Polio has made a comeback in war-torn Gaza. Here’s what we know so far

Once thought to be nearly eradicated, polio has made a troubling return in Gaza, sending shockwaves through the war-torn region.

The infection and subsequent partial paralysis of the 10-month-old Abdul-Rahman Abu Al-Jidyan has left health officials scrambling to contain its spread.

Authorities are now rushing to launch a mass vaccination campaign for children across the Palestinian enclave, starting on September 1.

“Polio does not distinguish between Palestinian and Israeli children,” the head of the UN agency for Palestinian refugees (UNRWA) said in a post on X. “Delaying a humanitarian pause will increase the risk of spread among children,” Philippe Lazzarini added.

Here’s what we know of the situation

Where did the infection come from?

The same strain that later infected the Palestinian baby, from the type 2 vaccine-derived polio virus that has also been detected in wastewater in some developed countries in recent years, was detected in July in six sewage samples taken in Khan Younis and Deir al Balah.

Although the exact entry point of the strain into Gaza remains unclear, genetic analysis suggests it closely resembles a variant found in Egypt, possibly introduced around September 2023, according to the World Health Organization.

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The WHO pointed to a drop in routine vaccinations in the Occupied Palestinian Territories, including Gaza, as a factor in the virus’s resurgence. Polio vaccination coverage, which stood at 99 per cent in 2022, fell to 89 per cent in 2023.

Health workers blame the closure of many hospitals in Gaza, often due to Israeli airstrikes or fuel restrictions, as a factor in declining vaccination rates. Meanwhile, Israel accuses Hamas of using hospitals for military purposes, exacerbating the healthcare crisis.

Additionally, aid workers highlight that the poor sanitation in Gaza, with open sewers and heaps of trash after nearly 11 months of war, has created a fertile environment for the virus to spread.

How will vaccination drive be carried out?

Israel’s military and Hamas have agreed to three separate, zoned three-day pauses in fighting to facilitate the first round of vaccinations.

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The campaign will begin in central Gaza on Sunday, with three consecutive daily pauses, then shift to southern Gaza for another three-day pause, followed by northern Gaza. Each pause can be extended to a fourth day if necessary.

The vaccines, released from global emergency stockpiles, have already arrived in Gaza and will be administered to 6,40,000 children under the age of 10. Around 2,700 healthcare workers will deliver the vaccines orally at medical centres and through mobile teams reaching the hundreds of thousands displaced by the war, according to UN aid workers.

The World Health Organization stresses that at least 95 per cent coverage is needed for a successful roll-out.

Israel’s military humanitarian unit (COGAT) stated that the campaign would be conducted in coordination with the Israeli military, as part of the routine humanitarian pauses allowing the population to access medical centres where vaccine is administered.

A second round of vaccinations is planned for late September.

What are the risks of polio spreading?

The Gaza case is seen as a setback for the global polio fight which has driven down cases by more than 99 per cent since 1988 thanks to mass vaccination campaigns.

Wild polio is now only endemic in Pakistan and Afghanistan although more than 30 countries are still listed by the WHO as subject to outbreaks, including Gaza’s neighbours Egypt and Israel.

The World Health Organization has warned of the further spread of polio within Gaza and across borders given the poor health and hygiene conditions there.

Poliomyelitis, which is spread mainly through the faecal-oral route, is a highly infectious virus that can invade the nervous system and cause paralysis and death in young children with those under 2 years old most at risk. In nearly all cases it has no symptoms, making it hard to detect.

With input from Reuters