Indonesia prepares mass polio vaccination

Indonesia’s first polio outbreak in a decade widened today with two new cases reported, as the government kicked off a massive eradication campaign that aims to vaccinate 6.4 million children in one day.

The latest cases of the crippling disease in the Bogor and Lebak regions of West Java province bring the total number of children infected since the outbreak was detected last month to 16, said Yusharmen, head of the Health Ministry’s epidemic surveillance office.

The announcement came after vice-president Jusuf Kalla’s wife, Mufidah Kalla, squeezed droplets of vaccine into a young boy’s mouth to symbolise the start of the immunisation drive that will occur in the capital, Jakarta, neighbouring West Java and Banten on Tuesday.

“It will be carried out in all hospitals, public health centres, airports, seaports, railway and bus stations as well as other public places,” Yusharmen said. “We hope we can finish it in one day.”

The government has already immunised about 6,000 children in a handful of affected villages.

But there remain stray families with children who have not swallowed the oral vaccination. They could become paralysed themselves or spread the virus to others even if they stay healthy – only about one in 200 kids infected ever develop symptoms.

“They know nothing about the usefulness of the vaccine,” said Dr. Immanuel Tarigan, who is helping co-ordinate vaccinations in some of the affected villages, about 62 miles south of Jakarta. “There are rumours that when kids get vaccinated, after that they get a fever.”

A small number of families also refuse the immunisations because they claim giving children any type of drug goes against their Muslim beliefs, Tarigan said. Most Muslims don’t hold such beliefs.

While those cases are rare – more than 80% of Indonesia’s 210 million people have already been vaccinated against polio – enough exist to keep the virus a threat in Indonesia.

Polio is spread when sewage-contaminated water comes into contact with unvaccinated children. It usually attacks the nervous system, causing paralysis, muscular atrophy, deformation and sometimes death.

Health officials suspect the latest outbreak was brought into Indonesia by a migrant worker or a Muslim pilgrim returning from the hajj in Saudi Arabia. Polio remains native in only six countries – Nigeria, India, Pakistan, Niger, Afghanistan and Egypt.

The WHO views the re-emergence in Indonesia as a setback to their plan to eradicate the disease from the world by year’s end because it is pulling valuable resources away from countries where polio is entrenched.

Officials say the Indonesian outbreak can likely be traced back to Nigeria, where polio vaccinations were suspended for several months in 2003 after radical Islamic preachers told parents the vaccinations were part of a US plot against Muslims and warned them against having their children immunised.

The outbreak in Indonesia was the first there since 1995. In an effort to make sure it does not spread beyond West Java, the free immunisation will be repeated for all children under age five in the same areas again next month to provide additional coverage.

“If the kid’s family is reluctant to come to the post, then the paramedics will go door-to-door,” said Captain Margono, an army official supervising the Cidahu subdistrict where the outbreak occurred.

Tarigan, the area’s doctor, said a mark will be left on houses where unvaccinated children live and local health workers will keep returning until each child has been immunised.

“We have a commitment to control it,” he said. “It’s equivalent to Aids ... maybe the person looks healthy, but if they are infected they can pass it on to others.”