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Burundi officials detect polio outbreak linked to vaccine

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A child cries after she was administered with a polio vaccine during a house to house vaccination exercise in Maiduguri, Nigeria, on Aug. 28, 2016. Health officials in Burundi on Friday March 17, 2023 have declared an outbreak of polio linked to the vaccine, the first time the paralytic disease has been detected in the east African country for more than three decades. Across Africa, there were more than 400 cases of polio last year linked to the oral vaccine, including Congo, Nigeria, Ethiopia and Zambia. (AP Photo/Sunday Alamba, File)

By Maria Cheng in London

LONDON (AP) — Health officials in Burundi have declared an outbreak of polio linked to the vaccine, the first time the paralytic disease has been detected in the East African country for more than three decades.

Polio has been diagnosed in an unvaccinated four-year-old child in the western part of the country and in two other children who were contacts of the child, authorities in Burundi confirmed in a statement on Friday. Officials also found traces of the virus in sewage samples, confirming the circulation of polio.

The virus that sickened the children was found to be a mutated strain of polio that initially came from an oral vaccine.

The Burundi government declared the polio outbreak to be a national public health emergency and plans to start an immunization campaign within weeks, aimed at protecting all children up to age seven.

“We are supporting the national efforts to ramp up polio vaccination to ensure no child is missed and faces polio’s debilitating impact,” said Dr. Matshidiso Moeti, WHO’s Africa director.

The epidemic is another setback for the global effort to wipe out polio led by the World Health Organization and partners, which first began in 1988 and initially aimed to eradicate the disease in a dozen years.

Polio is a highly infectious disease mostly spread through water and typically strikes children under five. There is no treatment. Although the oral vaccine used in the global effort to eradicate the disease is highly effective, it requires four doses.

The oral vaccine can also cause polio in about two to four children per 2 million doses. In extremely rare cases, the weakened virus can also sometimes mutate into a more dangerous form and spark outbreaks, especially in places with poor sanitation and low vaccination levels.

In recent years, the oral polio vaccine has caused far more cases of polio than the wild polio virus. Last year, cases linked to the oral vaccine turned up in rich countries including Britain, Israel and the U.S. for the first time in years.

Officials began rolling out a new oral polio vaccine last year that they hoped would be less likely to mutate into a version able to trigger new outbreaks. But the epidemic in Burundi — in addition to six cases in Congo — were found to have been sparked by the new oral vaccine.

Across Africa, more than 400 cases of polio last year were linked to the oral vaccine, including Congo, Nigeria, Ethiopia and Zambia.

The disease also remains stubbornly entrenched in Pakistan and Afghanistan, where transmission has never been stopped.

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Brownstone Institute

The Plan: Lock You Down for 130 Days

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From the Brownstone Institute

BY Jayanta BhattacharyaJAYANTA BHATTACHARYA

What if the coronavirus pandemic was not a once-in-a-century event but the beginning of a new era of regular deadly respiratory viral pandemics? The Biden administration is already planning for this future. Last year, it unveiled a national strategy to develop pharmaceutical firms’ capacity to create vaccines within 130 days of a pandemic emergency declaration.

The Biden plan enshrines former president Donald Trump‘s Operation Warp Speed as the model response for the next century of pandemics. Left unsaid is that, for the new pandemic plan to work as envisioned, it will require us to conduct dangerous gain-of-function research. It will also require cutting corners in the evaluation of the safety and efficacy of novel vaccines. And while the studies are underway, politicians will face tremendous pressure to impose draconian lockdowns to keep the population “safe.”

In the case of COVID-19 vaccines, it took about a year for governments to deploy the jab at scale after scientists sequenced the virus. Scientists identified a vaccine target—fragments of the spike protein that the virus uses to access cells—by early January 2020, even before the WHO declared a worldwide pandemic.

This rapid response was only possible because some scientists already knew much about the novel virus. Despite heavy regulations limiting the work, the US National Institutes of Health had funded collaborations between the EcoHealth Alliance and the Wuhan Institute of Virology. They collected bat viruses from the wild, enhanced their function to study their potential, and designed vaccines before the viruses infected humans.

While there is controversy over whether this gain-of-function work is responsible for the COVID pandemic, there is no question this research is potentially dangerous. Even cautious scientists sometimes accidentally leak hazardous, highly infectious viruses into the surrounding community. In December 2021, for instance, the virus that causes COVID-19 accidentally leaked out of a laboratory in Taiwan, where scientists were researching the virus.

A promising vaccine target would be needed immediately after a disease outbreak for the Biden pandemic plan to work. For that to be possible, there will need to be permanent support for research enhancing the capacity of viruses to infect and kill humans. The possibility of a deadly laboratory leak will hang over humanity into perpetuity.

Furthermore, before any mass vaccination campaign, pharmaceutical firms must test the vaccines for safety. High-quality randomized, controlled studies are needed to make sure the vaccine works.

In 1954, Jonas Salk’s group tested the vaccine in a million children before the polio mass vaccination campaign that effectively defanged the threat of polio to American children. Physicians need the results of these studies to provide accurate information to patients.

Operation Warp Speed cut red tape so that vaccine manufacturers could conduct these studies rapidly. The randomized trials cut some corners. For instance, the Pfizer and Moderna trials did not enroll enough people to determine whether the COVID vaccines reduce all-cause mortality.

Nor did they determine whether the vaccines stop disease transmission; a few months after the government deployed the vaccines, researchers found protection against infection was partial and short-lived. Each of these cut corners has since created policy controversies and uncertainty that better trials would have avoided. Because of the pressure to produce a vaccine within 130 days, President Biden’s pandemic plan will likely force randomized trials on future vaccines to cut the same corners.

This policy effectively guarantees that lockdowns will return to the US in the event of a new pandemic. Though the lockdowns did not work to protect populations from getting or spreading COVID—after 2.5 years, nearly everyone in the US has had COVID—public health bureaucracies like the CDC have not repudiated the strategy.

Imagine the early days of the next pandemic, with public health and the media fomenting fear of a new pathogen. The impetus to close schools, businesses, churches, beaches, and parks will be irresistible, though the pitch will be “130 days until the vax” rather than “two weeks to flatten the curve.”

When the vaccine finally arrives, the push to mass vaccinate for herd immunity will be enormous, even without evidence from the rushed trials that the vaccine provides long-lasting protection against disease transmission. This happened in 2021 with the COVID vaccine and would happen again amidst the pandemic panic. The government would push the vaccine even on populations at low risk from the novel pathogen. Mandates and discrimination against the unvaccinated would return, along with a fierce movement to resist them. The public’s remaining trust in public health would shatter.

Rather than pursue this foolish policy, the Biden administration should adopt the traditional strategy for managing new respiratory-virus pandemics. This strategy involves quickly identifying high-risk groups and adopting creative strategies to protect them while not throwing the rest of society into panic.

The development of vaccines and treatments should be encouraged, but without imposing an artificial timeline that guarantees corners will be cut in evaluation. And most of all, lockdowns—a disaster for children, the poor, and the working class—should be excised from the public health toolkit forever.

A version of this piece appeared in Newsweek

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  • Jayanta Bhattacharya

    Jay Bhattacharya is a physician, epidemiologist and health economist. He is Professor at Stanford Medical School, a Research Associate at the National Bureau of Economics Research, a Senior Fellow at the Stanford Institute for Economic Policy Research, a Faculty Member at the Stanford Freeman Spogli Institute, and a Fellow at the Academy of Science and Freedom. His research focuses on the economics of health care around the world with a particular emphasis on the health and well-being of vulnerable populations. Co-Author of the Great Barrington Declaration.

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