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After Covid-19 shutdown, Lahore’s fightback against polio begins | The National UAE.

[Oct 11, 2020]

Pakistan's vast effort to stamp out the crippling childhood disease was put on hold in March due to the pandemic.

A boy gets his finger marked after he is administered polio vaccine drops in Karachi, Pakistan. Reuters
A boy gets his finger marked after he is administered polio vaccine drops in Karachi, Pakistan. Reuters.

Ben Farmer writes:

Rania Bibi had spent four years administering polio drops in the backstreets of Lahore's Ravi Town neighbourhood before Covid-19 paused her life-saving work.

Pakistan's vast effort to stamp out the crippling childhood disease was put on hold in March amid fears door-to-door polio vaccination would spread the new coronavirus.

The break to her duties could not have come at a more difficult time. While the world in August celebrated the eradication of wild poliovirus from Africa, the news from its final two haunts of Pakistan and Afghanistan has been grimmer.

Cases rose sharply in 2019 and international monitors gave the programme a severe review for poor performance. Then just as efforts were being overhauled and redoubled, Covid-19 stepped in and shut them down.

It was while she was on this enforced break that Ms Bibi received the awful news that a toddler on her vaccination patch had caught polio and died.

“I cried when I heard he had died,” she told The National.

The death of 26-month-old Muhammad Ali in July was all the more disheartening because it was not the first in Ravi Town in 2020.

Lahore, the capital of Pakistan's Punjab province, had until recently appeared clear of polio after enormous efforts to vaccinate the young inhabitants. After recording a case in 2011, the city remained disease-free.

By 2018, the whole of Pakistan seemed on the verge of eradicating the childhood scourge. Health officials recorded only 12 cases in the whole of that year.

Yet on the cusp of a historic public health victory, the trend instead reversed. Last year saw 147 cases nationwide, including five in Lahore, and sewage samples show the virus is widespread.

An independent board of eminent public health doctors which monitors the global eradication campaign recently criticised the “jaw-dropping slump of performance”.

The board led by Sir Liam Donaldson, formerly England's chief medical officer, warned that unless Pakistan managed to shake up and turn around its programme within six months “the wheels will come off the Pakistan bus”.

With the pandemic, fortunately, having subsided in Pakistan, at least for now, the country's army of health workers resumed nationwide door-to-door campaigns late last month.

Dr Rana Muhammad Safdar, national co-ordinator for the campaign, admits there were “challenges” in 2019. Complacency had set in and political rifts were undermining efforts. The poorest resent the time and investment given to a polio campaign when the government will not provide even clean water or electricity. Most worrying has been a stubborn level of suspicion and conspiracy theory directed at the drops. Long-standing accusations that the campaign is a western plot to sterilise Muslims, or that the drops are otherwise harmful, have been fed by extremist groups and turbocharged by social media. The propaganda led to near hysteria in April 2019, when false rumours spread around the north-eastern city of Peshawar that schoolboys had fallen ill. In a single day, parents rushed 25,000 children to hospital and a state of emergency was declared.

Dr Safdar says lessons were learnt. The campaign has been given across-the-board political backing, he says, and education and outreach efforts have been redoubled. A revitalised campaign was launched late in 2019, only then to run headlong into the pandemic. Epidemiologists worry the hiatus will lead to a further increase in cases.

“Everyone was so depressed when we were regaining some momentum and Covid hit,” Dr Safdar says.

Capt Usman Younis, health secretary for Punjab, said it had been “disheartening” to see polio creep back into Lahore.

“We are very hopeful in about four months we will have a very, very different Punjab. Obviously, Covid has done some amount of damage because we did not do enough campaigns during this time,” he said.

The country's brush with coronavirus has made parents cautious, he said. When workers like Ms Bibi returned to work in late September, they wore masks and carried hand sanitiser on top of their usual equipment.

Nationwide, 260,000 vaccinators sought to vaccinate 40 million children and Ms Bibi was among 4,000 door-to-door teams working in Lahore alone, with another 1,000 teams posted in bazaars and bus stations to vaccinate passing children.

The death of little Muhammad Ali had made her more committed to finishing the job, she said.

“I'm motivated to do more.”


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Brainerd Rotary Club gears up for World Polio Day | Brainerd Dispatch.

[Oct 11th 2020]

World Polio Day is Oct. 24. Rotary International and local Rotary clubs such as the Brainerd Rotary Club and the Central Lakes Rotary Club of Pequot Lakes have been working for years to eradicate polio by raising awareness and funds to combat the highly infectious disease that attacks the nervous system.

This mother was cradling her child, as he received an oral polio vaccine, which would prevent the baby from acquiring the highly infectious disease poliomyelitis (polio), caused by the poliovirus. Photo / Centers for Disease Control and Prevention
This mother was cradling her child, as he received an oral polio vaccine, which would prevent the baby from acquiring the highly infectious disease poliomyelitis (polio), caused by the poliovirus. Photo / Centers for Disease Control and Prevention

Frank Lee writes:

Bob McLean of Nisswa knows getting people to care about World Polio Day during the coronavirus pandemic is a hard sell, but he and his fellow Rotarians aren’t going to stop trying.

World Polio Day is Oct. 24. The annual observance raises awareness about the disease and funds to end it and bring about “a world where no child lives in fear of paralysis from poliovirus.”

“The motto of Rotary, I think, best describes what we do. It’s basically doing good in the world through ‘service above self,’ so we’ve been very involved with many large projects, polio being the most significant,” McLean said.

McLean is retired from Happy Dancing Turtle, a nonprofit in Pine River. He is the district governor for Rotary District 5580, which includes the Rotary Club of Brainerd and the Central Lakes Rotary Club of Pequot Lakes.

“Rotary was the one that really started the whole initiative back in 1985 with the immunization effort. And back then, I think it was something in the neighborhood of like 250,000 people who had polio,” McLean said.

Poliomyelitis is a highly infectious disease that most commonly affects children under the age of 5, according to Rotary International. The poliovirus is spread from person to person through contaminated water, attacking the nervous system, and in some instances, leads to paralysis.

A woman received a vaccination from a health care professional. Photo by the Centers for Disease Control and Prevention on Unsplash.com
A woman received a vaccination from a health care professional. Photo by the Centers for Disease Control and Prevention on Unsplash.com

“In August, the entire continent of Africa was declared free of the wild poliovirus, leaving us with just two countries remaining in the entire world: Afghanistan and Pakistan. Even with a COVID Pandemic, progress continues to be made to achieve a world free of the wild poliovirus,” McLean stated in a letter to club leaders.

World Polio Day is a time for Rotarians from all over the world to come together, recognize their progress in their fight to end polio, and talk about the action they need to take to end polio for good, according to McLean. The theme for World Polio Day 2020 is “A win against polio is a win for global health.”

“The World Health Organization — once they saw what Rotary was able to accomplish in the Philippines — became a partner in the process. And then the Gates Foundation, very generous — exceptionally generous — in their contributions,” McLean said.

Rotary has contributed more than $2.1 billion to global polio eradication efforts. Since 1988, nearly 3 billion children have been immunized against polio, and nearly 19 million people are walking who would otherwise have been paralyzed, according to Rotary officials.

“All the clubs in our district are encouraged to help raise funds to help continue the vaccination process, so we’re encouraging all clubs in the district to — especially with World Polio Day — to put on some fun type event within their community that would help raise awareness,” he said.

The Central Lakes Rotary Club’s fundraiser “Pints for Polio” last year at Big Axe Brewing Co. in Nisswa included a portion of the proceeds from the sale of pints donated to the efforts to eradicate polio.

“There’s a number of clubs who have ordered COVID masks that have the Rotary and ‘End polio’ symbols on them, and those are going to be sold on Oct. 24 as a fundraiser,” McLean said.

The certification of Africa as wild poliovirus-free is a significant milestone that would not have been possible without the dedication and support of countless Rotary members, according to officials.

“It has taken many, many years to get to this point. But we’re now down to the last two countries in the world that have any polio cases left. And we’re hoping within the next three years or so, those two countries, Afghanistan and Pakistan, will also be free of the wild poliovirus,” he said.

McLean said the polio infrastructure Rotary helped build has been used over the last several months to respond to COVID-19 in many vulnerable countries. Rotary International includes 35,000 clubs around the world with 1.2 million members in 220 countries.

Some people who contracted polio end up with the inability to breathe on their own and often need the assistance of a medical device.

“They’re the lucky ones. They’re the ones who survived polio when they were young in contrast to those that were stricken and it became deadly for people because of the impact it has on their ability to breathe,” he said.

Within 10 years, as many as 200,000 new cases of polio could occur worldwide annually, according to Rotary International.

“For those that were living in countries where it continued to be, you know, pervasive, it was something that they were all just frightened to death about,” McLean said. “If you don’t eliminate polio from the face of the earth, it has every opportunity to crawl its way back up.”

For more information about Rotary International’s “End Polio Now” efforts, visit endpolio.org. And visit Rotary International’s Facebook page or endpolio.org at 8 a.m. on World Polio Day on Oct. 24 for an international broadcast about eradicating polio.

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FRANK LEE may be reached at 218-855-5863 or at frank.lee@brainerddispatch.com. Follow him on Twitter at www.twitter.com/DispatchFL.

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The reporting sensitivity of the Vaccine Adverse Event Reporting System (VAERS) for anaphylaxis and for Guillain-Barré syndrome | Vaccine.

[Pay to View Full Text] [Received 29 July 2020, Revised 24 September 2020, Accepted 26 September 2020, Available online 7 October 2020] [In Press, Corrected Proof]

Highlights.

* VAERS is a national passive post-licensure vaccine safety monitoring system.

* Only two previous studies exist on the sensitivity of VAERS reporting.

* We provide data on VAERS capture of anaphylaxis and Guillain-Barré syndrome.

Abstract.

Background.

Underreporting is a limitation common to passive surveillance systems, including the Vaccine Adverse Event Reporting System (VAERS) that monitors the safety of U.S.-licensed vaccines. Nonetheless, previous reports demonstrate substantial case capture for clinically severe adverse events (AEs), including 47% of intussusception cases after rotavirus vaccine, and 68% of vaccine associated paralytic polio after oral polio vaccine.

Objectives.

To determine the sensitivity of VAERS in capturing AE reports of anaphylaxis and Guillain-Barré syndrome (GBS) following vaccination and whether this is consistent with previous estimates for other severe AEs.

Methods.

We estimated VAERS reporting rates following vaccination for anaphylaxis and GBS. We used data from VAERS safety reviews as the numerator, and estimated incidence rates of anaphylaxis and GBS following vaccination from the Vaccine Safety Datalink (VSD) studies as the denominator. We defined reporting sensitivity as the VAERS reporting rate divided by the VSD incidence rate. Sensitivity was reported as either a single value, or a range if data were available from >1 study.

Results.

VAERS sensitivity for capturing anaphylaxis after seven different vaccines ranged from 13 to 76%; sensitivity for capturing GBS after three different vaccines ranged from 12 to 64%. For anaphylaxis, VAERS captured 13–27% of cases after the pneumococcal polysaccharide vaccine, 13% of cases after influenza vaccine, 21% of cases after varicella vaccine, 24% of cases after both the live attenuated zoster and quadrivalent human papillomavirus (4vHPV) vaccines, 25% of cases after the combined measles, mumps and rubella (MMR) vaccine, and 76% of cases after the 2009 H1N1 inactivated pandemic influenza vaccine. For GBS, VAERS captured 12% of cases after the 2012–13 inactivated seasonal influenza vaccine, 15–55% of cases after the 2009 H1N1 inactivated pandemic influenza vaccine, and 64% of cases after 4vHPV vaccine.

Conclusions

For anaphylaxis and GBS, VAERS sensitivity is comparable to previous estimates for detecting important AEs following vaccination.


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OCHA Syria Flash Update #01 Humanitarian Impact of Wildfires in Coastal Areas As of 11 October 2020 | ReliefWeb.

[Situation Report] [Source: OCHA] [Posted: 11Oct 2020] [Originally Published: 11 Oct 2020]

Highlights.

• From 8 October, at least 156 fires were reported in Lattakia (95), Tartous (49) and Homs (12) governorates, with significant spread across several areas on 9-10 October.

• As of 11 October, local authorities reported all fires had been contained and/or extinguished, however the risk for reignition in some areas remained.

• To date, three people are reported to have died in Lattakia, with a further 70 people from Lattakia and nine from Tartous admitted to hospitals.

• While verification is ongoing, some reports indicate as many as 25,000 people may have been displaced. Some early returns have also been reported.

• Overall, early estimates indicate up to 140,000 people (28,000 households) were affected through destruction of and damage to homes and assets, including agricultural land, loss of power and water supply and limited access to services such as hospitals.

• Over 9,000 hectares of agricultural and forested land are also reported destroyed.

• As fires approached, 15 COVID-19 patients from the ICU section of Al Haffa Hospital were evacuated to the Tishreen National Hospital in Lattakia City, however the hospital remains functional. WHO further reported medical personnel and nine patients from Al Qirdaha Hospital were evacuated, and the hospital is currently out of service.

• Severe damage is reported to electrical and water networks in Lattakia, with power supply cut off to some area to prevent further damage to infrastructure.

• Assessments to determine the full scope of impact are currently ongoing.

Situation Overview.

At the time of writing, large scale fires across the coastal regions in Syria have caused at least three deaths and dozens of injuries, with areas in Al Fakhoura, Al Qirdaha, Jableh and Lattakia districts in Lattakia Governorate and Safita district in Tartous Governorate particularly affected. While assessments are ongoing, local authorities report that up to 28,000 households have been directly impacted, including through casualties or medical conditions, with as many as 80 hospitalized due to smoke inhalation. In addition, significant loss of homes, personal possessions and/or livelihoods assets have been reported in some areas. As many as 25,000 people were reported to have displaced. Further, a significant number of households have been impacted due to disruptions in key public services, such as health, water and power supply. To date, an estimated 5,000 hectares of agricultural land, including orchards, olive trees, and greenhouses, and 4,000 hectares of forested land have been destroyed. Assessments are ongoing to determine the full scope of the impact, led by the Syrian Arab Red Crescent (SARC).

At the time of writing, reports indicate the fires had all been contained, with cooling procedures and monitoring ongoing, to mitigate the risk of reignition over the coming days.

Humanitarian Impact.

Over 9-10 October, significant displacements were reported in affected areas, particularly from Al Fakhoura, Al Qirdaha, Jableh and Lattakia districts in Lattakia Governorate, in addition to areas of recently returned IDPs in rural Al Haffa and rural Qastal Maaf districts. Some villages are reported to have completely evacuated as fires approached, with residents taking shelter with family and friends, in schools and vacant shelters. In Ras Al Basit and Badrousieh villages, where significant numbers of displaced persons live, some are reported to have stayed overnight on the beach. In Homs, while agricultural land has been impacted, no displacements are reported to have occurred.

While verification is ongoing, the majority of those still displaced are reported to be living with host families. On 9 October, authorities opened up three schools in Deir Zeinoun, Al Fakhoura and Ein Al Arous villages in Lattakia as emergency shelters for 400 people, although families reportedly left the following day. A further two schools in Balluran and Al Qirdaha towns have been designated to host IDPs if required. As of 10 October, 1,500 people are reported to have returned to their homes. With early reports indicating that some villages have sustained severe damage, it can be expected that some of the displaced may not be able to return to their homes in the short-term.

Priority needs for the displaced include shelter and Non-Food Items such as blankets, clothes, hygiene and dignity kits as well as food assistance, and Water, Sanitation and Hygiene services. Health equipment, such as oxygen cylinders and nebulizers are also urgently needed to treat the effects of smoke inhalation. Additionally, in light of the evacuation of COVID- 19 patients and personnel from some hospitals, health facilities also require specialist COVID-19 resources including Personal Protective Equipment and other supplies to protect medical staff and other patients. A polio vaccination campaign targeting children under five years in Lattakia and Tartous has been postponed. Humanitarian Response and Coordination

The UN Country Team and the Area Humanitarian Country Team in Tartous held emergency meetings on 10 and 11 October to discuss rapid interventions and actions. Emergency assessments are ongoing with the results expected in the coming days.

At present, SARC has deployed three ambulances to Banias, Safita and Mashta El Helu districts in Lattakia as well as four mobile water tanks to support firefighting teams. A mobile clinic is on standby, and partners have confirmed readiness to provide emergency food assistance and core relief items. OCHA is coordinating with authorities and humanitarian partners to develop a contingency response plan.

UN Office for the Coordination of Humanitarian Affairs:
To learn more about OCHA's activities, please visit https://www.unocha.org/.


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