Madagascar - Polio outbreak 2023

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Madagascar: Epidemic - The country risks spreading poliomyelitis

JULY 27, 2023
Madagascar Express (Antananarivo)
By Miangaly Ralitera

The resurgence of poliomyelitis in Madagascar presents an international threat. The virus is spreading everywhere, while the population has low immunity.

Madagascar poses a potential risk of spreading poliomyelitis internationally. He is infected with circulating poliovirus, derived from a type 1 vaccine strain (cVDPV1). This was announced at the thirty-fifth meeting of the International Health Regulations (IHR) Emergency Committee on Polio in May. This virus is circulating strongly in Madagascar, with two hundred and eighty-seven confirmed cases since September 2020 and nearly two hundred environmental samples, taken from several areas, positive, according to the World Health Organization (WHO), July 25, as part of the launch of the anti-poliomyelitis vaccination campaign.

This stratification of the risks of the spread of poliomyelitis risks putting a brake on the tourism sector, which is however beginning to catch its breath, after the epidemic of coronavirus. “Tourists have already asked us for information on the poliomyelitis epidemic at the beginning of this month of July. Not being yet informed by the extent of the situation, at the time, we reassured them, and they came. We don't know what will happen now. But for the moment, there is no cancellation, ”says a manager of a travel agency. WHO does not advocate any travel or trade restrictions. However, the committee issued recommendations.

Maximum target

Thus, Madagascar must vaccinate against poliomyelitis all residents and long-term visitors of all ages, between four weeks and twelve months before international travel. Ensure that people undertaking urgent travel (within four weeks), who have not received a dose in the previous four weeks to twelve months, receive one dose of polio vaccine, at least, upon departure .

Ensure that these travelers receive an International Certificate of Vaccination to record their polio vaccination and serve as proof of vaccination. Restrict the international travel of any resident who does not have appropriate polio vaccination documents at the point of departure. This emergence and continued transmission of cVDPV1 in Madagascar reveals gaps in population immunity against type 1 polioviruses.

Madagascar is on the verge of immunizing the maximum number of targets, by offering doses of vaccines to adults and children in the regions of Analamanga, Vakinankaratra, Alaotra Mangoro and Atsimo Andrefana, and to children under 15 years of the remaining regions this week. “The ideal is to strengthen epidemiological surveillance, and to vaccinate the entire population, to stem this epidemic. If a positive case is not detected within the community, it will be a reservoir of the virus and will spread the disease”, notes Doctor Jaurès Rabemanantena, epidemiologist and former member of the Polio free label certification committee, in 2018.
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OUTBREAK - High suspicion of polio-related deaths

07/29/2023 07:16 Madagascar Express

Epidemic: Vaccination against poliomyelitis is an emergency. The virus is spreading in Madagascar. Its effects are harmful.

Devastating
Scientists declare urgency for polio vaccination. Strong suspicions of deaths linked to this disease have been reported since the resurgence of the disease. Dr. Jean Rubis Andriantsoa, ​​member of the National Academy of Medicine announced, during a usual communication at the Akademia Malagasy in Tsimbazaza, Thursday, the death of eight adults. “I'm just reporting what my colleagues have told me,” he told us. Twenty-one adults in the regions of Vakinankaratra, Alaotra Mangoro, Analamanga, Atsimo-Andrefana reportedly showed symptoms of this disease. Seven of them are said to have died, including a 75-year-old. “Unfortunately, we could not confirm whether these were really poliomyelitis cases, as the analysis could not be carried out. It is done by faecal sampling. Which is no longer possible, in the event of death. This remains, therefore, strong suspicions of cases of poliomyelitis”, explains Professor Noëline Ravelomanana, president of the National Polio Certification Committee, in 2018. A source at the Ministry of Public Health has neither denied nor confirmed these cases of death. "It's not official," she says. This disease leaves devastating sequelae.

“Polio kills. When it attacks the lungs, it tightens the diaphragm muscles. This is what can cause death,” explains Professor Noëline Ravelomanana. While poliomyelitis does not kill people who contract it, it leaves them paralyzed or, at best, disabled. And it is irreversible. “A 24-year-old student from the University of Antananarivo has poliomyelitis. He is paralyzed. The other person, aged 32, is also in Antananarivo”, continues Professor Noëline Ravelomanana. Vigilance should be as high as possible. This virus was detected at several canals in Antananarivo and in other regions, according to the results of analyzes of sample samples. With weak immunity, there is a risk of developing the symptoms, or even the complication of the disease. The World Health Organization (WHO) has declared two hundred and eighty-seven cases since the year 2020, including nearly seventy cases this year. Other medical sources note, moreover, that people who suffer from the complication of this disease are hospitalized.

Refusal of the poliomyelitis vaccine
Not all vaccine targets may be reached, health workers fear. They face numerous refusals and, sometimes, hostilities from their targets. “Men generally refuse the vaccine,” they note. Some say they are against it. Others are skeptical and don't believe in vaccines or poliomyelitis. There are also those who think they are already immune. “I no longer need these extra doses. I have already been vaccinated against poliomyelitis, in childhood”, notes a forty-year-old.

Vaccinators also note that people with a low standard of living are more accessible than the “rich” and those with an average standard of living. It is the low rate of vaccination coverage that has, however, caused the resurgence of this disease, which was, however, already eliminated in Madagascar, in 2018. The Ministry of Public Health and its partners plan to vaccinate the entire population, children and adults, from the regions of Alaotra Mangoro, Analamanga, Atsimo Andrefana and Vakinankaratra, and children under 15 from other regions, this week.

https://www.moov.mg/article/77696-epidemie-forte-suspicion-de-deces-lies-a-la-poliomyelite#body2​

 

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EPIDEMIC – The fight against polio remains difficult

10/18/2023
07:09

Madagascar Express

Health: The fourth vaccination campaign against poliomyelitis began yesterday. Children under 15 are the main targets.

A difficult mission. Vonisoa, a mother in the city of Antananarivo, did not allow vaccinators to give doses of polio vaccine to her daughter yesterday during the opening of the fourth vaccination campaign against this disease disabling. “My daughter received all doses of vaccine before her ninth month. It was explained to me at the time that these vaccines will protect her from several diseases, including polio, for her entire life. She even received a certificate for it. So, for me, there is no longer any point in vaccinating her,” she says. Her sister, a health worker, convinced her of the importance of this vaccine, but it was not enough to change her mind.

“She warned me that adults have been infected with polio, but for me, we are protected. In any case, I am not convinced by these vaccination campaigns. For me, they are too commercial,” she continues. Her daughter will, however, be included in the list of vaccinated children, in this fourth vaccination campaign, as in previous campaigns. Vaccinators marked her left little finger with a marker, although she did not receive any doses. “Auditors will come by,” they tell the mother, to explain the reason for this mark.

Complicated mission
This case of parents who refuse to vaccinate their children is not isolated, during vaccination campaigns. " There are many. Some go so far as to threaten us,” health workers tell us, to show the difficulty of this mission. The question is where they are going to throw the vaccine doses supposedly “used” in their report, but which were not actually used, with the people who refused to be vaccinated. If they throw them into the community, this will create a new risk of spreading the virus if they get into the mouth. The polio vaccine is an attenuated virus. Hygiene rules, such as washing hands with soap and water regularly, and defecation in appropriate places, are still very little respected in Madagascar. While these are the best ways, after the vaccine, to protect yourself against this virus.

It takes several vaccination campaigns to eliminate polio. Madagascar is in its fourth year this year, after the new increase in cases, and in particular, the detection of the disease in adults. The increase in children with zero doses of vaccine, during the coronavirus epidemic, explains this epidemic resurgence. Getting vaccinated several times is essential to protect yourself against this disease, according to health professionals. This is the reason for these repeated campaigns.

https://moov.mg/article/80028-epidemie-la-lutte-contre-la-poliomyelite-demeure-difficile#body2

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