Papua New Guinea records its first confirmed case of polio in 18 years through a 6-year-old boy from Morobe province, the World Health Organization reveals Monday.

The country, certified polio-free since 2000 along with other nations in WHO’s Western Pacific region, suspected the case of the virus back in April and confirmed the diagnosis in May.

Confirmed Outbreak

The U.S. Centers for Disease Control and Prevention confirmed last June 22 that the same virus found in the boy, who had lower limb weakness and suffered permanent paralysis, was also detected in the stool samples of two other children in the community. This prompted health authorities to declare an outbreak, as it meant that the virus was making its rounds in the area.

“Our immediate priority is to respond and prevent more children from being infected,” said Pascoe Kase, Secretary of the National Department of Health, in a WHO announcement. The agency is now working with WHO and other partners to conduct large-scale immunization campaigns as well as strengthen surveillance and house-to-house surveys in the locality and neighboring provinces.

Polio, short for poliomyelitis, is an infectious viral condition affecting the brain and spinal cord, leading to permanent paralysis in a small sample of patients. Mainly affecting children, the disease can be fatal and spread from one person to another via contaminated food and water.

The Morobe province, situated on Papua New Guinea’s northern coast, is home to over 500,000. CNN reported that water, sanitation, and hygiene are all current challenges in the area, and that polio vaccine reach remains low. Less than two-thirds of its children have been given the recommended three doses.

Polio Vaccine At Work

The oral polio vaccine offers the poliovirus’s weakened version in order to activate the patient’s immune system. Upon ingestion, this form of virus quickly replicates in the intestines and antibodies then start to activate against the actual virus.

Once excreted, the vaccine-virus may be communicated to other individuals before it dies out — something that proper sanitation can prevent. The WHO explained that unvaccinated children may come into contact with the virus this way and accidentally develop immunity.

On rare instances, however, the excreted vaccine-virus can keep circulating for a longer time and undergo genetic alterations, through which it may change into a paralysis-causing form.

Due to relatively limited travel and the immunization in place, WHO set a low risk of international spread from Papua New Guinea to other countries. But it still recommends all travelers to polio-affected regions to be vaccinated against the disease.

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