2024 Gaza Strip polio epidemic

Last updated

2024 Gaza Strip polio outbreak
Disease Polio
Virus strain Circulating vaccine–derived poliovirus type 2 (cVDPV2)
SourceWastewater
Location Khan Yunis and Deir al-Balah, Gaza Strip
First reportedCentral Gaza Strip
Date16 July 2024 – present
Confirmed cases1 [1]
Active cases1 [2]
Suspected cases‡3 [3]
‡Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

The 2024 Gaza Strip polio outbreak is an ongoing outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2) in the Gaza Strip, first discovered on 16 July 2024 and officially declared an epidemic by the Gaza health ministry on 29 July. [4] [5] The Gaza health ministry stated that the epidemic presented a significant risk to Gaza's citizens and to bordering countries, and called the outbreak "a setback to the global polio eradication program". [6] The World Health Organization reported that it was "very likely" that polio cases infected citizens of Gaza and were spreading among its population, although detecting cases would be very challenging due to the virus being asymptomatic in most cases and due to Israeli medical blockades preventing confirmation of cases. [5] The epidemic marked the first occurrence of poliovirus in the Gaza Strip since the virus was completely eradicated from the region 25 years prior. [7]

Contents

On 16 August, tests in Jordan confirmed the first polio infection in Gaza, located in the central Gaza strip. [8]

So far the United Nations has confirmed one case of paralysis in a 10-month-old baby. [9]

On 29 August 2024, Israel made a "preliminary commitment" to comply to pauses in the fighting to facilitate a vaccination campaign. [10] 14 days later the World Health Organization reported that polio vaccination for children of the Gaza strip was achieved. [11]

Background

The Gaza Strip is experiencing a humanitarian crisis as a result of the Israel–Hamas war. [12] [13] The crisis includes both an impending famine and the destruction of its healthcare system. At the start of the war, Israel tightened its blockade on the Gaza Strip, which has resulted in significant shortages of fuel, food, medication, water, and essential medical supplies. [12] [14] This siege resulted in a 90% drop in electricity availability, impacting hospital power supplies, sewage plants, and shutting down the desalination plants that provide drinking water. [15] Widespread disease outbreaks have spread across Gaza as a result. [13]

Public health experts warned of the outbreak and spread of disease in Gaza. According to Oxfam and the United Nations, Gaza's lack of clean water and sanitation would trigger a rise in cholera and other harmful and potentially-deadly infectious diseases. [16] Oxfam stated Gaza's sewage pumping stations and wastewater treatment facilities had ceased operations, so the buildup of solid waste and unburied bodies were likely vectors of disease. [16] Due to the lack of clean drinking water, Gaza residents were drinking water contaminated with sewage, seawater, and farm water, another major source of disease. [16] WHO egional emergency director Richard Brennan stated, "The conditions are ripe for the spread of a number of diarrhoeal and skin diseases". [16]

Raw sewage overflowed in the streets, causing a significant health and environmental disaster. [17] Flooding in Gaza spread sewage water, raising fears of the spread of disease. [18] [19] On 19 January, Yahya Al-Sarraj, the mayor of Gaza City, stated more than 50,000 tons of trash had accumulated in the city, further leading to the spread of disease. [20] Parents reported children falling sick after being exposed to raw sewage. [21] In May 2024, the UN stated, "Mosquitoes, flies and rats are spreading, and so are diseases." [22] Oxfam reported the threat of disease outbreaks due to an accumulation of "human waste and rivers of sewage in the streets". [23]

History

The Gaza Strip had successfully eradicated polio and there had been no cases for over 20 years, however there was some evidence of asymptomatic transmission in the occupied Palestinian territories found during a small outbreak in Israel.[ citation needed ]

Epidemiology

On 16 July 2024, an investigation of sewage sites in the Gaza Strip by the Global Polio Laboratory Network of the World Health Organization (WHO) discovered traces of circulating vaccine-derived poliovirus type 2 in all six test samples among two regions in Khan Yunis and Deir al-Balah. [4] [24] Genomic sequencing of the isolated poliovirus traces by the Centers for Disease Control and Prevention (CDC) found that they had close genetic linkage between each other, and were closely related to cVDPV2 that circulated in Egypt throughout the 2nd half of 2023 and was last detected in December 2023. Research into genetic changes present in the samples indicated that the poliovirus could have spread to Gaza as soon as September 2023. [25]

As of 23 July 2024, no tests had yet been conducted for polio cases or symptoms of paralysis in humans. [26] WHO and UNICEF planned to bring fifty human sample kits to the Gaza Strip on 25 July 2024 and investigate them at a lab in Jordan. [24] In late-July, three cases of acute flaccid paralysis were diagnosed in the Gaza Strip with researchers determining that poliovirus was a potential cause, leading them to take samples of the cases and send them to Jordan for analysis. [27]

The WHO reported that Gaza immunization rates were at 99% in 2022, and fell to 89% in 2023 due to decimation of the Gazan health system in addition to "lack of security, access obstruction, constant population displacement, shortages of medical supplies, poor quality of water and weakened sanitation". [4]

Dr. Lior Nesher, the Israeli Infectious Disease Institute director at the Beersheba Soroka Medical Hospital, claimed that attempts to halt the "ecological movement" of the poliovirus would be "almost impossible", emphasizing that the virus "does not respect borders". He reported that the poliovirus could spread from sewage to underground aquifers as a result of flooding during the rainy season. He stated that even though most Israeli soldiers were immunized against the virus, they could still carry it in their clothes, in mud, and in feces produced with bowel movements, which could cause the virus to spread throughout Israel. He also noted a marked increase in vaccine non-compliance in Israel compared to a few years ago, which could allow the virus to spread easier throughout non-immunized citizens and unvaccinated children. According to his statistics, rates of Israeli measles vaccination were below herd immunity percentages of 92–93%, which could indicate a lack of herd immunity towards polio in the Israeli population were the virus to circulate in Israel. [28]

On 29 July, the Gaza Health Ministry officially declared a polio epidemic in the Gaza Strip, stating that the circulating poliovirus throughout large deposits of wastewater posed a significant health threat to Gaza and countries bordering it. The ministry called the epidemic "a setback to the global polio eradication program" and placed blame on the destruction of hospitals and medical infrastructure by Israel. [6] On 30 July, the WHO reported that it was "very likely" that polio had infected and spread among citizens Gaza. [5]

On 16 August, the Palestinian Ministry of Health recorded the first confirmed case of polio in Gaza in the city of Deir al-Balah. [29] The first polio victim was a ten-month old baby who "stopped crawling, stopped moving, stopped standing up, and stopped sitting." [30]

Response

Humanitarian response

Head of WHO's Palestinian team Dr. Ayadil Saparbekov stated that organization workers were conducting risk assessments and distributing information about protection from polio to the Gazan population. He noted that it would be very difficult for citizens to be able to follow the guidelines recommended due to the lack of wastewater and sanitation treatment and the resulting buildup of waste and debris in densely crowded refugee encampments throughout the Gaza Strip. [4]

Efforts to limit the spread of the disease were significantly complicated by difficulties in moving humanitarian aid into Gaza including sanitation equipment and adequate nutrition. In addition, dangerous conditions in the Gaza Strip due to military assaults and airstrikes prevented safe allocation of resources across the territory to isolated regions and populations with the greatest susceptibility. [4]

WHO vaccination drive

On 12 September the World Health Organization reported reaching the target of polio vaccination for children of the Gaza strip. [11] One week later, the United Nations stated that its second round of polio vaccinations would include doses of micronutrients and a nutritional screening. [31] The W.H.O. began its second round of polio vaccinations on 14 October 2024. [32] It was delayed due to intense bombardment in northern Gaza, however, where the campaign had sought to vaccinate more than 100,000 children. [33]

In early-November 2024, WHO stated it would resume polio vaccinations in northern Gaza but only in Gaza City. [34] The following day, however, an Israeli drone reportedly bombed the polio vaccination site, the Sheikh Radwan Clinic, wounding three children. [35] The World Health Organization later stated six people, including four children, were injured in the strike. [36] UNICEF condemned the strike, stating, "Health workers and other humanitarian staff cannot do their jobs in the midst of ongoing attacks." [37]

Israeli response

The IDF started a voluntary vaccination campaign for its soldiers. [38] It also announced cooperating with humanitarian agencies for vaccine delivery in Gaza, with ~300,000 vaccines delivered since the start of the conflict in October. [4]

Human Rights Watch stated that both Israel's attacks on healthcare and water infrastructure and obstruction of humanitarian aid were worsening the polio epidemic. [39]

See also

Related Research Articles

<span class="mw-page-title-main">Polio</span> Infectious disease caused by poliovirus

Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe symptoms develop such as headache, neck stiffness, and paresthesia. These symptoms usually pass within one or two weeks. A less common symptom is permanent paralysis, and possible death in extreme cases. Years after recovery, post-polio syndrome may occur, with a slow development of muscle weakness similar to what the person had during the initial infection.

<span class="mw-page-title-main">Polio vaccine</span> Vaccine to prevent poliomyelitis

Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated poliovirus given by injection (IPV) and a weakened poliovirus given by mouth (OPV). The World Health Organization (WHO) recommends all children be fully vaccinated against polio. The two vaccines have eliminated polio from most of the world, and reduced the number of cases reported each year from an estimated 350,000 in 1988 to 33 in 2018.

<span class="mw-page-title-main">Poliovirus</span> Enterovirus

Poliovirus, the causative agent of polio, is a serotype of the species Enterovirus C, in the family of Picornaviridae. There are three poliovirus serotypes, numbered 1, 2, and 3.

The oral polio vaccine (OPV) AIDS hypothesis is a now-discredited hypothesis that the AIDS pandemic originated from live polio vaccines prepared in chimpanzee tissue cultures, accidentally contaminated with simian immunodeficiency virus and then administered to up to one million Africans between 1957 and 1960 in experimental mass vaccination campaigns.

<span class="mw-page-title-main">Pulse Polio</span> Indian governmental immunisation campaign

Pulse Polio is an immunisation campaign established by the government of India to eliminate poliomyelitis (polio) in India by vaccinating all children under the age of five years against the polio virus. The project fights polio through a large-scale, pulse vaccination programme and monitoring for poliomyelitis cases.

<span class="mw-page-title-main">Ali Maow Maalin</span> Hospital worker, last naturally acquired case of smallpox (1954–2013)

Ali Maow Maalin was a Somali hospital cook and health worker from Merca who is the last person known to have been infected with naturally occurring Variola minor smallpox. He was diagnosed with the disease in October 1977 and made a full recovery. Although he had many contacts, none of them developed the disease, and an aggressive containment campaign was successful in preventing an outbreak. Smallpox was declared to have been eradicated globally by the World Health Organization (WHO) two years later. Maalin was subsequently involved in the successful poliomyelitis eradication campaign in Somalia, and he died of malaria while carrying out polio vaccinations after the re-emergence of the poliovirus in 2013.

<span class="mw-page-title-main">Polio eradication</span> Effort to permanently eliminate all cases of poliomyelitis infection

Polio eradication, the goal of permanent global cessation of circulation of the poliovirus and hence elimination of the poliomyelitis (polio) it causes, is the aim of a multinational public health effort begun in 1988, led by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Rotary Foundation. These organizations, along with the U.S. Centers for Disease Control and Prevention (CDC) and The Gates Foundation, have spearheaded the campaign through the Global Polio Eradication Initiative (GPEI). Successful eradication of infectious diseases has been achieved twice before, with smallpox in humans and rinderpest in ruminants.

<span class="mw-page-title-main">History of polio</span>

The history of polio (poliomyelitis) infections began during prehistory. Although major polio epidemics were unknown before the 20th century, the disease has caused paralysis and death for much of human history. Over millennia, polio survived quietly as an endemic pathogen until the 1900s when major epidemics began to occur in Europe. Soon after, widespread epidemics appeared in the rest of the world. By 1910, frequent epidemics became regular events throughout the developed world primarily in cities during the summer months. At its peak in the 1940s and 1950s, polio would paralyze or kill over half a million people worldwide every year.

Mass vaccination is a public policy effort to vaccinate a large number of people, possibly the entire population of the world or of a country or region, within a short period of time. This policy may be directed during a pandemic, when there is a localized outbreak or scare of a disease for which a vaccine exists, or when a new vaccine is invented.

<span class="mw-page-title-main">Eradication of infectious diseases</span> Elimination of a disease from all hosts

The eradication of infectious diseases is the reduction of the prevalence of an infectious disease in the global host population to zero.

<span class="mw-page-title-main">Joseph L. Melnick</span> American epidemiologist

Joseph Louis Melnick was an American epidemiologist who performed breakthrough research on the spread of polio. The New York Times called him "a founder of modern virology".

Pakistan is one of the two remaining countries in the world where poliomyelitis (polio) is still categorized as an endemic viral infection, the other one being Afghanistan. While it has yet to fully eradicate Polio, there has been a major downwards trend in the number of reported cases per year; the total count of wild poliovirus cases in Pakistan in 2019 was down to 147, compared to 84 in 2020, 1 in 2021, 20 in 2022, 6 in 2023 and 41 as of October 2024.

India National PolioPlus Society is a non-profit organization. The Initiative has achieved significant progress toward its goals. There has been a dramatic decline in cases everywhere in the seventeen years since the target was set in 1988.

<span class="mw-page-title-main">Global Polio Eradication Initiative</span> Initiative to eradicate polio

The Global Polio Eradication Initiative is an initiative created in 1988, just after the World Health Assembly resolved to eradicate the disease poliomyelitis. Led by the World Health Organization, it is the largest international public health initiative in history.

<span class="mw-page-title-main">2019–2021 polio outbreak in the Philippines</span> Disease outbreak in the Philippines

The 2019–2021 polio outbreak in the Philippines was an epidemic. For the previous 19 years, the Philippines was free of any polio-related diseases. On September 14, 2019, the disease began to resurface through a positive test result done to a 3-year-old girl from Mindanao. After the confirmation of a second case from tests done on a 5-year-old boy, the government of the Philippines publicly declared a polio outbreak on September 19, 2019. On June 11, 2021, the WHO announced that the outbreak has ended.

<span class="mw-page-title-main">Michael J. Ryan (doctor)</span> Irish doctor and Chief Executive Director of the WHO Health Emergencies Programme

Michael Joseph Ryan is an Irish epidemiologist and former trauma surgeon, specialising in infectious disease and public health. He is executive director of the World Health Organization's Health Emergencies Programme, leading the team responsible for the international containment and treatment of COVID-19. Ryan has held leadership positions and has worked on various outbreak response teams in the field to eradicate the spread of diseases including bacillary dysentery, cholera, Crimean–Congo hemorrhagic fever, Ebola, Marburg virus disease, measles, meningitis, relapsing fever, Rift Valley fever, SARS, and Shigellosis.

The World Health Organization (WHO) created the Global Commission for the Certification of the Eradication of Poliomyelitis in 1995 to independently verify the eradication of wild poliovirus. The GCC certified the worldwide eradication of indigenous wild poliovirus type 2 on 20 September 2015, and wild poliovirus type 3 on 17 October 2019. In addition, five of the six World Health Organization Regions certified their status as free of indigenous transmission of all three serotypes of wild poliovirus :

Misinformation related to immunization and the use of vaccines circulates in mass media and social media in spite of the fact that there is no serious hesitancy or debate within mainstream medical and scientific circles about the benefits of vaccination. Unsubstantiated safety concerns related to vaccines are often presented on the internet as being scientific information. A large proportion of internet sources on the topic are mostly inaccurate which can lead people searching for information to form misconceptions relating to vaccines.

<span class="mw-page-title-main">Gaza humanitarian crisis (2023–present)</span>

The Gaza Strip is experiencing a humanitarian crisis as a result of the Israel–Hamas war. The crisis includes both an impending famine and a healthcare collapse. At the start of the war, Israel tightened its blockade on the Gaza Strip, which has resulted in significant shortages of fuel, food, medication, water, and essential medical supplies. This siege resulted in a 90% drop in electricity availability, impacting hospital power supplies, sewage plants, and shutting down the desalination plants that provide drinking water. Doctors warned of disease outbreaks spreading due to overcrowded hospitals.

Events in the year 2024 in Palestine.

References

  1. ↑ "Gaza sees first polio case in 25 years as UN calls for mass vaccinations". The Guardian. 2024-08-16. ISSN   0261-3077 . Retrieved 2024-08-17.
  2. ↑ "Gaza sees first polio case in 25 years as UN calls for mass vaccinations". The Guardian. 2024-08-16. ISSN   0261-3077 . Retrieved 2024-08-17.
  3. ↑ "WHO warns Gaza at 'high risk' of polio outbreak". Financial Times. Retrieved 23 July 2024.
  4. 1 2 3 4 5 6 "Polio in Gaza: WHO 'extremely worried' about possible outbreak". www.bbc.com. Retrieved 23 July 2024.
  5. 1 2 3 "Polio cases 'very likely' in Gaza population, WHO says". Reuters. 30 July 2024. Retrieved 30 July 2024.
  6. 1 2 "Gaza Health Ministry Declares Territory 'Polio Epidemic Area'". Barron's. 30 July 2024. Retrieved 30 July 2024.
  7. ↑ Al-Taher, Nada (30 July 2024). "Gaza declares polio epidemic 25 years after disease was eradicated in enclave". The National. Retrieved 30 July 2024.
  8. ↑ "Gaza sees first polio case in 25 years as UN calls for mass vaccinations". The Guardian. 2024-08-16. ISSN   0261-3077 . Retrieved 2024-08-17.
  9. ↑ "Baby contracts Gaza's first case of polio in 25 years". www.bbc.com. 24 August 2024. Retrieved 24 August 2024.
  10. ↑ "UN says Israel agrees to pauses in Gaza fighting for polio vaccinations". Al Jazeera . 29 Aug 2024. Retrieved 30 August 2024.
  11. 1 2 "WHO 'confident' that polio vaccine drive in Gaza hit target of 90% of kids under 10 | The Times of Israel". The Times of Israel .
  12. 1 2 Ioanes, Ellen (14 October 2023). "Gaza's spiraling humanitarian crisis, explained". Vox . Archived from the original on 14 October 2023. Retrieved 16 October 2023.
  13. 1 2 Marsi, Federica (14 October 2023). "Gaza doctors warn of a humanitarian catastrophe after Israeli attacks". Al Jazeera. Archived from the original on 14 October 2023. Retrieved 25 October 2023.
  14. ↑ Gottbrath, Laurin-Whitney. "Gaza "fast becoming hell hole" on "brink of collapse" amid Israel strikes: UN". Axios . Archived from the original on 16 October 2023. Retrieved 16 October 2023.
  15. ↑ Mellen, Ruby; Chen, Szu Yu (26 October 2023). "See how Israel's siege has plunged Gaza into darkness and isolation". The Washington Post . Archived from the original on 27 October 2023. Retrieved 27 October 2023.
  16. 1 2 3 4 Marsi, Federica. "Gaza's next big threat: Cholera, infectious diseases amid Israeli blockade". Al Jazeera. Archived from the original on 21 October 2023. Retrieved 24 October 2023.
  17. ↑ "Sewage Is Flowing into the Streets because Pumps Don't Have Electricity". Calgary Herald . Archived from the original on 18 November 2023. Retrieved 14 November 2023.
  18. ↑ "Gaza flooding latest disaster to hit desperate Palestinians". UN News. United Nations. 14 December 2023. Archived from the original on 18 January 2024. Retrieved 7 January 2024.
  19. ↑ "Gaza's Jabalia refugee camp overrun with sewage water". Al Jazeera . Archived from the original on 7 January 2024. Retrieved 7 January 2024.
  20. ↑ "Gaza City mayor: Fuel depletion poses challenge to providing services". Al Jazeera . Archived from the original on 19 February 2024. Retrieved 20 January 2024.
  21. ↑ Yang, Maya; Sedghi, Amy; Abdul, Geneva; Fulton, Adam (21 January 2024). "WHO: three in four Palestinians in Gaza internally displaced". The Guardian . Archived from the original on 19 February 2024. Retrieved 22 January 2024.
  22. ↑ "UN sounds alarms on 'sanitation crisis' in war-stricken Gaza". Al Jazeera . Archived from the original on 10 May 2024. Retrieved 10 May 2024.
  23. ↑ Shurafa, Wafaa. "Misery deepens in Gaza's Rafah as Israeli troops press operation". ABC News . Associated Press. Archived from the original on 20 May 2024. Retrieved 20 May 2024.
  24. 1 2 "WHO voices 'extreme' concern over possibility of mass outbreak of polio in Gaza". Anadolu Ajansı. Retrieved 23 July 2024.
  25. ↑ "WHO Briefing Notes for UNOG Palais Briefing, 23 July 2024 - occupied Palestinian territory | ReliefWeb". reliefweb.int. 2024-07-23. Retrieved 23 July 2024.
  26. ↑ "WHO warns Gaza at 'high risk' of polio outbreak". Financial Times. Retrieved 23 July 2024.
  27. ↑ "Gaza remains at 'high risk' of polio virus spread, warn UN aid teams | UN News". news.un.org. 2024-08-14. Retrieved 2024-08-17.
  28. ↑ Bletter, Diana (23 July 2024). "Disease expert warns polio outbreak in Gaza could spread to Israel". Times of Israel. Retrieved 23 July 2024.
  29. ↑ Siddiqui, Usaid (16 August 2024). "Health ministry records first confirmed case of polio in Gaza". Al Jazeera . Archived from the original on 16 August 2024. Retrieved 16 August 2024.
  30. ↑ Shurafa, Wafaa. "A 10-month-old Palestinian baby suddenly stopped crawling. Polio had struck Gaza". Associated Press. Retrieved 15 September 2024.
  31. ↑ Nichols, Michelle. "UN to add nutrients to second round of Gaza polio vaccinations". Reuters. Retrieved 22 September 2024.
  32. ↑ Farge, Emma. "Second phase of polio vaccination campaign begins in Gaza, WHO says". Reuters. Retrieved 16 October 2024.
  33. ↑ "Israeli strikes delay polio vaccine campaign in the north". UN News. Retrieved 25 October 2024.
  34. ↑ Williams, Matthias. "Delayed Gaza polio vaccinations to resume on Saturday, agencies say". Reuters. Retrieved 2 November 2024.
  35. ↑ "3 children injured in Israeli strike on Gaza clinic during polio vaccination". Xinhua. Retrieved 3 November 2024.
  36. ↑ "WHO Says Strike On Gaza Vaccination Centre Wounds Four Children". Barron's. Agence France Presse. Retrieved 3 November 2024.
  37. ↑ Berger, Miriam. "Polio vaccinations resume in Gaza City amid 'near-impossible conditions'". The Washington Post. Retrieved 3 November 2024.
  38. ↑ "Israeli soldiers to receive polio shots after virus detected in Gaza: Reports". POLITICO . 21 July 2024. Retrieved 24 August 2024.
  39. ↑ "Gaza: Israeli Aid Obstruction Inflaming Polio Outbreak". Human Rights Watch. Retrieved 10 September 2024.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.