Health Insight Magazine

The virus is most often spread by the faecal-oral route from one person to another.

Poliovirus enters through the mouth and multiplies in the intestine.

Infected individuals shed poliovirus into the environment for several weeks, where it can spread rapidly through a community, especially in areas of poor sanitation and hygiene.

If a sufficient number of children are fully immunised against polio, the virus is unable to find susceptible children to infect, and dies out.

Young children who are not yet toilet-trained are a ready source of transmission, regardless of their environment.

Polio can be spread when food or drink is contaminated by faeces.

There is also evidence that flies can passively transfer poliovirus from faeces to food.

Most people infected with the poliovirus have no signs of illness and are never aware they have been infected.

These symptomless people carry the virus in their intestines and can “silently” spread the infection to thousands of others before the first case of polio paralysis emerges.

What are the signs and symptoms of polio?

Most infected people (90%) have no symptoms or very mild symptoms and usually go unrecognized.

In others, initial symptoms include fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs.

What is the current situation of polio in Kenya?

Kenya has been free of any wild poliovirus (WPV) circulation since 2014.

However, Kenya and the Horn of Africa Region continues to be at higher risk of polio due to low immunization coverage magnified with population movement.

On 6 April 2018, the Kenya Medical Research Institute (KEMRI) laboratory notified the MoH of acirculating vaccine-derived poliovirus (cVDPV)in the sewage in Kamukunji sub-county, in Nairobi.

This poliovirus was detected in an environmental sample collected on 21 March 2018 as part of routine surveillance activities by MoH.

As a result, MoH has further intensified surveillance activities to detect any circulation of poliovirus.

The positive environmental sewage sample indicates circulation of the poliovirus in the community, which places everyone at risk of contracting polio.

What is the circulating vaccine-derived poliovirus (cVDPV)?

On very rare occasions, if a population is seriously under-immunized, there are enough susceptible children for the excreted vaccine-derived polioviruses to begin circulating in the community.

If the vaccine-virus is able to circulate for a prolonged period of time uninterrupted, it can mutate and, over the course of 12-18 months, reacquire neurovirulence.

These viruses are called circulating vaccine-derived polioviruses(cVDPV).

The lower the population immunity, the longer these viruses survive.

The longer they survive, the more they replicate, change, and exchange genetic material with other enteroviruses as they spread through a community.

If a population is fully immunized against polio, it will be protected against the spread of both wild and vaccine strains of poliovirus.

What is environmental surveillance?

The MoH routinely collects samples from sewages in residential areas for testing the presence of poliovirus.

Environmental surveillance is very important in early detection of new poliovirus.

It helps MoH identify areas where individuals infected by the virus, are excreting it in their stool into the sewage but are not showing any signs of paralysis and can transmit the infection to others.

Is there a cure for polio?

No, there is no cure for polio.

Polio can only be prevented by immunization.

A safe and effective vaccine exists - the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV).

OPV and IPV offer essential protection for children against polio.

Since there is no cure for polio, what is the Government of Kenya doing?

The MoH, in collaboration with partners, plans to conduct a polio vaccination campaign in Nairobi County.

The campaign scheduled from 9-13 May 2018 will target an estimated 800,000 children under the age of five years with OPV.

Subsequent rounds will be conducted in high-risk counties between June and July to ensure maximum protection.

The upcoming May campaign will be conducted through house-to-house visits by vaccination teams who will administer OPV for children under five.

Is it important to immunize children again and again with OPV?

Yes, it is important.

All children must receive the polio vaccine every time there is a campaign, regardless of if the child has received the vaccine before.

Extra doses given during vaccination campaigns give valuable additional immunity against polio.

Polio vaccine has no harm when administered multiple times.

The number of doses it takes to immunize a child depends entirely on the child's health and nutritional status, and how many other viruses a child has been exposed to.

For maximum protection against polio and other vaccine preventable diseases, parents should ensure that all children complete their routine immunization schedules before age two.

After receiving OPV during campaigns, it is very important that children still need to complete their routine immunization doses given at birth, 6 weeks, 10 weeks and 14 weeks of age.

How do we know the vaccine against is polio safe?

The polio vaccine, whether offered during campaigns or for routine immunization is safe and effective.

The Government of Kenya through the MoH has the overall responsibility to ensure that all vaccines used in Kenya are safe.

The MoH also has the overall mandate to protect citizens especially children against vaccine preventable diseases by administering vaccines that are proven to be safe and effective.

The vaccines supplied through MoH for both routine immunization and for campaigns are the same ones used all over the world and are prequalified by the World Health Organization (WHO).

Furthermore in Kenya, the MoH, through the National Regulation and Safely Authority, does independent random analysis of all vaccines used in this country and have confirmed that they are of international standards and safe for use.

All medical supplies and commodities including vaccines that are used in the country must undergo rigorous quality control testing procedures by the Pharmacy and Poisons Board (National Quality Control laboratory), the body legally mandated to ensure quality, safety and efficacy of all medical products under CAP 244 of the Laws of Kenya.

Appeal from the Government of Kenya

The Government appeals to the general public and other partners for support in ensuring all parents and caretakers with children under the age of five years vaccinate their children during these upcoming polio campaigns.

Do the members of the public have a role in polio eradication in Kenya?

Yes, the members of the public have the following responsibilities; ensuring their children are vaccinated both during polio campaigns and routine immunization activities; report any children who have missed polio vaccination to the nearest health facility; tell a friend/neighbour about the ongoing polio campaigns and importance of routine immunizations; report any immunization refusals within their areas; and report any suspected cases of polio disease.

What are the required actions from the community leaders?

We urge community leaders to actively advocate for vaccination and the life-saving benefits of vaccination in their respective communities; actively address caregivers in your community who are refusing polio vaccination and address and dispel any misconceptions regarding vaccination; for religious leaders to highlight the religious basis for supporting vaccination; and finally motivate and encourage the frontline health workers.

What is the required action from the media?

As the media, we urge you to be active partners in promoting health seeking behaviours including immunization.

This can be achieved through getting the correct information and use all opportunities to air key messages on immunization; actively advocating for vaccination as a means of saving children’s lives; motivate and encourage families to get their children vaccinated every time there is a campaign - two drops each time; provide media space for focal persons from MoH and partners; and participate in media roundtable/briefings.

For more information contact:

The Head, Division of Disease Surveillance and Epidemic Response,

Ministry of Health, P.O. Box 20781-00202, NAIROBI.

Tel: 0729 471 414; 0732 353 535

E-mail: [email protected]

Website: www.ddsr.or.ke

Twitter: #vaccineswork

You may also report directly through Ministry of Health (MoH) Hotlines 0732 353 535 or 0729 471 414.