One more to go.
October 24, 2019 9:46 PM   Subscribe

WHO just declared another polio virus strain eradicated. For polio to be fully eradicated, all three wild polio strains — types 1, 2, and 3 — need to stop circulating. The three strains all cause the same horrible symptoms, including paralysis and death, but are virologically distinct. Type 2 was eradicated back in 2015; the last case of type 3 polio surfaced in northern Nigeria in 2012 and the virus hasn’t been seen since. A poliovirus can be considered eradicated if it hasn’t been detected for three years. “[The eradication of type 3 polio] is a significant achievement that should reinvigorate the eradication process and provides motivation for the final step — the eradication of wild poliovirus type 1,” said David Salisbury, chair of the independent Global Commission for the Certification of Poliomyelitis Eradication, in a statement Thursday. Today, only type 1 remains at large — in Afghanistan and Pakistan. If it’s eradicated, polio will join smallpox as the only two human scourges wiped off the face of the planet. (A third disease that’s been eradicated, rinderpest, is spread mainly in cattle.) And today’s news is a step in that right direction.
posted by Homo neanderthalensis (13 comments total) 37 users marked this as a favorite
 
A successful disease eradication is one of the highest achievements of global cooperation, and is an example of collective action actively destroying a potential market in medicines for the collective good.
posted by jaduncan at 9:54 PM on October 24, 2019 [20 favorites]


I so hope we can do this. This shitty timeline can give us this one golden thing.
posted by away for regrooving at 10:13 PM on October 24, 2019 [10 favorites]


Bookkeeping question: so why was type 3 not declared eradicated in 2012 + 3 = 2015? What's the trigger for now?
the last case of type 3 polio surfaced in northern Nigeria in 2012 and the virus hasn’t been seen since. A poliovirus can be considered eradicated if it hasn’t been detected for three years.

Question for virologists or whoever: we have circulating vaccine-derived poliovirus; is any of that type 2 or 3 virus from recent OPV (which was bivalent 1+3) or from pre-2015 OPV (containing 2)? If so is it functionally meaningful to say that types 2 or 3 are eradicating? (maybe if the cVDPV is less virulent it is)
posted by away for regrooving at 10:22 PM on October 24, 2019


My Gran had polio as a child and as a consequence throughout her life couldn't properly use one arm (that's the very short version). The subject came up with one of my customers at work, a real 90-ish yr old Gran of a woman herself and she promptly quoted off the full/Latinate name of the condition whilst in the course of telling about her career as a nurse.

Chuffed to hear another strain gone.
posted by I'm always feeling, Blue at 10:23 PM on October 24, 2019 [3 favorites]




The eradication of rinderpest means that measles is also eradicable now
posted by ocschwar at 4:03 AM on October 25, 2019 [4 favorites]


Bookkeeping question: so why was type 3 not declared eradicated in 2012 + 3 = 2015? What's the trigger for now?
the last case of type 3 polio surfaced in northern Nigeria in 2012 and the virus hasn’t been seen since. A poliovirus can be considered eradicated if it hasn’t been detected for three years.


The key there is “can be”. That’s the minimum standard for eradication, but there are other steps that must be taken so we’re not declaring stuff eradicated prematurely and ending vaccination programs and suchlike.
posted by Etrigan at 4:28 AM on October 25, 2019


If it’s eradicated, polio will join smallpox as the only two human scourges wiped off the face of the planet.

Am I wrong in remembering that samples of the smallpox virus still exist in research and/or military facilities?
posted by Thorzdad at 4:33 AM on October 25, 2019 [1 favorite]


This is good news but it comes at the same time as the emergence of a new extremely polio-like illness, acute flaccid myelitis (AFM) in the United States which is pretty frightening.
posted by srboisvert at 5:50 AM on October 25, 2019 [1 favorite]




Polio eradication is important work. In some places, it is dangerous work that people risk their lives to achieve. In Pakistan this year, polio workers and the police protecting them were injured and killed in multiple attacks against them. These attacks were due in part to hoax videos spread on Facebook. I thought this passage (from the article I linked) was especially remarkable:
Khalida Nasareen, 61, area supervisor in Orangi Town in the north of Karachi, said: “Absolutely, God willing, we will end polio soon, but unfortunately bad people try to run down our work. We have to face that propaganda head on. It hurts but it passes and we will bring it back to where we were.

“If we can save the life of one child, I feel as though I’m contributing to saving humanity. Ours is a poor neighbourhood which lacks basic services and with poverty comes lack of awareness and education. It’s a cause I’m willing to die for.”
I can't find a comprehensive tally, but between 2012 and 2015 alone, 68 people involved in polio vaccination programs were killed in Pakistan.

In neighboring India, the annual number of polio cases dropped from 742 to 1 between 2009 and 2011. That single case in 2011 was the last documented case in India, and the disease is now considered eradicated there. People involved in the eradication attribute support from Muslim clerics in India as a contributing factor for success.

The same has not been true in Pakistan. Local support for vaccination programs has been undermined by the CIA's use of a fake vaccination program to confirm the Bin Laden family's presence there. The use of such cover programs has engendered mistrust of healthcare workers. Had healthcare programs never been used as cover, many of these murdered healthcare providers would likely still be alive today, and there would likely have been far fewer cases of polio in Pakistan. We would likely be closer to eradicating the disease.

The use of these programs as cover has caused such harm that the CIA announced in 2014 that it would cease the practice. It's the right thing to do, but I suspect it will take many, many years for polio eradication efforts to recover from the damage already done.

To be sure, there are other confounding factors (like drone warfare and the overall political situation) that make the situation in Pakistan very different from the situation in India, but the CIA's use of a vaccination program as cover is one of the Obama-era actions that still bothers me. It's commendable that this practice ended under Obama's tenure, but I wish it had never happened in the first place.

I don't know whether Obama's ever been asked if he signed off on that particular method of intelligence-gathering in that particular instance. If not, I hope someone asks it of him someday. If so, I would be grateful if someone pointed me to his response. I think that Obama generally got much more right than he got wrong. But this is one very specific instance where I think an acknowledgment and apology from a former president would do much to prevent a similar mistake from being made again.

This is a long-winded comment and I want to end it on a positive note. The people who continue to work toward the eradication of polio and other diseases are doing truly heroic things. The fact that this goal is within sight is itself an amazing achievement. There is a real possibility to end an enduring form of human suffering. That is amazing.
posted by compartment at 8:22 AM on October 25, 2019 [16 favorites]


Dear anti-vaxxers: This is not a challenge.
posted by bowmaniac at 9:01 AM on October 25, 2019 [1 favorite]


Episode 3 of Inside Bill's Brain on Netflix is focused on his foundations efforts to eradicate polio. He and Warren Buffet have financed a lot of this effort.
posted by COD at 2:26 PM on October 25, 2019


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