From: stevel@aio.jsc.nasa.gov (Steve Lancaster)
Newsgroups: misc.handicap
Subject: This can be PREVENTED!
Summary: This can happen here!
Keywords: polio epidemic vaccine Netherlands
Date: 22 Dec 92 17:01:06 GMT
Reply-To: stevel@aio.jsc.nasa.gov (Steve Lancaster)
Originator: wtm@sheldev.shel.isc-br.com

Index Number: 26880

Bill, Please "waste" the bandwidth to re-broadcast this portion of the
HICN newsletter (from sci.med) in the misc.handicap newsgroup.

To all:

This can be prevented. Please ask your friends, who have pre-school age
children, if their children are completely vaccinated against all
childhood illness, especially against polio.  According to a recently
released study, the United States ranks 9th (Thats right ninth!) in the
world in the number of its population completely vaccinated against
polio.

The polio vaccine is amazingly effective and safe. If you are concerned
about the rare cases of polio caused by the oral polio vaccine, see your
physician about having the injected (killed) polio vaccine administered,
followed by (after a delay to allow immnuity levels to rise) a complete
course of the oral polio vaccine.

If you have any doubt about the benefits of an effective vaccination
program, just walk a mile with  the braces and crutches of, or roll a mile
in the wheelchair of someone who had "preventable" polio. They have a
lifelong reminder of just what the benefits are.

One can only hope that the persons responsible for the decision not to
have their followers vaccinated, fall into the group of people who contract
"preventable" polio as a result of this outbreak.

[Forwarded, edited material follows]

Volume  5, Number  6                                         December 20, 1992

              +------------------------------------------------+
              !                                                !
              !              Health Info-Com Network           !
              !                    Newsletter                  !
              +------------------------------------------------+
                         Editor: David Dodell, D.M.D.
    10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA
                          Telephone +1 (602) 860-1121
                              FAX +1 (602) 451-1165

Compilation Copyright 1992 by David Dodell,  D.M.D.  All  rights  Reserved.
License  is  hereby  granted  to republish on electronic media for which no
fees are charged,  so long as the text of this copyright notice and license
are attached intact to any and all republished portion or portions.

[Lots of stuff deleted]

     The outbreak in the Netherlands of poliomyelitis among  unvaccinated
persons who are members of religious groups that  generally do not accept
vaccination is continuing (1). From  September 17 through December 5, 1992, 54
cases of poliomyelitis were reported to the Netherlands' Office of the Chief
Medical  Officer of Health (Figure 1). Of the 54 patients, 41 (76%) had
paralytic manifestations of this illness; one neonate died, and 12 patients
had aseptic meningitis. Fifty-one (94%) of the cases have been laboratory
confirmed: 40 patients had wild poliovirus type 3  isolated from stool, and 11
had IgM-specific antibody to poliovirus  type 3 suggestive of recent
infection. All of the reported cases have occurred among unvaccinated (n=53)
or inadequately vaccinated (n=1) persons belonging to a religious denomination
that routinely does not accept vaccination. Patients ranged in age from less
than 1 month to 56 years (mean age: 18.9 years). Of the 12 provinces in the
Netherlands, seven have reported cases of poliomyelitis; the most severely
affected provinces are South Holland and Gelderland.

Reported by:

JK van Wijngaarden, MD, Div of Infectious Diseases, Office of the Chief
Medical Officer of Health; AM van Loon, PhD, P Oostvogel, MD, MN Mulders, MSc,
Laboratory of Virology, National Institute for Public Health and Environmental
Protection; J  Buitenwerf, PhD, Laboratory of Virology, CF Engelhard, MD, Dept
of Infectious Diseases, Municipal Health Svcs, Rotterdam, the Netherlands.
World Health Organization, Geneva. Div of Immunization, National Center for
Prevention Svcs; Div of Viral and  Rickettsial Diseases, National Center for
Infectious Diseases, CDC.

Editorial Note:

The poliomyelitis epidemic in the Netherlands  continues despite control
measures initiated by the Dutch health authorities, including offering oral
poliovirus vaccine to all previously unvaccinated persons belonging to
affected religious  groups and to other previously unvaccinated persons aged
less than 41 years and offering one dose of enhanced-potency inactivated
poliovirus vaccine to persons who are incompletely vaccinated. Based on the
ratio of cases of asymptomatic infection to paralytic disease for persons
infected with poliovirus type 3 (at least  1000:1) (2), an estimated 54,000
persons in the Netherlands may  have been infected with wild poliovirus type 3
during this outbreak. Therefore, the risk for infection may be greater than
previously assumed for unvaccinated or inadequately vaccinated travelers to
the Netherlands. In addition, the potential for spread  of this poliovirus to
other areas (including the North American  continent) by asymptomatically
infected travelers from the Netherlands--even if not directly linked to a
clinical case--also  may be higher than previously assumed.
     To prevent transmission of imported polioviruses and cases of paralytic
disease in the United States, increased efforts are  necessary to vaccinate
all unvaccinated or inadequately vaccinated persons in the United States in
accordance with recommendations of the Advisory Committee on Immunization
Practices (3,4). Public health agencies and health-care providers should
intensify outreach, especially to unvaccinated persons in these religious
communities who do not routinely accept vaccination.
     The risk for acquiring poliomyelitis while in the Netherlands is
considered small because of the excellent sanitation in the country and
because transmission of the poliovirus has been limited  primarily to
unvaccinated religious groups. Nonetheless, the polio immunity of travelers to
the Netherlands should be evaluated, and  persons with inadequate protection
should complete a primary vaccination series with three doses of poliovirus
vaccine before departure. For travelers with a completed primary series of
poliovirus vaccine, it may be prudent to obtain one dose of poliovirus vaccine
before departure, especially if extensive travel  in the Netherlands or
contact with persons in the affected religious groups is anticipated.

References

1. CDC. Poliomyelitis--Netherlands, 1992. MMWR 1992;41:775-8.

2. Salk JE. Requirements for persistent immunity to poliovirus. Tr Ass Am
Physicians 1956; 69:105-14

3. CDC. Poliomyelitis prevention. MMWR 1982;31:22-6,31-4.

4. CDC. Poliomyelitis prevention: enhanced-potency inactivated poliomyelitis
vaccine--supplementary statement. MMWR 1987;36:795-8.

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