On August 25, Nigeria marked three years without a case of Wild Polio Virus (WPV). The last case of the wild poliovirus, isolated in a child in Borno State, was recorded on August 21, 2016. The landmark achievement is a step towards declaring Nigeria polio-free by the World Health Organisation (WHO). With this achievement, Nigeria has exited the comity of polio-endemic countries, leaving Pakistan and Afghanistan as the only two remaining members of the group worldwide.
The development also indicates that the poliovirus has been eradicated from Africa, as Nigeria is the last country on the continent that has witnessed a case of polio. Apart from the Borno State case in 2016, the last case on the continent was in the Puntland region of Somalia in 2014.
The insurgency in Nigeria’s North East region has been cited as a major hindrance to polio eradication in the country. But military successes against Boko Haram as well as political and financial support by the government have assisted in fighting the virus.
Polio, short for poliomyelitis, or infantile paralysis, is an infectious disease caused by the polio virus. It is a highly infectious viral disease that mainly affects young children. It has been described as a viral disease that wreaks havoc on motor neurons, often paralyzing sufferers for life. The poliovirus is transmitted by person-to-person and spread mainly through the infected faecal-oral route. The virus may also be spread by food or water containing human faeces and, less commonly, from infected saliva. The virus multiplies in the intestines from where it can invade the nervous system and cause paralysis.
According to the WHO, the initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. Although there is no cure yet for the disease, the poliovirus can be prevented by immunisation.
The disease has been around for thousands of years, but it was first recognised as a distinct medical condition in 1789 by the English physician, Michael Underwood. The virus that causes the disease was identified by Karl Landsteiner, the Austrian immunologist in 1908.
In Nigeria, many have been aware of a disease causing lameness in children for long. During the colonial period, immunisation was mainly for expatriates. In the 1980s, there was the implementation of the Expanded Programme on Immunisation (EPI), which included polio vaccination as part of primary health care.
But intensive efforts to eradicate polio across the country did not begin until 1988. At the 41st World Health Assembly of that year, delegates from 166 countries adopted a landmark resolution – the WHA 41.28 – for the worldwide eradication of polio by 2000. Several countries were certified polio-free by that year, but not Nigeria.
In 2006, Nigeria had the greatest number of confirmed cases of polio worldwide. But with a number of interventions by government, international agencies and other development partners, there was a drastic reduction in the number of fresh polio cases. By the end of 2010, case numbers had declined dramatically, but polio was still a major risk in the country. In 2012, and with 223 victims, Nigeria accounted for more than half of all global polio cases.
This can probably explain the wide jubilation over the nation’s polio-free status. We commend the Federal Ministry of Health, the states’ health authorities as well as the development partners for the great achievement.
But Nigerians must bear in mind that it is not yet over. We recall that the country was on the verge of being declared polio-free in 2016 when the single incident in Borno curtailed that celebration. Therefore, the country cannot rest on its oars. There is so much to be done within the remaining six months to ensure that we are certified polio-free.
The government and its development partners must continue to strengthen routine immunisation. There is need for continued monitoring and surveillance of the disease. Sensitisation efforts must also continue. There must be sustained effort to ensure that Nigeria is polio-free.