Saturday, November 19, 2022

Indonesia: Extraordinary Event (KLB) Declared In Aceh After Child Diagnosed With Polio

Credit Wikipedia 


In addition to hosting the 3rd year of our COVID pandemic, a war in Europe, and the unprecedented spread of HPAI H5 around the world, 2022 has also witnessed the resurgence of polio in a number of countries previously declared free of the disease, including the United States and England. 

Overnight the Pidie Regency in Aceh, Indonesia announced the discovery of a case of polio in a (reportedly unimmunized) 7 year-old child who was first struck with a flu-like illness on October 6th, and three days later developed signs of paralysis. 

Fewer than 1% of those infected develop paralysis, while the rest are either asymptomatic or have flu-like illness.  All, however, can shed the polio virus for weeks, meaning that 1 case of paralysis very probably indicates a much larger outbreak. 

Indonesia, along with 10 other South-East Asia countries (Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste) were  certified as being polio-free by the WHO in 2014 (see WHO South-East Asia Region certified polio-free).

But after decades of progress in eradicating the disease, since 2014 we've seen a worrisome resurgence of polio around the world, prompting the WHO to declare polio a PHEIC (Public Health Emergency of International Concern) on May 5th, 2014. 

The latest WHO extension (see Statement of the Thirty-second Polio IHR Emergency Committee) was published in June.

I'm sure we'll get more details in the days to come, but the (translated) press release from Pidie Regency follows:

The Acting Regent and Health Office Follow up on the Discovery of Polio Cases in Pidie

Saturday, November 19, 2022

A case of Polio (withered paralysis) in a child was found in Pidie on November 10, 2022. This finding was confirmed by the results of laboratory tests by Prof. Sri Oemijati, Ministry of Health, Jakarta, which is a national reference laboratory.

The discovery of this case began with a 7-year-old child, a resident of Mane District. At first the child has a fever, then pain appears in the joints and weakness of the limbs.

After physical and laboratory examinations, it was stated that the patient had been infected with the Polio virus.

This was confirmed by the Acting Regent of Pidie, Ir Wahyudi Adisiswanto M.Si, together with the Head of the Pidie Health Service, Dr. Arika Aboebakar, Sp.OG, at the local Regent's Hall, Friday (18/11/2022).

In this case, the Acting Regent stated that Pidie experienced an Extraordinary Event (KLB) status.

"With the discovery of a Polio case in Pidie, we declare this as an Extraordinary Event, because as we know, Indonesia and other Southeast Asian countries have been declared Polio-free," said the Acting Regent of Pidie.

Meanwhile the Head of the Pidie Health Service stated that his party together with a team from the Aceh Health Service, the Ministry of Health, WHO and UNICEF had made an initial response in the form of an Epidemiological Investigation (PE).

Including searching for additional cases in affected areas both in the community and through visits to local health centers and hospitals.

Next, carry out a review of immunization coverage and a social assessment to find out how people in the affected areas receive immunization.

"Apart from that, the coordination and activation of the Rapid Action Team (TGC) will also be carried out immediately," explained Dr. Arika.

Arika added that the Polio virus is transmitted through water contaminated with faeces containing the Polio virus. If this virus enters the body of a child who has not received complete polio immunization, the virus will multiply in the digestive tract and attack the child's nervous system.

He said again, causing paralysis. This can happen if immunization coverage is low for a long time, coupled with unfavorable environmental sanitation conditions, such as open defecation (BABS).

Furthermore, for the current treatment of patients, a repeat visit has been made by the Pediatrician and it is recommended that medical rehabilitation be carried out.

The Health Office through the Mane Health Center facilitated referrals to T Chik Ditiro Sigli Hospital.

To deal with outbreaks, according to the instructions from the Expert Committee Team, a sub-PIN immunization response will be carried out immediately by providing polio drip immunization for all children aged 0 – <13 years.

The Pidie District Government also immediately increases public education about the importance of routine immunization and clean and healthy living behavior, especially the behavior of defecating in latrines and involving all parties.

"This education will involve all parties, starting from regional leaders and SKPK heads, religious leaders, community leaders, youth groups, PKK, professional organizations, mass organizations, educational institutions, health cadres, academics, mass media, and other elements of society, to support prevention of transmission of the Polio Virus," concluded Dr. Arika.

Please note, Polio is a highly contagious disease and can cause permanent paralysis, even death, especially in children aged <5 years who are not completely immunized against polio.

The polio virus enters the body through the mouth, originating from water or food that has been contaminated with feces/feces of an infected person.

Early symptoms of polio include fever, fatigue, headaches. vomiting, stiffness in the neck, pain in the legs.

Present with the Acting Regent, Pidie Regional Secretary, H. Idhami, S.Sos., M.Sc., and Accompanying the venue, the Head of the Pidie TP PKK, Ny. Hj Suaidah Sulaiman, Ass III, Drs Sayuti, MM

Then from WHO, from the Indonesian Ministry of Health, Head of P2P Dinkes Pidie, from TCD Sigli Hospital, Head of Mane Health Center, and Head. Sigli City Health Center.