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City of Banjul
Monday, May 23, 2022

Silent night

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By Ayomide Precious Akinola

UTG Medical Students’ Association

It was a cold and rainy night, darkness had rampaged the brightness of the moonlight, the trees and beasts could attest to this fact as they were subjects to that night of silence. As I walked home from church in that quiet and windy night, I heard a loud cry which seemed to be coming from the bushes, scared I was, so I quickened my footsteps but as I approached the end of the road the pitch of the cry was louder this time. As I widened my gaze, I could see a little boy left in the cold all by himself, he looked like he was about two years old and was shivering so bad. Who could have left a poor boy in the rain to die?”  I thought”. I carried him in my arms because he was so weak and feeble, his legs looked thin and floppy, his hips and shoulders were dislocated, he had a hunchback and his elbows were bent. Putting my thoughts together I screamed in my head “Oh no, not another Polio victim!!”

What is Poliomyelitis?

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Poliomyelitis (polio) is a highly infectious viral disease that largely affects children under five years of age. The virus is transmitted by person-to-person mainly through the fecal -oral route; so that means if a person comes in contact with feces that has the poliovirus and then touches his/her mouth without washing their hands with soap and water it can be transmitted or, less frequently, by a common vehicle (e.g. contaminated water or food) it can divide and increase in the intestine, from where it can enter the brain and nerves to cause paralysis. There is no cure.

Epidemiology of Poliovirus

Wild poliovirus cases have decreased over 99% since 1988, from an estimated 350,000 cases in more than 125 endemic countries then to 33 reported cases in 2018. Out of the 3 strains of the poliovirus (type 1, 2, 3).Poliovirus type 2 was eradicated in 2018.

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In the Gambia, a country with an estimated number of 768,995 inhabitants at that time was involved in an epidemic of type 1 poliovirus involving 305 cases following a 6-year period after 5 cases were reported. Cases lived in all parts of the country except Banjul (the capital city). In 2004 the Gambia was declared polio free after massive child immunization efforts.

As of May 2021, the Gambia declared a “public health emergency” after two samples from sewers in Banjul and Kotu were positive for type 2 poliovirus. 9 positive samples were detected in 2021. In November 2021, a 6-day polio vaccination campaign was carried out for children between the ages of 0-5 years in different regions in the country and another campaign took place in March 2022.

Symptoms of polio

About 95-99% of people who contact polio are asymptomatic but it does not mean they cannot transmit it to other people.

Non paralytic polio symptoms: It can last from 1-10 days, these signs and symptoms can be flu like and include:

o          Fever

o          Sore throat

o          Headache

o          Vomiting

o          Fatigue

o          Meningitis

Paralytic polio symptoms: About 1% of polio cases can develop into paralytic polio. These symptoms initially are similar to non -paralytic polio but after a week the severe symptoms appear and include:

o          Loss of reflexes

o          Severe spasms (uncontrollable body movement)

o          Muscle pain

o          Sudden paralysis (loss of body parts movement)

o          Floppy limbs

o          Deformed limbs

It is rare for full and permanent paralysis to occur.

Have you heard about post-polio syndrome?

It is possible for polio to return after you have recovered, it can occur after 15 to 40 years. Common symptoms are:

o          Muscle and joint weakness and pain

o          Exhaustion or fatigue

o          Muscle wasting (loss of muscle and shrinking)

o          Sleep apnea (breathing repeatedly stops and starts) and depression

o          Cold intolerance

o          Trouble with concentration and memory

How to prevent polio?

o          The best way to prevent polio is to get the vaccination. Children of age 0-5 years should get their polio shots according to the vaccination schedule.

o          Wash your hands with soap and water.

o          Wash foods and vegetables thoroughly.

o          Use alcohol-based sanitizer.

It is a big fact that people born in the silent generation (1925-1950) were unfortunately affected by polio due to the vaccine’s invention in 1955.

Types of polio vaccine

There are 2 types of polio vaccine:

Inactivated poliovirus vaccine and Oral poliovirus vaccine

Inactivated polio vaccine:

It protects people from all three types of polioviruses. It does not contain the live virus, so people that receive the vaccine cannot cause transmission of the virus to others. It cannot cause the disease. However it does not stop the transmission from an already infected person to another, the vaccine is injectable.

Oral polio vaccine:

It is a mixture of live attenuated (reduced effect) polio strains of all three types, it is administered orally. In the event of infection, this protects the individual against polio paralysis by preventing the spread of the virus to the nervous system (brain and nerves), so it can stop person to person transmission of the virus. However in rare cases the vaccine has shown to cause vaccine- associated paralysis, causing it to be transmissible and to cause paralysis.

Paralytic Polio:

About 1% of polio cases can develop into paralytic polio. These symptoms initially are similar to non-paralytic polio but after a week the severe symptoms appear and include:

o          Loss of reflexes

o          Severe spasms and muscle pain,

o          Floppy limbs,

o          Sudden paralysis (temporary or permanent), deformed limbs

 It is rare for full and permanent paralysis to occur.

It refers to a cluster of potentially disabling signs and symptoms that appear decades-an average of 15 to 40 years after the initial polio illness. It’s possible for polio to return after you have recovered. Common symptoms are:

o          Muscle and joint weakness and pain

o          Exhaustion or fatigue

o          Muscle wasting (muscle reduction)

o          Sleep apnea (breathing repeatedly stops and starts during sleep) and depression

o          Cold temperatures intolerance (cannot withstand cold temperature)

o          Trouble with concentration and memory

How to prevent polio?

The best way to prevent polio is to get vaccinated. Children of age 0-5 years should get their polio shots according to the vaccination schedule.

Vaccination schedule:

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