Could Polio Return to the U.S. and Canada?

In December, an outbreak of measles at Disneyland put a spotlight on the issue of vaccinations. According to the United States Centre for Disease Control (CDC) there were 644 cases of the measles from 27 states in 2014, the largest number of cases since it was thought to be eliminated in 2000.

The culprit is the anti-vaccination movement, a science-doubting crowd that believes vaccines have not been properly tested for safety, have unintended side effects, and aren’t effective at preventing disease, anyway. All of these claims, of course, have been proven false repeatedly with peer reviewed science.

Still, the anti-vaccination movement persists, and the campaign of disinformation it wages is beginning to have real consequences for society in general. That’s because as the numbers of people who aren’t vaccinated rise, it puts a dent in diseases that were thought to be eradicated. Scientists consider an eradication level of 95% ensured what is referred to as “herd immunity” or “community immunity”.

Achieving this herd immunity is important because the mumps vaccine, to use an example of another disease that has seen recent outbreaks, is just 88% effective, explaining why someone can easily contract the disease even if they have been vaccinated.

The U.N. warns that Canada is flirting with danger. The country is now one of the few industrialized countries in the world with a vaccination rate of 85%, a number that pulls our rating on the well being of children down.

We have to do a better job of reassuring, telling parents it is safe and not only is it safe, but it protects your child from something that could be a thousand times worse.

So what happens now?

CDC Director Director Tom Frieden warns that if the education of the junk-science crowd is not successful, we could be in for larger outbreaks.

“We are very concerned by the growing number of people who are susceptible to measles, and the possibility that we could have a large outbreak in this country as a result,” he said on CBS’s “Face the Nation” recently.

The measles can be deadly, but it is nothing compared to the highly contagious polio. Polio once killed or paralyzed hundreds of thousands of children each year. But the discovery of virus vaccine by Jonas Salk, which was announced to the world on April 12th, 1955, was a watershed moment in public health. After three doses of the polio virus, more than 99% of people achieve immunity to the disease.

Dr. Victor Goldbloom, a pediatrician and chair of the Advisory Council of the Canadian Institute of Child Health, reflected on the elimination of polio in light of the recent outbreaks of diseases thought to be virtually eliminated..

“In the first half of the twentieth century we had polio every summer; dozens and dozens and sometimes hundreds of cases. Every 15 years there was a major epidemic.”

Goldbloom explained to RCINet’s Lynn Desjardins that there were major polio epidemics in 1916, 1931 and in 1946, but that an expected outbreak in 1961 didn’t happen because of the polio vaccine.

“We have to do a better job of reassuring, telling parents it is safe and not only is it safe, but it protects your child from something that could be a thousand times worse”, says Goldbloom.

Polio was thought to be the third disease ever eradicated, after after smallpox and rinderpest, and the vaccine marked the end of a nearly two centuries of it appearing each summer, usually to deadlier effect.

That an outbreak of the measles happened where it did it almost certainly not an accident. Orange County is ground zero for the anti-vaccination movement.

Polio was identified as early as 1789 in England, and outbreaks became increasingly severe over the next century. In 1952, the disease reached a peak in the United States, but was eliminated in the Western Hemisphere in 1991.

But the disease has returned. Last May, the World Health Organization declared a global health emergency for only the second time since 2007. In places like Pakistan, Cameroon and Afghanistan, there is an increasing occurrence of Polio. Demand for the polio vaccine has risen sharply, causing shortages in some parts of the world.

“Things are going in the wrong direction and have to get back on track before something terrible happens,” said WHO spokesperson Gregory Hartl. “So we’re saying to the Pakistanis, the Syrians and the Cameroonians, ‘You’ve really got to get your acts together”.

In war torn Syria, vaccination rates for Polio have fallen below 90% and 13 cases of the disease showed up in late 2013.

What is surprising experts is how the disease is traveling. The CDC is looking to contain the spread.

“What we don’t want is cases moving into places like the Central African Republic, South Sudan or the Ukraine,” said Rebecca M. Martin, who is director of global immunization for the CDC.

Containing the disease in the war torn and impoverished places it is flaring up is the first and most important step to ensuring that it does not return to the Western World.

But that possibility, according to former CDC director Walter A. Orenstein, is not off the table.

“It certainly could,” he told National Geographic recently.

“The important thing is for all of us to help all countries interrupt transmission,” said Orenstein. “It’s a service to their population and a service to our own. When it comes to eradication, 99 percent reduction isn’t good enough. It has to be 100 percent. And it’s doable.”

That an outbreak of the measles happened where it did it almost certainly not an accident. Orange County is ground zero for the anti-vaccination movement. The number of kindergarten aged kids who had flu shots fell from 92.9% in 2003 to 89.3% in 2012, meaning a cluster that was nearing herd immunity is now slipping dangerously away from it.