And He said, If you hearken to the voice of the Lord, your God, and you do what is proper in His eyes, and you listen closely to His commandments and observe all His statutes, all the sicknesses that I have visited upon Egypt I will not visit upon you, for I, the Lord, heal you. (Exodus 15,26)
Poliomyelitis, or polio, a disease which struck fear into the hearts of parents worldwide in the twentieth century, has long been considered eradicated in the Western world. Recently, however, routine testing of sewage in southern Israel has turned up several incidences of the wild poliovirus, wPV1. So far, no cases of paralytic polio have been reported, but the Ministry of Health has begun an oral vaccine campaign to prevent the possible spread of the disease among the population.
Polio has affected humanity for millennia, but until the late nineteenth century, its effects were not devastating. Most patients who contracted the virus were children aged 6 months to 4 years, and usually only suffered mild symptoms. About 150 years ago, however, with improved hygiene and medical practices, people began to get ill later in life, when the risks of paralysis or death were much higher. The 1950s and 60s saw the worst of the polio epidemic, with as many as 58,000 people affected in the US in a single year, including over 3,100 deaths.
A concerted effort to treat and prevent polio began, resulting in the development of two vaccines which together helped eliminate the virus in the Western world. The first, called the Salk vaccine after its creator, Jonah Salk, uses killed viral samples and is administered by injection. Also known as IPV (inactivated poliovirus vaccine), it is designed to promote antibody development in the vaccinated individual. The second, Albert Sabin’s oral polio vaccine (OPV, or Sabin vaccine), is taken by mouth and designed to prevent the spread of the virus. It uses a weakened (attenuated) live virus.
Many countries which are considered polio-free have abandoned the OPV in favor of the IPV. Israel has not used the oral vaccine in the past eight years. Now, due to the recent discovery, Health Minister Yael German plans to invest millions of shekels in oral vaccines to prevent the virus from spreading further. 150,000 children in southern Israel are the initial target of the campaign, but, “we are prepared to vaccinate with OPV the whole population in the relevant age groups in the South or even in the whole country,” said Professor Roni Gamzu, director-general of the Health Ministry.
The decision follows a visit from representatives of the World Health Organization and the US Center for Disease Control. After sewage samples tested positive, Israel invited the polio experts to help determine the best course of action.
It is important to stress that no incidents of paralytic polio have been reported in Israel in about 25 years, and that thus far the wild virus has been contained in the southern region. It is apparently centred around the Bedouin town of Rahat, where rates of vaccination are lower than in the general population. Genetic evidence and epidemiology show that the virus is of South Asian origin. “We had to be careful, as viruses do not respect borders,” Gamzu said.
For the past eight years, the practice in Israel has been to inoculate children with IPV at well-baby clinics. Israel has a 95% vaccination rate against polio, prompting one WHO representative to say, “You do it better than we do in Germany.” However, the Health Ministry is unwilling to take chances, and is therefore launching the current OPV campaign.
In both Deuteronomy and Joshua, the bible urges us “Only take heed to thyself, and keep thy soul diligently…” From this we learn that we are obligated to protect our health. Regular vaccination is just one way we can do that.
