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Expert warns polio’s return could shatter Israel’s public health image, hurt tourism
There’s still only one clinical case and two other positive tests, but Prof. Nadav Davidovitch says situation is serious as virus can dodge elimination by spreading at small scale
The reemergence of polio could cause paralysis among dozens of Israeli children, shatter the country’s global reputation as a leading light in public health and discourage tourism, a top epidemiologist has warned.
For the first time in decades, Israel has a child sick with polio, and two others have tested positive but are asymptomatic. All three are from the Jerusalem area.
In a country used to tracking coronavirus figures, the numbers seem tiny, but doctors are warning the situation was far more serious than appears.
The international health community is on a mission to eradicate polio and has reduced cases by 99 percent since launching a global initiative in the late 1980s. With the recent discoveries, Israel is now one of just 23 countries to report cases in the last year.
“Polio now survives only among the world’s poorest and most marginalized communities, where it stalks the most vulnerable children,” according to information published several years ago by the World Health Organization, which leads the initiative.
Israel, widely revered in health circles for its trailblazing vaccination campaign against COVID-19, is now a conspicuous entry on the WHO’s map of polio cases, which comprises far poorer countries.
Fellow entrants with a single case over the last 12 months are Malawi, Yemen, Liberia, Burkina Faso, and Guinea. If Israel confirms another clinical case it will rank with Somalia, Ukraine, Mozambique, Pakistan and South Sudan.
Epidemiologist Prof. Nadav Davidovitch, a senior official in Israel’s doctor’s union, warned Israel’s addition to the list carries a real stigma.
“People don’t appreciate that being marked as a country with polio is serious, and is a category we really don’t want to be in,” he told The Times of Israel.
“This is a disease that is marked for eradication, and the fact it seems to now be spreading in Israel could very much harm our reputation for advanced health, and could impact incoming travel. People could become cautious about visiting, especially the immunocompromised.”
He also said Israel could potentially “impede the global and regional progress of eradication.”
Each country that has polio cases, even if just a few, is seen as keeping alive a virus that should be eliminated. Only Nigeria, where the militant Boko Haram has hampered vaccination efforts, had triple figures of cases over the last year to 412 in total.
Aside from Nigeria, polio is dodging elimination in poor countries with relatively small case numbers. The world’s most polio-affected countries include Cameroon, Guinea-Bissau and Benin, each with three cases over the last year. Yemen and Madagascar had 13, Niger had 14 and Senegal had 15. Afghanistan had 19, the Democratic Republic of Congo had 23 and Tajikistan had 27.
Davidovitch said that Israel isn’t heading for numbers like Nigeria, but could well see numerous cases unless polio is dealt with swiftly.
While Israel has high child vaccination rates, and polio protection among children is well above 90 percent, families that don’t vaccinate often live in the same areas, attend the same schools and share social circles, increasing the chances of spread.
Davidovitch and other experts note that a mistrust of polio vaccines in parts of the ultra-Orthodox community have led to lower-than-normal vaccination rates in some communities, especially in the Jerusalem area.
Davidovitch said the only effective way to address the problem is by promoting vaccination with oral drops, which contain a weakened form of the live virus. They give protection to those who aren’t yet vaccinated.
Those who are vaccinated by the injection, which contains a killed vaccine, are protected against illness, but not necessarily against transmission. Drops almost eliminate their ability to transmit the virus.
“Israel has the tools to take care of this, but needs to act quickly,” said Davidovitch. “Unlike with COVID, vaccination needs to happen quickly to prove effective and to prevent cases from rising. Israel invested lots of energy into building an excellent epidemiological and clinical surveillance system for polio and we must invest in it, and act on the information it’s giving us.”