting the disease,” he explained. Research into how it started is ongoing. Namibia received above normal rainfall in a very long time this year which caused floods in various parts of the country. Although some observers suspect the floods may have carried faecal material into water bodies, Shangula would not immediately link the floods to the outbreak. Below is the list of recent eradication efforts around the world in 2005. 1,831 cases of wild poliovirus ‘ 727 Nigeria (endemic) ‘ 478 Yemen (importation) ‘ 299 Indonesia (importation) ‘ 154 Somalia (importation) ‘ 64 India (endemic) ‘ 27 Pakistan (endemic) ‘ 27 Sudan (re-established transmission) ‘ 20 Ethiopia (importation) ‘ 9 Angola (importation) ‘ 9 Niger (endemic) ‘ 7 Afghanistan (endemic) ‘ 4 Nepal (importation) ‘ 3 Mali (importation) ‘ 1 Chad (re-established transmission) ‘ 1 Eritrea (importation) ‘ 1 Cameroon (importation) (Source – Wikipedia, the free encyclopedia).

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