The World Health Organization (WHO) said yesterday that it had detected a case of the crippling polio virus in Indonesia, indicating that an outbreak rooted in Africa has leapt the Indian Ocean.
The case, affecting a 20-month-old girl on Java, is the first polio infection in Indonesia in nine years, according to Bardan Rana, a medical officer with the UN agency.
Indonesian health officials have launched an immunization drive targeting 5 million children to prevent the spread of the virus which may have been transported from Nigeria via Saudi Arabia.
"There has been a case in Indonesia, the lab has confirmed it. The sequencing has shown that the case was imported and matches strains of the virus found in Saudi Arabia," Rana said.
The virus is believed to have been carried to Saudi Arabia by Muslim pilgrims heading to Mecca. It may have been passed on to Indonesia, the world's largest Muslim-populated country, in the same way or through migrant workers.
"There are a lot of ports of entry and a lot of people working in the Middle East. It's not definite, but this is the most likely route," Rana said.
Polio remains endemic in only six countries, including Afghanistan, Egypt, India, Niger, Nigeria and Pakistan, with vaccination programs driving down the number of cases from 350,000 in 1988 to 1,243 last year.
But a handful of African and Middle Eastern nations have reported being reinfected following a boycott last year on polio vaccines in Nigeria, prompted by radical clerics claiming it had been contaminated by US agents.
Nigeria restarted vaccinations last July after an 11-month hiatus, but the disease has resurfaced in Benin, Chad, Cameroon, Botswana, Burkino Faso, Central African Republic, Ethiopia, Ghana, Guinea, Mali, Sudan, Togo and Yemen.
* Health officials believe the virus was carried from Nigeria to Saudi Arabia by Muslim pilgrims heading to Mecca and then to Indonesia by returning pilgrims or migrant workers.
* The Java toddler is the first case of polio infection in Indonesia in nine years.
* Two other suspected cases were found in the same area and tests are being carried out.
* The government hopes to inoculate 5 million children to prevent the spread of the disease.
* More than 4,000 children have been immunized so far.
Rana said the Indonesian government has begun a major vaccination campaign in the densely populated region of Sukabumi in West Java province where the case was detected on April 21 and confirmed six days later.
"All children under the age of five are being immunized by teams going house-to-house in four surrounding villages. Surveillance has been intensified and spread to a much wider area," he said.
Health ministry secretary-general Umar Fahmi said two other suspected cases had been found in Sukabumi and tests were being carried out.
"We are still waiting for the lab test results," he said.
He said more than 4,000 children had been immunized and 115 children who had contact with the infected child had been identified.
"We are still trying to ascertain, but I have received a report that 13 of them were positive but did not show symptoms because they have immunity," he said.
Rana said that although there was resistance to immunization in many Muslim countries because of fears that the vaccine could lead to impotency, there were few refusals in Indonesia.
Polio is a waterborne virus that usually affects infants and young children, causing paralysis, withered muscles and sometimes death. There is no cure.
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