Polio Alarm

The battle to eradicate polio from the globe received another serious setback yesterday with the news that the disease __________ (1) (to spread) to Indonesia as well as Yemen, both of which (2) ______________ (to be) polio-free for over 10 years.

The World Health Organization yesterday confirmed that an 18-month-old child (3) _________________ (to paralyze) by polio in a village in west Java, Indonesia. It was the first time that a polio case (4) ______________ (to register) in the country since 1995. Experts said they couldn’t determine how widespread the disease (5) __________________ (to be) until all suspected cases (6) _______________________ (to investigate). Teams of WHO staff flew to Indonesia to help the government limit the outbreak. Four thousand children in villages already (7) ________________ (to immunize).

That news followed revelations that there (8) ______________ (to be) 22 confirmed polio cases in the past fortnight in Yemen, which (9)________________ (to be) free of polio since 1996.

The strain of polio virus in all the cases (10) _______________ (to identify) as the one that (11) ____________________ (to cause) a large outbreak of the disease in Nigeria last year. Immunization against polio (12) ____________________ (to stop) in the Nigerian state of Kano two years ago because of local suspicions and rumours that the vaccine (13) __________________ (to design) to make Muslim children infertile.

After intense negotiations and a supply of vaccine made in an Islamic country – Indonesia – the immunization began again last August. But the virus, which (14) _____________________ (to be) responsible for 814 cases of polio in Niger and Nigeria up to March this year, (15) ______________ (to carry) out of Nigeria into neighbouring countries including Sudan, and now (16) ______________________ (to travel) as far as Indonesia. WHO staff said yesterday they (17) ____________________ (not to know) whether the virus (18) _____________________ (to go) straight from Sudan to Indonesia, or whether it first (19) ___________________ (to convey) to Saudi Arabia, the site of two cases.

David Heymann, the WHO director general’s representative, said it was possible the virus (20) _____________________ (to carry) to west Java during a pilgrimage to a shrine this year. Fortunately, however, Indonesia’s child immunization rate is 90%. Yemen, he said, (21) ________________ (to be) a different story. Immunization coverage (22) ________________ (not to be) high, but a national campaign (23) _______________ (to take) place last month because of the country’s proximity to Sudan. The first four confirmed cases (24) _______________ (to be) in the south-west, on the Red Sea coast. Ten days later it (25) __________________ (to report) that 18 other cases (26) _______________ (to identify) across the country.

The high point of the polio eradication campaign was in 2003, when the disease (27) _______________________ (to disappear) from all but six countries. Since the Kano episode, however, polio (28) _____________________ (to spread) to 12 countries.

(From ‘The Guardian’, abridged)