Wednesday - July 04, 2012

False Alarm

I saw a billboard by the side of the road the other day. I didn’t have too much time to read it, since my concentration was more on the road and all the traffic cones as one of our local cowpaths undergoes widening to officially become the minor highway that it’s turned into over the years. Some routes are just too convenient, and eventually they just get overwhelmed with traffic. And several eternities after that the government cottons to that reality and sends out the asphalt gang.

So anyway, I’m coming south from Washington into Glen Gardner, and I catch a glance at a billboard ... End Polio Now it tells me. Say what?? That billboard has been used for health messages in the past for years - deer ticks, well water inspection, folic acid for prenatal care, etc - so I was shocked. Polio? “Holy ****”, I’m thinking as I motor past Sanatorium Rd, the street where one of the largest tuberculosis recovery facilities in state history once existed, “now polio is making a comeback? The world’s gone mad! It’s gotta be all those unchecked illegals with their diseases sneaking in!”

A bit more research shows that India has just had it’s first full year EVER without a polio case. Ever. While the Salk and the Sabin vaccines virtually eliminated polio in the USA in the late 50s and early 60s, followed by a massive world-wide immunization program that protected most of the world within the next decade, some of the farthest and poorest corners are still at risk. India was one of them, but efforts over the last 10 years or so by the WHO and by the Bill and Melinda Gates Foundation have inoculated tens of millions of children there.

Incidents of polio from the wild disease only exist in 3 countries at this point. Nigeria, Pakistan, and Afghanistan. Three of the poorest corners of the globe, and all three with heavy radical Islam influence.

In Afghanistan I read that the Taliban is actively fighting the vaccination teams, even killing them. And my reaction to that was typical too: filthy murderous primitives, using children as a political lever, probably chopping off arms once the doctors visit villages, just like Pol Pot and those African shamans. And while I may be somewhat right with that view, I may also be somewhat wrong. The Taliban may be somewhat justified in their actions.

You see, there are three kinds of polio virus: type 1, type 2, and type 3. And there are two kinds of polio vaccine: injected (Salk, IPV) and oral (Sabin, OPV). And the vaccines now come in three varieties, which I think relate to the strains of the virus they contain: monovalent, bivalent, and trivalent. And the vaccines almost always work. Almost. But not always. The Salk vaccine, known as IPV (Injected Polio Vaccine) only contains the dead virus. It needs to be administered by a health worker qualified to give injections, and thus costs upwards of a dollar per dose. The Sabin vaccine, known as OPV (Oral Polio Vaccine) contains dead and “neutralized” virus, and can be administered by anyone. This drops the cost to about a dime. Recent studies have shown that the bivalent form of the vaccine might be more efficacious than the mono- or trivalent versions, but that probably won’t lower the cost noticeably. The cost numbers I’m throwing around are inexact, but close. And it actually requires 2 or 3 inoculations to fully protect a child, so the real cost per child is tripled.

All polio vaccination in the USA is done with the IPV these days. The risk from that form of the vaccine is far lower than the risk from the oral form.

The point is that even Bill Gates can only afford to immunize the entire world with the oral vaccine, and that vaccine isn’t perfect. Some children get polio from receiving the vaccine. Some die. The numbers are quite low - the risk is something like 1 in 10,000 - but the risk is still there. And it may be (I’m just tossing this idea out there) that weaker, more malnourished children have a higher incidence of getting infected from the immunization. And that’s likely what the Taliban is objecting to. Don’t ask me what goes on in Nigeria. Probably witch doctors and evil spirits for all I know. There are also other voices - naysayers, Luddites, the tinfoil hat brigade, and perhaps some with well thought out objections - who feel that the whole OPV effort is hardly more than a tax dodge and a way to support Big Pharma by emptying their warehouses of unwanted and outdated medicines. Oh, its also the root of the great cancer epidemic we’ve had since then, and that was likely known at the time the vaccines hit the market. That’s a bit too cynical, even for me.

I invite any of the MDs we have here as members to comment professionally, and I welcome enlightening comments by members who have personal knowledge or who have made more research effort than I. I may be misstating things here, and I welcome correction and enlightenment. Our more mature readers will remember the polio outbreaks of the 40s and 50s. The summers of fear. The horror and the heartbreak. I turn 52 on Veteran’s Day, and polio has hardly been part of my life. By the time I was old enough to be aware of such things, the pandemic was pretty much over in America. I’d see the rare child with legs braces or crutches, we all collected our pennies for UNICEF at Halloween, and you’d hear adults talk about how things used to be. And that was it. By the time I was in high school even those conversations were a thing of the past. But the virus is not dead. Polio still exists “in the wild”. Which means there’s probably some in your house, or in your yard, or even on your skin right now. I’ll leave you with one statistic I ran across while looking things up for this post: 95% of American children are fully immunized against polio before they enter the public school system. If I had young children, I would not want them to be part of that 5%. Would you??

The lady on the billboard above is Megan Jones-Holt, resident of my town and District Governor of Rotary here in NJ.

Posted by Drew458     on 07/04/2012 at 09:46 AM   
Filed Under: • Health-Medicine •  
• Comments (2) • Trackbacks(0)  Permalink •  

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