Matthieu Aikins investigates the “all-out, very expensive effort to eliminate the last few problem areas in some of the most troubled and undeveloped parts of the final three countries where polio is endemic: Afghanistan, Pakistan, and Nigeria”:
The poliomyelitis virus has likely been living with humans for millennia. Archaeological excavations of prehistoric burial grounds, as well as paintings in ancient Egyptian monuments, show limb paralysis that is probably the result of polio. The virus, part of the enterovirus genus, is extremely contagious and spreads through two routes—oral-oral, through saliva, or more commonly fecal-oral, like when an infected person’s feces contaminate the water supply. In the crowded, unsanitary cities of antiquity and medieval times, this meant that virtually everyone would have been exposed to the virus in childhood. For most people, this wasn’t a problem:
The virus typically infects only the mucosal tissues of the gastrointestinal system for a few weeks, where the immune system clears it before any harm is done. After that, the infected person would be immune to future infections from the same strain. However, in less than 1 percent of infections, the virus attacks the central nervous system and causes paralysis. Typically this affects just the legs. But in 5 to 10 percent of paralytic cases (that is, 0.05 percent of total infections), polio paralyzes the breathing muscles, meaning that without artificial respiration the patient will suffocate.
All this explains why polio is so difficult to annihilate. For every one person who actually gets sick, nearly 200 are carrying the virus and infecting others.
(Photo: Fawad Rahmani, 11, makes his way home using his crutches and special braces fitted from the ICRC Orthopedic clinic in Kabul, Afghanistan on September 26, 2009. Fawad has had polio since he was two years old. Health care is one of many problems facing Afghanistan, eight years after the war began to oust the Taliban regime, even as the country receives billions of dollars in international aid. Afghanistan is still fighting to eradicate polio to which they are one of the few countries still dealing with the disease. Earlier this month UNICEF launched an immunization campaign targeting 1.2 million children with an aim is to immunize every child under five. By Paula Bronstein/Getty Images)
The Dish 