Africa's Polio Efforts Aiding Bird Flu Fight

By David Brown
Washington Post Staff Writer
Monday, February 13, 2006

Africa's response to the first appearance of H5N1 bird flu on the continent may be aided by its fight against an entirely unrelated infection -- polio.

Nigeria, where the dangerous flu strain was found in chickens last week, is the focus of a high-stakes endgame effort to eradicate polio from the world. The work is being done by thousands of vaccinators and surveillance officers equipped with maps that record every house in every village and who are able to move diagnostic specimens from patient to laboratory quickly and safely.

This extensive public health infrastructure is now mobilizing against avian flu.

A four-day campaign, begun over the weekend, to vaccinate 40 million Nigerian children is being used to deliver a message to thousands of village leaders that people should not touch or eat sick chickens. More elaborate activities may begin later.

"The polio organization has offered to use all its network to deliver information, and also for surveillance and case detection. We are going to support all kinds of activities to mitigate the impact of avian flu," said Mohammed Belhocine, the World Health Organization's representative in Nigeria.

The H5N1 strain of avian influenza has infected 166 people and killed 88 since 2003. Most had direct contact with infected chickens, which have died in the tens of millions. The more people the virus infects, the greater its chance of evolving into a pandemic strain that could spread worldwide rapidly.

Should the polio workers become flu fighters, it would not be the first time the eradication campaign paid unexpected dividends. In recent years, polio teams have helped rescue earthquake survivors in Pakistan, investigate a lethal outbreak of Marburg virus in Angola, find victims of the rare Crimean-Congo fever in Afghanistan, and deliver malaria-preventing mosquito nets to mothers in Niger.

The versatility of the polio campaign is ironic as well as unanticipated.

In the past six years, the eradication initiative has missed two self-imposed deadlines to complete a task begun in 1988. It has suffered setbacks, including a revolt against vaccination in Nigeria's northern states in 2003 that led to a resurgence of polio there and a temporary reappearance of the disease in 18 other countries. It has spent $3.2 billion and is chronically short of money. Until a revised strategy and a new vaccine were introduced last year, the 18-year effort was on the verge of unraveling.

Begun by the Rotary International network of clubs, polio eradication has been criticized by some experts as a public health "trophy" that diverts time, money and labor from worse diseases and bigger problems.

But on the way to its still-unreached goal, the initiative has put in place an infrastructure of people, skill and equipment that can respond quickly to crises in the poorest, most crowded and inaccessible places on Earth.

"It is a network that is in place and that we hope countries will maintain and broaden in scope," said David L. Heymann, director of polio eradication at the WHO headquarters in Geneva.

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