World Health Organization: Polio Is an International Emergency

The spread of the vaccine-preventable poliovirus so far in 2014 has been "extraordinary," the agency warned today.

Today the World Health Organization declared an international emergency around the resurgence of a vaccine-preventable infectious disease that can paralyze a kid within hours. (Or, in the WHO's ominously, passively voiced statement: "It was the unanimous view of the committee that the conditions for a Public Health Emergency of International Concern have been met.") So far in 2014, they have recorded 68 cases, almost three times as many as during the same period last year.

Poliomyelitis is a highly contagious infectious disease that, in the mid-twentieth century, paralyzed or killed around half a million people every year. In the wake of Jonas Salk's 1957 vaccine, the disease became rapidly, drastically less common. In recent years, international health organizations have painted a picture of inevitability: Polio should soon be totally eliminated from Earth. This is a rosy Vine from The Gates Foundation last year:

But this morning the WHO committee said the international spread of polio to date in 2014 "constitutes an 'extraordinary event' and a public health risk to other [countries] for which a coordinated international response is essential." This is only the second time ever that this level of warning has come from the WHO (Influenza outbreaks in 2009 being the first). Kids aren't getting vaccinated, especially in conflict zones, and adult travelers in endemic areas aren't getting their vaccine boosters. The Geneva-based committee said that more than half of the polio cases in 2013 resulted from international spread.

The WHO named Pakistan, Syria, and Cameroon as the nidi of the viral spread, labeling them "States currently exporting wild poliovirus." Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia, and Nigeria are named as infected countries that are not currently exporting the virus. The committee recommends that all residents and travelers be re-inoculated against the virus (resident-travelers from polio-infected countries should have received one documented additional dose of the vaccine four to twelve months before any international travel), and they should be required to carry a standardized proof-of-inoculation document. All children in these countries should be inoculated or re-inoculated.

This isn't to say that polio is imminently taking over the world; the growing numbers are just jarring in the context of the Global Polio Eradication Initiative, wherein the WHO, CDC, Unicef, and Rotary International put the world on track to have zero cases by 2018 and discontinue the vaccine in 2019. (Before that the goal was 2005.) This time the initiative has gone so far as to already publish guidelines for life after polio is eliminated, including debate over how much of the vaccine we should keep around just to be safe.

Messages of inevitable victory breed confidence and reassurance, but they also engender complacency. In light of the spread so far this year, the 2018 goal is dubious. The WHO warned today that "if unchecked, this situation could result in failure to eradicate one of the world's most serious vaccine-preventable diseases."