An editorial in The Lancet Infectious Diseases: A wake-up call for polio eradication. Excerpt:
In a letter published in The Lancet in November, German scientists Martin Eichner and Stefan Brockmann wrote that the Syrian polio outbreak could represent a real threat to Europe, which has been free from polio for more than 10 years. The virus could easily be transmitted from Syria by displaced people as easily as it can be transmitted from other countries where the infection is endemic.
At present, polio is endemic in three countries—Afghanistan, Nigeria, and Pakistan. Until poliovirus transmission is interrupted in these strongholds, all countries remain at risk, as shown not only by the outbreak in Syria, but also in recurrent outbreaks across sub-Saharan Africa, including an ongoing outbreak in Somalia. In southern Afghanistan, where the disease is endemic, the news is good, because no new endemic cases have been reported this year.
The major barrier to eradication in Nigeria and Pakistan is access—security fears have prevented health workers from reaching the at-risk populations, and misplaced beliefs about vaccine safety and the motives of vaccine campaigns have led to high rates of vaccine refusal. There is a need for culturally tailored solutions to combat these erroneous suspicions.
The outbreak in Syria could have major health consequences for other countries, and the government there must assist in providing health-care workers and aid organisations with access to at-risk populations. But the outbreak also serves as a reminder that high vaccination coverage is essential in countries where the disease is not currently circulating.
Although it seems like a major setback to eradication efforts, the polio outbreak in Syria might be used as an opportunity to reinvigorate eradication campaigns in Afghanistan, Nigeria, Pakistan, and surrounding countries by reminding local political, religious, and community leaders that the persistence of poliovirus transmission there has global repercussions.