Pakistani Polio Hits Syria, Proving No Country Is Safe Until All Are

Viruses cross borders invisibly and dangerously. The fighting in Syria has made that especially easy for polio

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Ibrahim Chalhoub / AFP / Getty Images

A Syrian refugee child receives a vaccination against polio at the Bashaer dispensary, in the Abu Samra district of the northern Lebanese port city of Tripoli, on Nov. 9, 2013

The polio virus that crippled at least 13 Syrian children last month originated in Pakistan, according to the World Health Organization (WHO). It does not look as if the disease came into the country with Pakistani militants aligned with rebels fighting the regime of President Bashar Assad, as was alleged last week by a government official. Instead, it appears it has been lurking in the Middle East region for at least a year, seeking any opportunity to infect a vulnerable population. It finally got its chance in Syria, where the ongoing conflict has obstructed the vaccination campaigns that are the only way to ensure the virus stops in its tracks. Before this most recent outbreak, Syria had been polio-free since 1999. It is conflict in Pakistan’s tribal areas that has allowed the virus to flourish and hitch a ride west, demonstrating that as long as polio has a foothold in one country, no other country is safe.

Genetic sequencing of the virus that spread through Deir ez-Zor in eastern Syria, threatening tens of thousands of unvaccinated children, indicates that this particular strain is closely related to samples discovered in the sewage systems of Egypt, the Gaza Strip, Israel and the West Bank late last year. “With large-scale population movements ongoing within and between Syria and surrounding countries, it is very unlikely that it will ever be possible to state definitively how the virus came into the country,” says the WHO’s polio-eradication spokesman Oliver Rosenbauer. “This is the big danger with this disease, in that it can travel across wide geographic areas with population movements.”

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In response, the WHO has mounted a massive, region-wide campaign that aims to vaccinate some 20 million children under the age of 5 in the next six months. It will be an expensive and arduous undertaking, with no guarantees that vaccination teams will reach the most vulnerable children before the virus does. The only way to protect every single child from a crippling disease that has no cure is to eradicate the virus entirely.

The world is tantalizingly close to that goal: after a 28-year campaign, polio is endemic in only three countries: Pakistan, Afghanistan and Nigeria. Even those outliers are on their way toward complete eradication. But a recent antivaccine movement spearheaded by the Pakistani Taliban has threatened Pakistan’s progress. Taliban leaders have banned polio vaccinations in their areas as long as U.S. drones continue to attack militants. Several health workers who defied the ban have since been shot or killed. The result: 56 children have been paralyzed in Pakistan so far this year, up from 48 last year.

“Taliban leaders are essentially holding their own children hostage, just to stop drones,” says Aziz Memon, Rotary International’s PolioPlus chairman for Pakistan, by telephone. By doing so, he says, they are threatening the rest of the world’s children. “This virus is vicious. It is going to travel, and it will seek out the vulnerable. The only way to prevent outbreaks like the one we are seeing in Syria is to stop it here in Pakistan. And the sooner the better.”

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