Can polio return to Brazil? expert comments

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Low vaccination coverage and recent suspected case in Pará reinforce the alert that the virus may circulate again in the country

In October 2022, Brazil got a scare with the notification of a possible case of poliomyelitis in a three-year-old child, in Santo Antônio do Tauá, in the northeast of Pará. This because the disease was considered eradicated in the country in 1994.

Although the Ministry of Health rejected the hypothesis and stated that the case could, in fact, be an adverse reaction of the vaccine itself (caused by a possible error in the vaccination schedule), the episode drew attention to the real risk of the return of polio in Brazil.

This is an alert that the Pan American Health Organization (PAHO) has already been issuing: according to the entity, the country is on the “high risk” list for the return of polio. The main factor behind this is the low adherence to the vaccination campaign against the disease.

According to data from the Ministry of Health, vaccination coverage has so far reached only 65% ​​of children under 5 years old – and the goal is to vaccinate 95% of them. Therefore, understand what happened in Pará and why this case is so emblematic to warn about the concrete risk of the return of a disease that has not circulated in Brazil for 28 years.

Polio: what happened in Pará?

It all started at the beginning of October, when the Pará State Department of Public Health (Sespa) notified the Ministry of Health to inform that it was investigating a suspected infantile paralysis in a three-year-old boy from the municipality of Santo Antônio do Tauá, in the northeast of the state.

The child began to show some symptoms on August 21, including fever, muscle pain, myalgia and an acute flaccid paralysis typical of poliomyelitis. Days later, she lost the strength of her lower limbs and was taken to a Basic Health Unit (BHU).

Know more: What are the symptoms of polio?

Based on this picture, a stool examination was performed on the boy, in which the presence of poliovirus. Therefore, the case was considered suspicious for the disease.

However, on October 7, the Ministry of Health reported that it was not poliomyelitis, but probably a condition of acute flaccid paralysis attributed to the use of the oral polio vaccine (OPV) without the inactivated vaccine having been applied first. poliomyelitis (VIP).

“In the child’s vaccination book, there is no record of inactivated polio vaccine (VIP), which must be administered prior to OPV. In general, the oral polio vaccine is well tolerated, and very rarely is it associated with any serious adverse events. It is noteworthy that the risk of acute flaccid paralysis with OPV is very rare and that when OPV is applied as a booster after the basic regimen with the VIP vaccine, this risk is practically nil.

Read more: Polio: Understand what it takes to fight polio

This possibility was raised, because the virus present in the child’s feces was the Sabin Like 3 poliovirus, one of the components of the polio booster dose. “This is not the wild polio virus, it is the vaccine virus”, explains Isabella Ballalai, vice president of the Brazilian Society of Immunizations (SBIm), in an interview with MinhaVida.

“The oral polio vaccine is an attenuated vaccine, meaning it contains two weakened poliovirus types (1 and 3). The Ministry’s recommendation is that three doses of the inactivated vaccine, with the dead virus, be administered before applying the oral dose”, he adds.

Following this vaccination schedule is essential to avoid cases of poliomyelitis associated with the vaccine virus, as is suspected in the case in Pará. This is because, when administering only the attenuated vaccine, there is a risk of 1 in 2.4 million vaccinated children develop the disease. The inactivated vaccine comes in as a protection against the wild virus and the attenuated vaccine virus, as Isabella explains.

Is the risk of polio coming back real?

Although infection with the wild polio virus was ruled out, the case of Pará reinforced an alert that had been made for years: the risk of the disease returning to Brazil. “It is already certain that it is not polio, it was a scare, but this is a scenario that we will need to get used to: whenever a child has an acute flaccid paralysis, it will be mandatory to investigate whether it is polio or not”, explains the deputy. -president of SBIm.

It is worth mentioning that the Ministry has not yet concluded the investigation to find out whether, in fact, the acute flaccid paralysis was caused by the vaccine virus or not. “According to the information we have, the child presented these symptoms one day after receiving the vaccine. Is it impossible to have been an adverse reaction? No, but it’s unlikely. Even the vaccine virus needs time to cause the disease”, says Isabella. Therefore, other possible causes, such as Guillain Barré Syndrome, have not yet been ruled out.

However, the expert warns: the chances of poliomyelitis returning to Brazil are real and this is getting closer and closer to happening. “I’m hoping it doesn’t happen, but [a doença] yes, you can come back at any time. The way to not let this happen is to establish an engagement of all public health, including the federal and municipal spheres, to take information to families, calling them to vaccinate their children under five years old”, emphasizes the doctor.

Importance of complete vaccination

THE only way to prevent the polio and ensuring that the disease remains eradicated in Brazil is vaccination. National campaigns take place annually and all children under five years of age must be immunized.

The polio vaccination schedule is three doses of the injectable vaccine at 2, 4, and 6 months. Then, two more booster doses are given with the bivalent oral vaccine, in droplets, at 15 months and at 4 years.

Know more: 5 reasons to keep your vaccination book up to date

The World Health Organization (WHO) recommendation is that countries implement measures to increase polio vaccination coverage to 95%. In this year’s campaign, which began on August 8 and ended on September 30, Brazil reached only 65.6% of the expected audience, according to the Ministry of Health.

O state of paraíba was the only one to reach the goal, reaching 95.09%, followed by Amapá, which had 90.08%. Given this scenario, even after the end of the national vaccination campaign, 12 states and the Federal District decided to extend the action due to low adherence.

Last Monday (17), the Minister of Health, Marcelo Queiroga, made a new appeal for parents or guardians to take their children to vaccination rooms. This is because polio can lead to total or partial paralysis of the lower limbscausing several impacts on the lives of those who acquire the disease.

Content for educational purposes only. Consult a Doctor.

The translator user relied on the following source:

Minha Vida Website – REF99827

Disclaimer – (English version>) This content has been prepared based on information from research, additional publications, or the translation/verification work of a volunteer editor of this web council. This is a non-profit service. It is strongly recommended that all details and information published be carefully verified. We never allow medication recommendations, medication package inserts or any medication guidance. We never allow partisan politics as information.

Isenção de responsabilidade – (versão em português): Este conteúdo foi preparado com base em informações de pesquisas, publicações adicionais ou no trabalho de tradução/verificação de um editor voluntário deste conselho web. Este é um serviço sem fins lucrativos. É altamente recomendável que todos os detalhes e informações publicadas sejam verificadas cuidadosamente. Nunca permitimos recomendações de medicamentos, bulas ou qualquer orientação sobre medicamentos. Nunca permitimos a política partidária como base para checagem. Para mais informações, leia nossos termos.

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