Fighting Polio in Pakistan and Afghanistan

Not reaching every child jeopardizes progress and risks reintroduction in other parts of the world

saw an overall decrease in wild poliovirus (WPV) cases from January – September 2013 compared with the same time period in 2012 according to data published in the Morbidity and Mortality Weekly Report. Since 2012, transmission of indigenous WPV has been limited to three countries: Afghanistan, Pakistan, and Nigeria. Results for Nigeria will be released in December.

Both countries still face significant challenges in reaching unvaccinated children. Afghanistan is fighting a polio outbreak in the Eastern Region while Pakistan continues to see polio increases in the conflict-affected Federally Administered Tribal Areas (FATA), where there is a ban on polio vaccination, and in security-compromised Khyber Pakhtunkhwa Province. The potential risk of transmission to other countries highlights the need for strong ongoing global efforts to eradicate this disease.

“Although there have been setbacks, we are making progress towards global polio eradication,” said CDC Director Dr. Tom Frieden, M.D., M.P.H. “There is encouraging progress in Afghanistan, but, as long as transmission is uninterrupted in Pakistan and Nigeria, the risk for spread to other countries continues because polio anywhere presents a threat of polio everywhere."

Crimean-Congo Hemorrhagic Fever Death in Pakistan

A patient who had symptoms of Crimean-Congo hemorrhagic fever (CCHF) died on Tuesday [22 Oct 2013] in Lahore Pakistan

CCHF is a tick borne viral disease. Its symptoms include fever, bloody urine, vomiting, and nose bleeding. 30 per cent of the cases result in death on the 2nd week of the illness.

According to [local] sources, a 31 year old person, a suspected case of CCHF, was under treatment at a private clinic in the Ferozepur Road area of Lahore. He was brought to the hospital 5 days ago but died of the illness. The doctors said that blood samples of the patient have been sent to the National Institute of Health. A family member said the man's health destabilized after he visited a local cattle market to purchase a sacrificial animal.

This was the 1st death caused by CCHF in Punjab; however, the provincial Health Department has not, so far, confirmed diagnosis of the cause of death officially.

Although this may be the 1st death from the disease in Punjab province, CCHF is no longer rare in Pakistan, and it becomes particularly evident during the periods when animals are sacrificed during religious rituals.

CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5 to 6 days, with a documented maximum of 13 days.

It is not correct to state that the disease is transmitted mainly to humans from pets. CCHF is a tickborne disease, and humans acquire infection directly by tick bite or by contact with the blood of infected livestock. Confirmation of the diagnosis by laboratory diagnostics is awaited.

Source www.promedmail.org