Israel's campaign of polio vaccination in the south will be expanded to include the whole of the country, starting August 18, the Ministry of Health announced Friday. The decision was made in view of evidence suggesting that the polio virus is present in sewage systems throughout the country.
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Although the first detection of the virus was in May, officials believe that it has been spreading since February. The strain is similar to the one detected in sewage systems in Egypt in 2012.
Polio is an infectious disease caused by a virus which is transmitted between humans, especially children. It enters the body through the mouth and exits in feces. The disease is usually symptom-free, but one in a thousand unvaccinated people develop the active disease, which paralyzes the limbs. In extreme cases, respiratory muscles can be paralyzed, leading to death.
A meeting chaired by Health Minister Yael German was held Friday morning, with the participation of professional representatives from the Ministry, the Ministry’s advisory committee on polio headed by Professor Eli Somekh, the head of the union of Israeli pediatricians, and representatives of a team handling infectious diseases, headed by Professor Dan Engelhard from Hadassah hospital, as well as other physicians and laboratory personnel.
According to the new plan, from August 18 parents will be asked to bring all children between the ages of 4 months and 9 and a half years (born in January 2004) to well-baby clinics (Tipat Halav) in order to receive further inoculation with a weakened polio virus, in addition to the routine vaccination given at 2, 4 and 6 months of age, as well as in the second grade.
Samples taken from sewage systems showed the virus is present in sewage treatment plants in Lod and Ramle. In early July, the virus was also found in the sewage systems of Modi’in and other cities in the Sharon area. So far no virus has been detected in the sewage systems in Tel Aviv and its satellite cities, as well as in the north.
Fecal samples were taken from residents of Israel in an attempt to gauge the extent of the problem. This procedure found 28 carriers of the virus, including 26 children who are immunized against the virus until the age of ten. The virus was also detected in a young baby, less than two months old, and in a 70 year old man. These carriers did not have the active disease. They all live in the south and their families were notified. The present outbreak of the virus, first detected at the end of May in the sewage system of Rahat, has not led to any cases of active polio.
In the course of the vaccination campaign which started last Monday in 66 towns and cities in the south, twenty thousand children were vaccinated. These constitute roughly 20% of the final target population, according to the Health Ministry. According to Ministry figures, so far vaccinations have been given to between 20 and 32% of children in Be'er Sheva, Dimona, Kiryat Gat, Yeruham, Omer and Arad. The Bedouin settlement of Tel Sheva saw similar compliance, with 24.7% of children there receiving the vaccine. In contrast, in the Bedouin city of Rahat only 12.3% were vaccinated.
The director general of the Health Ministry, Professor Roni Gamzu, intends to accelerate the pace of vaccination so that fifty thousand children will be vaccinated next week. At a press conference he stated that the Ministry plans to complete vaccinations in the south within a month, all given at the baby-well clinics. They are considering further complementary vaccination in grades one to three, based on parental compliance.
The Ministry is concerned that “the segment of the population born after 2005 is not immunized against the weakened virus, and could become a source for the expansion of the virus. Since the virus has been detected repeatedly, complementary vaccinations will be given across the country to children born after 2004. The Ministry is preparing for the massive campaign beginning on August 18 at the clinics and calls on parents to bring their children.”
The vaccine, which is supposed to prevent infection within families, is given as two drops on the tongue. It contains two weakened virus strains that have appeared recently, strains 1 and 3. Children with family members who have a compromised immune system will not be given the vaccine out of concern that these family members might get the disease. These include people with leukemia, lymphoma, carcinomatosis, or people undergoing immunosuppressant treatment, such as radiation, chemotherapy or high steroid doses. Vaccines will also not be given to children with genetic disorders in their immune systems, or to children who are allergic to the polio vaccine or to neomycin or polymyxin, or to carriers of AIDS.
The vaccine carries a less than one in a million risk of causing active polio in family members, with negligible risks to the children getting the vaccine, since they have already been immunized with the dead virus. The Health Ministry has ordered one million vaccines from GlaxoSmithKline.