WHO Says It Again: Declare Emergency On Polio

The spread of polio remains a global public health concern, says the World Health Organization (WHO).

KUALA LUMPUR, Dec 26 — The World Health Organization (WHO) once again urged Malaysia and other countries to declare a national public health emergency over their respective polio outbreaks.

Citing the spread of the vaccine-derived poliovirus type 1 (cVDPV1) from the Philippines to Malaysia, as well as documented spreads of wild poliovirus 1 (WPV1) in Pakistan and Afghanistan, the public health agency of the United Nations (UN) said these countries should be on emergency-mode for nine months, at the most.

“Residents, long-term visitors, and travellers to these areas also should be protected against the disease,” read a UN statement published yesterday following the latest meeting of the WHO’s Emergency Committee last month.

“The experts further recommended intensifying coordination to increase vaccination coverage of people travelling who regularly cross borders, and to improve monitoring of the quality of vaccination at transit points as well as tracking of unvaccinated travellers.”

The WHO highlighted polio outbreaks in Africa, the Eastern Mediterranean, Southeast Asia and the Western Pacific regions, while seven countries have reported outbreaks since the WHO Emergency Committee’s last meeting.

Malaysia’s Ministry of Health (MOH) announced on December 8 that a three-month-old Malaysian baby boy from Tuaran, Sabah, became the first reported polio case in Malaysia 27 years after the last case in 1992, and 19 years after Malaysia was declared polio-free in 2000.

Tests showed the boy was infected with a polio strain that shared genetic links with the virus detected in the Philippine cases, which has since reported an eighth case of polio. Sabah is the nearest Malaysian state to the Philippines.

On December 20, the WHO said a state of emergency at the state and national levels for Malaysia, and other countries in the region, should be declared for six months with no reported infections, and until there is documentation of full application of high-quality eradication activities in all infected and high-risk areas. It has since proposed this to be increased to a nine-month period.

However, Malaysia’s MOH has since confirmed to CodeBlue that it does not currently plan to follow WHO’s advice to declare a national public health emergency over polio as the outbreak is contained in Sabah, and not the whole country. Sabah is separated from peninsular Malaysia by the South China Sea, and the only other Malaysian state on Borneo island with Sabah is Sarawak.

MOH clarified too that it did not mean the ministry was snubbing the recommendations given by the agency, noting that it had stepped up its polio eradication methods in the East Malaysian state, as advised by the WHO.

An MOH spokesman added that while an emergency will not be declared at the national level, steps had been taken at the federal level at MOH to begin immediate work on containing the outbreak in Sabah, including purchasing polio vaccines, the use of which is the only way of preventing the disease from spreading.

However, MOH has yet to say if Malaysia would restrict at all departure points those who lack documentation of appropriate polio vaccination, or if it would ensure that residents and long-term residents (or those who stay in the country for more than four weeks) would receive polio vaccination, as recommended by the WHO previously.

Meanwhile, the WHO expressed concern yesterday over “the significant increase” in cases of WPV1, the last of three strains to be eliminated, noting that there were 28 cases in 2018, compared to 113 as at mid-December last year.

It said there has not been any “significant success” yet in reversing this trend”, adding that the international spread of WPV1 is at its highest point since the declaration of a public health emergency of international concern in 2014.

On a positive note, WPV1 has not been detected in Nigeria for three years, meaning that the African region could be certified as being virus-free this year, the WHO said, also commending efforts to reach children in its northern Borno state.

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