Rare Afghan Polio Case Tied to Pakistan

datguy79

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KABUL, Afghanistan — A 3-year-old girl in Kabul has contracted polio, the first confirmed case in the capital in 12 years, health officials said Tuesday.

Afghanistan is one of only three countries where polio is still endemic, and it has been inching closer to its goal of eradicating the disease. But it is next door to Pakistan, where polio is much more widespread, especially in the tribal areas along the border, and most of Afghanistan's remaining polio cases are traceable to Pakistan.

Health officials say that was the probably the case with the girl in Kabul, whose name is Sakhina. Her family previously lived in Pakistan and her father is a taxi driver who travels frequently to the tribal areas. The specific strain of virus she contracted is known to be common there, they said.

In Pakistan, which recorded 93 new cases of polio last year, and in Nigeria, with 53 new cases, vaccination workers trying to eliminate the disease have been attacked by Islamic militants. That trend was particularly aggravated in Pakistan by the case of Dr. Shakil Afridi, who was convicted of treason after helping the C.I.A. find Osama bin Laden, using a vaccination campaign as his cover.

"The C.I.A. has a lot to answer for in setting back polio eradication years," a United Nations official in Afghanistan said last year, speaking on condition of anonymity because of the political sensitivity of his views.

Taliban militants in Pakistan have repeatedly attacked vaccination teams, accusing them of acting as American spies. As a result, parts of Pakistan, especially those dominated by the militants in Waziristan and the Kyber Agency area near the Afghan border, are the only places left in the world where the virus is unchecked over large areas.

By contrast, Afghanistan's Taliban militants have cooperated with international and Afghan-government vaccination drives in recent years. That helped reduce the number of new cases in Afghanistan to 37 in 2012 and to 14 last year, down from 80 cases in 2011, according to Unicef statistics.

One of those 14 cases for 2013, it is now known, was the 3-year-old girl in Kabul, who became paralyzed from the disease in November. The case was not previously disclosed publicly by health workers.

"It is actually not worrying to have such a case," said Mohammad Taufiq Mashaal, director general of preventive medicine for the Afghan Ministry of Public Health. "It is the first case since 2001 in Kabul, but it is a pure importation from Pakistan.:lol:

Even so, Unicef, the Ministry of Public Health and the World Health Organization are taking preventive steps to try to contain the virus in Kabul, according to Akhil Iyer, the country director here for Unicef, who said, "Every case of polio is a concern."

The agencies on Sunday began vaccinating 73,000 children under the age of 5 in the immediate area where the girl lived, and expect to complete the job on Wednesday, Mr. Iyer said, with two broader vaccination campaigns to follow this month and next.

Mr. Iyer said that the girl in Kabul had been vaccinated several times, but that some children do not get complete coverage from the vaccines because of problems like rampant diarrhea in poor communities, which can leach the oral vaccine from the children's bodies.

Polio, shirt for poliomyelitis, is an incurable viral infection that in some cases causes partial, often severe irreversible paralysis; it is sometimes fatal. Because many people can carry the virus without experiencing any symptoms, and carriers can unwittingly infect thousands of other people, the World Health Organization considers a single symptomatic polio case to constitute an epidemic.

Most of Afghanistan's new cases come from Pakistan, but there are also areas of Afghanistan where the virus remains endemic, mainly in the south, in parts of Uruzgan, Kandahar and Helmand Provinces where heavy conflict has made vaccination campaigns difficult. "The trend is very encouraging," said Dr. Mashaal. "The girl in Kabul was just a cluster of one."

By that he meant that a high rate of immunization in other children around her kept the disease from spreading.

"We did not see an outbreak of the disease in Kabul at all, there were no other cases," Mr. Iyer of Unicef said. "It meant the population, in terms of immunity, is well protected." He said the country's goal of eradicating the disease by 2015 was still achievable.:thumb:

India, which as recently as 2009 had more new cases of polio than any other country, completely eradicated the disease by 2012. The Indian government will now require travelers from Afghanistan to show proof of polio vaccination, according to Kanishka Turkistani, a spokesman for the Afghan Health Ministry.


http://www.nytimes.com/2014/02/12/world/asia/rare-afghan-polio-case-tied-to-pakistan.html?hp&_r=0
 

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