The tragedy of polio is not just the way it blights lives or even that the world came tantalisingly close to eradicating this wholly preventable disease only a few years ago. The cruellest aspect is the way it flourishes in situations already marked by human misery, as demonstrated by the outbreaks in previously polio-free countries like Syria and now Iraq.
The World Health Organisation cited the case of a baby boy in Baghdad who was diagnosed with polio this week, the first case in Iraq in 14 years. The strain was described as being the same as the one that emerged in Syria in January and led to 25 people being infected.
This case displayed many of polio’s cruel traits. The carrier was the boy’s three-year-old sister who, as often happens, showed no signs of the disease herself. Neither had been immunised. Previous outbreaks suggest this single case is likely to be followed by others because there is likely to have been a lag of four to five months between exposure and the baby showing symptoms and being diagnosed, by which time hundreds are likely to have come into contact with the pathogen.
There is no mystery about the conditions where polio thrives – regions where governments do not fulfil even the most basic functions of looking after their people. This can be for reasons of conflict, as in Iraq and Syria. Sometimes it is combined with ignorance and ideology, such as in Nigeria, where rumours circulated that the polio vaccine contained pork extracts. On the Afghan-Pakistan border areas, immunisation teams have been attacked, accused of being spies for the West or part of a plot to sterilise Muslims.
Polio also augurs poorly for any such region where it re-emerges because it is symptomatic of a much greater malaise. Eradicating polio does not require every person to be immunised because of an effect known as “herd immunity”, in which if a sufficient proportion of a population has received vaccinations, the pathogen’s cycle of transmission is disrupted and it dies out, protecting the community as a whole. For polio, that figure is estimated at between 80 to 86 per cent and the emergence of it in Syria and Iraq shows just how big a swathe of the population has missed out on vital vaccinations.
In the context of warfare and refugees, with a generation missing out on an education, polio seems like the final cruel addition to the misery.
