Polio and Antipolio program

An Indian child receives polio vaccination drops during an antipolio campaign in Kabul on March 24, 2014.

Polio's history and its threat

After more than half a century of increasingly successful efforts to eradicatepolio, the paralyzing and sometimes fatal disease is staging a comeback and crossing international borders.

This week, theWorld Health Organization issued a statementcalling the spread of the disease from Pakistan, Syria, and Cameroon an "extraordinary event" and a global public-health threat.

Until now, eradicating polio has been one of the most successful worldwide public-health efforts ever undertaken.In 1955, 28,985 Americans—mostly children—were stricken with polio.Then Jonas Salk developed a vaccine in 1955, which was followed by the Sabin oral vaccine in 1963. There hasn't been a case of polio on the United States since 1979.Since 1988 more than 2.5 billion children have been immunized worldwide, and theoverall number of polio cases has dropped by 99 percent.
To better understand how polio is again becoming a threat—and what should be done about it—National Geographic spoke withWalter A. Orenstein, associate director of theEmory Vaccine Center at the Emory University School of Medicine in Atlanta, Georgia, and former director of the Centers for Disease Control and Prevention's national immunization program.Ten countries continue to have cases of polio, and Pakistan, Syria, and Cameroon have allowed the virus to spread outside their borders.

What can be done to prevent its further spread?

The effort is to break the chains of transmission. The WHO is recommending that countries currently infected with polio ensurethat their people who are traveling outside the country get vaccinated. About 72 percentof the people who are infected with the polio virus have no symptoms, but they can still spread the disease. Polio is now in just a few countries. The concern is not to reinfect the countries that have gotten rid of polio.

How does the disease spread?

Several ways. I can have the virus in my salivaand it can spread if I cough or get it on my hands and touch someone. But the most common way the virus is spread is through thestool. If you don't have good hygiene, it's spread through fecal-oral contact.

What can be done to first contain, then wipe out, polio?

Vaccination is the key strategy. In this country, parents can ensure that they get their children vaccinated on schedule. [The CDC has a recommended vaccination schedule.] Our last outbreak occurred in 1979 among the Amish, an unvaccinated population.

What are the barriers to vaccination in the developing world?

Poverty, unrest, and war are major obstacles. The biggest concern, particularly with war, is not being able to vaccinate the children. There are efforts to gain political support to get medical help into these insecure areas. There are also efforts to set up posts and vaccinate people when they leave these insecure areas. We know that the vaccine works.

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