BOTSWANA Polio case concerns health officials

The virus is spreading because of Muslim leaders' objection to the vaccine.
TORONTO GLOBE AND MAIL
JOHANNESBURG, South Africa -- A child in a village in Botswana has been paralyzed by poliomyelitis, the strain of the virus from northern Nigeria that has been spreading because Muslim religious leaders there refuse to allow vaccinations for the disease.
Botswana, thousands of miles from Nigeria, has been polio-free for more than a decade. The new case has epidemiologists warning of the globalization of disease, and the World Heath Organization says it is a graphic illustration of the importance of immunization.
The 7-year-old boy in the Ngami district of northwestern Botswana developed paralysis in early February. Health workers in Botswana, a comparatively prosperous country in southern Africa with good surveillance for polio, recognized that he might have the virus even though the disease was eradicated there in 1991.
Lab results confirmed in March that he does have polio; genetic sequencing of the strain of the virus with which he was infected showed it came from northern Nigeria.
Nigeria is one of just six countries where polio is still endemic, and which U.N. health agencies are targeting in a final push to eradicate the disease.
Muslim suspicions
But last year, Islamic clerics in northern states refused to participate in a national vaccination program because, they said, the program was secretly an effort to render Muslim women infertile.
In 2003, Muslim leaders spread the word that the U.S. government had tainted the vaccine drops with either the AIDS virus or infertility drugs. Leaders in mainly Muslim northern Nigeria feel marginalized from the Christian south, and the federally initiated vaccination campaign was ideal fodder for scoring political points.
The Nigerian strain of the virus has spread with astounding speed. In the past 18 months, viruses shown by genetic analysis to have originated in northern Nigeria have caused new cases of the disease in eight previously polio-free countries: Ghana, Cameroon, Benin, Burkina Faso, Chad, the Central African Republic, Ivory Coast and Togo.
Poliomyelitis is a highly infectious disease caused by a virus that mainly affects children under 5. It invades the nervous system and can cause paralysis within a matter of hours. There is no cure, but it can be prevented with a vaccine that costs only pennies.
Nigerian vaccine program
Nigeria held a second round of vaccinations in February and March, and this time all but one northern state, Khano, allowed the program to go ahead.
The WHO is hoping that the next rounds of vaccinations, one next week, one in May and two in the fall, will be allowed to proceed in Khano.
To develop a sufficient level of immunity, 43 million children in the country have to be given the vaccine multiple times.
A team of four epidemiologists visited northern Botswana last month and questioned the infected boy's family and neighbors, and investigated patterns of travel in and out of the region. The boy did not travel, nor did he have any contact with anyone who had. The source of his infection remains a mystery.
Botswana is now working to increase health workers' knowledge about the disease and to boost the immunity of its children. So far there are no other cases of polio in the country.