Along with the research that I had to perform for this blog post, I also had to do some research about what exactly Poliomyelitis is (the only thing that came to mind prior to said research was Franklin D. Roosevelt). The most striking effect of the virus is the paralytic effect, as many frequently become paraplegic due to the nerve damage that the virus causes. The reason for my limited knowledge on the virus and disease is likely the same for most Americans. Polio has been eradicated in the United States by effective vaccine administration, so it is not a public health threat in the US, so it is no surprise that it’s not the talk of the town in the US. This is not the case for several other countries, though, including Pakistan , Nigeria, and, recently, the Philippines. This is due to the fact that polio vaccines are less accessible in impoverished countries and in countries with poor health systems.
As we learned in MCRO 251, there are two polio vaccines available: inactivated polio vaccine, or IPV, and oral polio vaccine, or OPV. Both are effective at providing immunity against the virus, but there are some distinct advantages and disadvantages to each. OPV is both cheaper and better at preventing the spread of the virus, while still providing immunity. This is because polio virus can be spread through feces and OPV, which is administered orally, stimulates the cells in your throat and gut to produce antibodies against it, so if polio virus were to enter a person, the mucosal antibodies would eliminate it before it entered the cells and replicated, also eliminating the possibility of orofecal transmission. IPV on the other hand, does not confer mucosal immunity, so although the individual is protected, the virus can still replicate in the throat and intestines, and thus it can still be spread to others. IPV also requires multiple doses. So, it sounds like OPV is better, right? Well, OPV consists of attenuated virus strains, so they are able to mutate and cause cases of Poliomyelitis, which is why it is no longer used in the US. In other countries, though, it is widely used, as it is the cheaper and more accessible option.
In some African countries, specifically, OPV is used over IPV and it has even been determined that in some, there are more cases of vaccine-derived polio than those infected by wild-polio viruses. There have been at least nine new cases of vaccine-derived polio spread across four countries (Mohamed, n.p.). Although there are initiatives to eradicate the virus in endemic countries, a lot of people are calling for the development of a safer, more accessible vaccine for these countries that are suffering from high rates of vaccine-derived polio and for those that are seeing low immunization rates due to inaccessible vaccines (Mohamed, n.p). But how is this going to get done? At the end of 2019, $2.6 billion was raised by global leaders and philanthropists to aid the polio eradication efforts. This money is being used by the Global Polio Eradication Initiative (GPEI) to reach children with the vaccine and to overcome other barriers that prevent immunization, be it reluctant parents or conflict within the country (World Health Organization). Two of the biggest targets for the GPEI campaign will be Pakistan and Afghanistan, which are now the only two countries experiencing endemic wild-polio. The campaign hopes to eradicate polio by 2023.
It is very interesting to see the healthcare disparities in the world and how little people, including myself unfortunately, know about them. It is crazy to think that the virus is still an issue in some countries when it has been eradicated in the US since 1979. The same goes for other diseases too, like measles, mumps, and rubella. As microbiologists, it is just as important to know about how viruses and bacteria affect different communities, epidemiology, that is, as it is to know the specific mechanisms they use to infect. Looking at it from an epidemiological perspective though, brings about so many other potential areas of analysis, like making healthcare, in general, accessible to everyone, or the history behind why some populations/communities are not being given the same sense of urgency as others. I will also end by saying that Polio is a perfect example of how important awareness is because awareness makes people realize how urgent and fixable these things are, and that is when foundations like GPEI are established and people fight for those that do not have the same healthcare systems first world countries.
Jaylin’s Thoughts: Microbiology 