3/25/2018. End Polio Now an Update. Type 3 has not been seen since The Polio Virus. Polio What is it and Where did it Originate?

Transcription

1 End Polio Now an Update The Polio Virus Presentation to the Northern California Chapter American Microbiology Association Spring Meeting, March 2, 2018 Polio What is it and Where did it Originate? Polio What is it and Where Did it Originate? Poliovirus, is a human enterovirus and the causative agent of poliomyelitis, or Polio. Known to exist in Egypt in the time of the pharaohs. The Poliovirus consists of an RNA genome enclosed in a protein shell called a capsid. Can interact in its host in two ways Infection not including the central nervous system Infection including the central nervous system, which can lead to paralysis and death. Less than 1% of cases results in paralysis. Spreads by oral-fecal route, multiplying in the intestine. Polio The Virus Polio The Virus Three serotypes of the wild virus Type 1, Type 2 and Type 3 Type 2 was declared eradicated in 2015 not seen since 1999 Type 3 has not been seen since 2012 Type 1 remains endemic All cases of Acute Flaccid Paralysis (AFP) among children under the age of 15 are tested and reported by the Global Polio Laboratory Network within 48 hours of onset for: Wild Polio virus Vaccine-derived Polio virus Of the ~100,000 cases tested, very few test positive for the poliovirus 1

2 Vaccine-Derived Polio Virus (VDPV) Vaccine-Derived Polio Virus Oral Polio Vaccine (OPV) contains a live, attenuated vaccine-virus VDPVs are rare strains of the virus that have genetically mutated from the strain contained in the OPV Three main types: Circulating Vaccine-derived poliovirus (cvdpv) Immunodeficiency-related Vaccine-derived poliovirus (ivdpv Three main types: Circulating Vaccine-derived poliovirus (cvdpv) occurs in seriously underimmunized communities Immunodeficiency-related Vaccine-derived poliovirus (ivdpv) occurs in people with rare immune deficiency disorders very rare. Ambiguous Vaccine-derived polio virus (avdpv) often derived from sewage of unknown source The Good News: Communities that are well-immunized against polio are protected from the spread of both wild and vaccine strains Life Goes on as Normal for All, But for Some The Bad News: Communities located in conflict zones, refugee communities and that border countries not polio-resilient are still at risk Far remote areas don t have the medical facility for braces or prosthetics instead use a pole 2

3 How Did Rotary Become Involved? How Did Rotary Become Involved? Taking a page from the eradication of smallpox, Rotary International President MAT Caparas sets as his signature project to eradicate Polio in the Philippines. The effort began in In 1985, Rotary International launched its Polio Plus program, with a goal to eliminate polio by immunizing every child in the world. A million of Rotarian volunteers have participated in National Immunization Days (NIDs) and contributed over $1.7 billion dollars of the $7.2 billion raised so far. In 1988, the Global Polio Eradication Initiative (GPEI), a public-private partnership between Rotary International, the World Health Organization, the CDC, UNICEF, the Gates Foundation and many governments, was formed. Since 1988, 2.5 billion children in 122 countries have been immunized against Polio. History and Milestones ,000 cases in 125 countries cases in 20 countries cases in 16 countries cases in 8 countries cases in 2 countries cases in 3 countries cases in two countries YTD cases in 2 countries! Results Less than 80 cases a year (in 1988, it was 80 cases every two hours) 15,000,000 people walking today who would have been paralyzed $27 billion saved today (direct medical costs) + $17 billion in improved nutrition, productivity and other unintended results. Polio Today Polio Today 2018 Year-to-Date: 2 cases (wild transmission) 0 cases cvdpd 2017: 22 cases (wild transmission) 95 cases cvdpd 3 Endemic countries 4 Outbreak countries 10 Key at-risk countries 3

4 Polio Looking into the Future One Video is Worth a Thousand Words Polio exists where governance and public health systems are the weakest and in conflict zones. By reaching every single child, the program provides an entry point for other interventions. The final push combines the use of complementary vaccines, higher quality campaigns and social mobilization to reach every single child. The Last Frontiers Pakistan and Afghanistan Number of unvaccinated children has declined from levels Both governments are on board at all levels 1800 health camps Women polio workers allowed at permanent transit points Still, the program has to work at safe access for polio workers Social Worker on Her Rounds If Mohammad will not go to the Mountain, the Mountain will go to Mohammad Vaccines Have to be Transported in Temperature Controlled Containers 4

5 End Game Predictions Indian Actor- Amitabh Bachhan Bollywood and Polio Last case of wild-transmitted polio virus in 2018 Three year monitoring effort Polio Free World by 2022 IF We all keep working to raise the $1.5 Billion needed for total eradication. Why Will It Cost So Much? 150,000 workers and six WHO offices 400 million children vaccinated each year Surveillance Activities in 70 countries Essential Risk Mitigation and sustainability activities Bring countries from polio-free to polioresilient After 2 years, scope will be scaled down What Happens if we Stop? Bill Gates In India, Supporting Polio From less than 100 Eradication cases/year today To 200,000 cases/year within ten years 5

6 KUDOS TO ROTARY Thank You! Cecelia Babkirk Chair, District 5170 Grants Subcommittee 6