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Polio Eradication is possible (Final Paper)

As many years passed, the medical world gained more knowledge about diseases,
however the absolute cure of poliomyelitis is still not found. So the best that we can
do in the present day is to focus on the prevention and the eradication of the disease.
Some people might say it is hard to completely get rid of polio in the whole world, but
statistically proven, polio cases have decreased over 99% since 1988. This fact is
really encouraging and thus the eradication of the polio worldwide will be achieved
soon in the future.
According to Center for Disease Control and Prevention (CDC), Polio is a disease
that mainly affects children under five years of age. One in 200 infections leads to
irreversible paralysis. Among those paralyzed, 5% to 10% die when their breathing
muscles become immobilized. Polio is mainly transmitted through fecal-oral route. It
is a highly infectious disease caused by a virus. As soon as the virus invades the
nervous system, it can cause total paralysis in hours. Because of the shocking impact
of the disease and how it will ruin the life of a person once he catch the disease, it is
really important to get rid of polio. The CDC website also stated that the program of
polio eradication started in 1988, the Global Polio Eradication Initiative (GPEI),
leading by national governments, World Health Organization (WHO), Rotary
International, the US Centers for Disease Control and Prevention (CDC), The United
Nations Children's Fund (UNICEF), and supported by key partners including the Bill
and Melinda Gates Foundation. Theres also Rotary Internationals commitment
raising funds to protect all children from the disease.
There is no cure (for polio), but there are safe and effective vaccines. Therefore,
the strategy to eradicate polio is based on preventing infection by immunizing every
child to stop transmission and ultimately make the world polio free (CDC). Even

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with just one person in the world has polio, people who are not immunized are still in
danger, therefore makes the polio eradication hard to achieve. Although improved
public sanitation and careful personal hygiene may help reduce the spread of polio,
the most effective way to prevent the disease is with polio vaccine. Oral polio
vaccines (OPV) and inactivated poliomyelitis vaccine (IPV) are two really effective
polio vaccines existed that can prevent people from contracting the disease. According
to Aamir Shahzad who works in the department of structural biology and
biomolecular Chemistry at University of Vienna. These two vaccines have eradicated
polio from most countries and have reduced the worldwide incidence of polio from
350,000 cases in 1988 to just 1300 cases in 2007.
As we strive for polio eradication, the replacement of OPV to IPV is a must.
Because OPV uses live attenuated virus, thus theres a chance of people getting the
actual disease form the vaccination itself. Even though vaccine associated polio
occurs in such a small number it is necessary to prevent it from happening. In the
other hand, IPV is inactivated. It wont cause polio and is safe for people with
weakened immune systems. Though IPV is more expensive to make, it eliminates the
vaccine-associated polio.
When there is a lot of polio cases, the use of OPV which is highly effective and
cheap to make is encouraged. According to The Global Polio Eradication Initiative,
during the first half of the 20th century, no illness causes more fear and panic than did
polio. It mainly infected children in the summer, creating great scares for parents.
Thanks to Albert Sabin, the inventor of OPV. He makes the immunization of 80
million people worldwide possible. OPV is easy to give. It is administered by drops in
the mouth. After the vaccine is swallowed, the attenuated virus multiplies in the small
intestine and lymph nodes and causes the generation of antibodies against wild virus.

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It is also shed through the inoculated persons feces, thus indirectly immunizing other
people through the fecal-oral route. OPV became the predominant vaccine after it was
introduced in the early 1960s. Between 1962 and 1964 about 100 million people in
the U.S. received Sabin's vaccine and reduced the polio mortality greatly. But in the
modern time, countries like United States where polio is already eradicated, the use of
IPV is necessary. In 2005, it was reported that children in a small village in the United
States had contracted vaccine-derived polio. In Nigeria, more than 70 cases have been
reported. In 2006, about 1600 cases of vaccine-induced polio occurred in India,
according to the Indian Medical Association Sub-Committee on Immunizations
report on the Polio Eradication Initiative. The point to be noted is that these cases
were reported during repeated mass-immunization campaigns in which repeated doses
of OPV were administered. In 2008, many cases of polio were reported in all
provinces of Pakistan, where OPV is used for repeated mass-immunization
campaigns. When the death cause by the vaccine-associated polio kills more people
than the actual disease, we should start using IPV invented by Jonas Salk. IPV uses
dead viruses, so people have no chance of getting vaccine-associated polio paralysis,
and IPV triggers good immune response in most people. When polio is endemic, the
country should use OPV, and eventually, the country will get to a point where polio is
no longer exist. It almost only exist on the viruses you are being vaccinated. At that
point, the replacement of OPV to IPV should be taken. Nigeria was one of the three
countries that still have polio present until February of 2014. The introducing of IPV
is the main reason.
Another reason to complete replace OPV with IPV is that, recently study show
that OPV viruses can regain fitness and neuro-virulence (immunity) with continuous
people to people transmissions in areas of low population immunity. An example

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would be: Circulating vaccine-derived polioviruses (cVDPVs) were first recognized
on Hispaniola in 2000 and have since caused outbreaks and isolated cases of paralytic
disease from viruses of all three serotypes in multiple locations. The existence of
cVDPVs shows us that all OPV use will need to be stopped in order to achieve full
polio eradication.
Now we know exactly how to completely eradicate polio, why are we not doing
the right things. What is preventing us from doing it? The answer is: The most
important point of eradication of polio is depending on reaching every child with
vaccines, whether through campaigns or routine immunization systems. There are
only two countries that are still struggling with polio. They are Afghanistan and
Pakistan. With 36% of its population living below the poverty line, Afghanistan is
only second to Bangladesh as Asia's poorest country. Poverty is most heavily
concentrated in the rural areas of Afghanistan. While 90% of urban households have
access to electricity, only 29% of rural households do. And for Pakistan, it is not a
poor country at all comparing to Afghanistan. However, the population of Pakistan
was being uninformed, considering vaccination unimportant, and have to travel long
distances to vaccination sites. So it is really hard to deliver vaccines to the remaining
two countries. But GPEI is still working really hard to help them.
The eradication of Polio would be an amazing feat that the world would most
likely celebrate. Economic modelling has found that the eradication of polio would
save at least US$ 4050 billion over the next 20 years, mostly in low-income
countries. This means, that money could be used to improve the world and used in
schools or governments. More importantly, complete eradication would mean that
no child will ever again, need to suffer the terrible effects of lifelong polioparalysis.

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The Global Polio Eradication Initiative along with the support of the WHO,
UNICEF, the CDC, Rotary International, the Bill and Melinda Gates Foundation, and
others, all contributed to help Polio eradication. Their main ideas were to focus on
strengthening and have routine immunization in some instances (e.g., measles
immunization in the Americas) and the delivery of vitamins to people for them to
have a healthier body. If we can all get vaccinated for polio and follow the plan, the
eradication of polio is waiting for us in the future.

Work Cited
Global

Polio

Eradication

Initiative

Home.

Web.

13

Dec.

2015.

<http://www.polioeradication.org/>.
Hopkins, Donald. "Disease Eradication NEJM." New England Journal of
Medicine. 3 Jan. 2013. Web. 28 Sept. 2015.
Modlin, John. and Wenger, Jay. "Achieving and Maintaining Polio Eradication - New
Strategies NEJM." New England Journal of Medicine. 16 Oct. 2014. Web. 28
Sept. 2015.
"Polio Eradication" CDC. 2 Sep. 2014. Web. 28 Sept. 2015.
"Polio eradication: the CIA and their unintended victims The Lancet. 31 May 2014.
Web. 28 Sept. 2015.
"Poliomyelitis." WHO. Oct. 2014. Web. 28 Sept. 2015.
"Polio Symptoms. May Clinic. 11 Mar. 2014. Web. 28 Sept. 2015.

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Shahzad, Aamir. Time for a Worldwide Shift From Oral Polio Vaccine to Inactivated
Polio Vaccine. Oxford Journals. Medicine & Health. Clinical Infectious Diseases.
Volume 49, Issue 8. Pp. 1287-1288. 2015.
"Vaccines and Diseases." World Health Organization. 15 Aug. 2015. Web. 28 Sept.
2015.
"Vaccine Research Will Accelerate Eradication of Polio." Centers for Disease Control
and Prevention. Centers for Disease Control and Prevention, 07 Feb. 2014. Web.
28 Sept. 2015