The Israeli Pediatric Association (IPA) issued an urgent appeal on Sunday calling on the government and the medical community to quickly and aggressively address an ongoing polio outbreak.
The IPA – the umbrella organization that brings together the Israeli Association of Ambulatory Pediatrics and the Israeli Society of Clinical Pediatrics – released a note in which it shares its position and explains the origin, according to her, of the epidemic as well as the initiatives to be taken to overcome it. The first priority, according to the document, is to identify and vaccinate the 175,922 Israeli children who have not received the polio vaccine – a vaccine that consists of a series of injections that provides optimal protection once morest this disease. viral disease that can lead to paralysis, disability or even death.
Four children have been infected with polio since the end of February. The first case involved an eight-year-old boy from Safed who showed signs of limb paralysis. The other three had been in contact with the child and they had tested positive for the disease, nevertheless developing an asymptomatic form.
According to Dr. Liat Ashkenazi-Hoffnung, director of the day hospital ward at the Schneider Pediatric Hospital, the current outbreak is caused by the cVDPV2 strain that had never circulated in Israel.
“We know that this strain is identical to a strain that has been identified in London and New York and that there has also been a clinical case in New York. Israel has a population that interacts with the populations that are there and that is apparently how the strain entered Israel,” she commented.
« L’OPV [le vaccin oral] which is administered in Israel does not prevent the spread of the cVDPV2 strain. Which means the only way to fully protect a child once morest this strain is to get the IPV vaccine,” she adds.
Dr. Liat Ashkenazi Hoffnung, Director of the Day Hospital Department at Schneider Pediatric Hospital. (Courtesy: Schneider Children’s Hospital)
In Israel, the polio vaccine consists of four injections of the IPV vaccine before the child reaches the age of 18 months, and a new injection when he enters CE1. Babies and toddlers also receive two doses of oral polio vaccine (OPV), given to them by drip, which provides full protection once morest polio, also preventing virus shedding in the school. through the sewage system. It also allows a child not to contaminate others.
The disease spreads mainly through feces and oral contamination. Less commonly, it can be transmitted through the air, through droplets of saliva.
“If we have been able to achieve a level of global polio eradication, then we should be able to cope with IPVs only – but as there are strains currently circulating, the only way to decrease the excretion of the virus through feces is OPV,” notes Ashkenazi-Hoffnung.
Between 1998 and 2022, no clinical cases of polio had been reported in Israel. The symptomatic form of the disease reappeared in March last year, when an unvaccinated girl in Jerusalem was seen for paralysis and was diagnosed with polio. This put Israel back on the list of the World Health Organization’s Polio Eradication Initiative, which identifies countries with epidemics.
A nationwide campaign followed last year to fully immunize children aged zero to 17 who were not yet vaccinated.
It has only been since 2015 that a second dose of OPV has made it part of the protocol – and the hope had been that the 2022 campaign would get older children who had only received one dose to be injected with the second. The campaign had been successful in terms of infant vaccination coverage – 37,000 had been vaccinated by that time. 96% of babies had also received their two doses of OPV.
A medical clown with an Israeli child getting a polio shot, August 19, 2013. (Yossi Zeliger/Flash90)
“We have achieved 85% OPV coverage among young children, which is excellent. And in tweens and teens ages 10-17, we’re at 50%, which isn’t bad,” Ashkenazi-Hoffnung said.
“The sewage has been cleaned of the virus that is circulating at the moment and the World Health Organization has taken Israel off the map,” she continues.
Clinical cases of polio emerge in unvaccinated populations
According to the Israel Pediatric Association and its president, Professor Zachi Grossman, communities with low vaccination rates are not necessarily anti-vax. It’s regarding families haredim in general, with many children, who do not always make routine visits to clinics and pediatricians. These families also tend to live in close contact with each other – circumstances where the disease can be transmitted easily from one child to another.
“For these families, vaccination or non-vaccination is not a matter of ideology. It’s a practical and technical matter of taking their children to the pediatrician,” Grossman says.
He warns, however, that children in all communities are vulnerable to polio, urging adults and children alike to maintain good hygiene practices (including frequent hand washing) in addition to vaccinations.
President of the Israel Pediatric Association, Professor Zachi Grossman (Courtesy)
Grossman and Ashkenazi-Hoffnung are both members of the IPA group working on children with polio, as well as of the to this of the Ministry of Health. They both explain that the note issued on Sunday was intended to raise awareness of the epidemic among family doctors, pediatricians and other health personnel. If a child presents with any limb or other weakness, tests should be conducted to determine if the cause is possibly the polio virus, the task force said.
According to Grossman, the note is also a request to the government to allocate more resources to an immediate vaccination campaign.
“The highest level of government must support the creation of mobile vaccination units that will go to neighborhoods and homes. We will only be able to reach many of these unvaccinated children if we go to their homes,” Grossman says.
The Ministry of Health has indicated that it plans to launch such an operation on March 29.
“There is a designated budget that will be used to strengthen the personnel that will allow vaccination to enter homes. A supplier has been chosen following a call for tenders and the nurses who will work for this supplier will undergo professional training… This home vaccination service will be made available to families who wish it and there will be an expansion of vaccination efforts in pediatric clinics,” the ministry said in an email.
Following the current polio outbreak, the New York Department of Health on March 10 called on all residents to get the polio vaccine before leaving for Israel. The department also called on travelers to follow guidance from the Center for Disease Control (CDC) which advised the public to take polio precautions before traveling to the UK, Ukraine, Afghanistan, Pakistan, Indonesia, Nigeria, Ivory Coast and several other countries in central Africa.
