The recent outbreak of polio in Namibia has got local disease experts worried. Health24 spoke to Prof Wolfgang Preiser, Head of Virology at the University of Stellenbosch, whose team first isolated the virus causing the outbreak.
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Prof Preiser says that the Namibian outbreak has come as something of a surprise, as Namibia – like South Africa – was considered to be one of those countries in which the virus was on its way to being eradicated.
“It shows yet again that authorities can never afford to be complacent about the re-emergence of infectious disease,” says Prof Preiser.
“The Namibian outbreak suggests that there may be thousands more infected. In other words, many may not be showing obvious symptoms, but they can still spread the disease. Something went wrong there. It seems that maybe not as many people were vaccinated as was thought. Possibly the vaccine was not given properly; or, people have lost their immunity.”
The risk is low – but serious
Prof Preiser explains that the chances of getting the most serious form of polio, which causes paralysis, are very slim – especially for those of us lucky enough to be living in good socio-economic conditions and following sound hygiene practices.
Prof Preiser says: “It’s unlikely you’ll get it, but it is worrying nonetheless. If you have been vaccinated, and you practise good hygiene, your risks are negligible. Even if you’ve never been vaccinated, the risk is still very low. Certainly, there’s no cause for panic, but it’s wise to take the issue seriously."
Do South Africans need a booster dose?
There are no guidelines for adult re-vaccination in South Africa, but Prof Preiser reckons it certainly won’t hurt to get a booster dose at some point, or to have the full course if you’ve never been vaccinated.
However, given the very low risk for developing serious complications from the disease, South Africans don't need to rush to get vaccinated, especially considering that currently stocks of available vaccine in the country appear to be low. Retailers of the vaccine expect to have more stock by mid-July.
What about travellers to Namibia?
If you are planning a trip to Namibia, it is advisable for adults to get vaccinated against polio.
“Children – as long as they’ve followed the standard vaccination regimen – would be my least worry. But with adults, most of whom were vaccinated in childhood, after two or three decades, the protection starts to wane,” says Prof Preiser.
The National Institute for Communicable Diseases advises the following for travellers to and from Namibia:
All travellers to Namibia (including returning residents) are advised to obtain a booster dose of polio vaccine, at least 10-14 days before travelling. If your trip is scheduled for sooner than that period, then you should still be immunised.
Be meticulous about hygiene, especially hand washing with soap and water after using the toilet and before handling food. Only drink water and eat food from safe sources.
The trivalent oral polio vaccine (TOPV) is the most accessible in South Africa and will be provided free of charge at government clinics. It can also be purchased through doctors or travel clinics very cheaply (at about R2-50 a dose). The other form of the vaccine is the inactivated polio vaccine (IPV), usually available combined with tetanus and diphtheria (TdP, which stands for tetanus, diphtheria and inactivated polio vaccine). The latter form of the vaccine is recommended for immuno-compromised individuals, and for pregnant women.
When returning to South Africa from Namibia, see a doctor immediately if you develop any symptoms of weakness in the limbs, or inability to move the limbs. Be sure to tell the doctor that you have recently visited Namibia.
There is no role for vaccination of people returning from Namibia to South Africa; the vaccine will not prevent the disease if a person is already infected. Spread of infection can be prevented through good hygiene practices.
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