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Albania: Epidemic Threatens Efforts To Eradicate Polio

London, 29 October 1996 (RFE/RL) -- An outbreak of polio in Albania is threatening World Health Organization plans to help eradicate the disease by immunizing 120 million children in 18 countries in the Mediterranean, Caucasus and Central Asia.

The disease was identified in northwestern Albania in April and later spread to Tirana and the rest of the country. So far 66 cases have been reported and there have been 7 deaths.

It's the first known outbreak of polio in a country that was previously free of the paralyzing disease for many years. It has raised a question mark over ambitious World Health Organization (WHO) plans to totally eradicate polio by the year 2000.

The WHO has already been successful in wiping out smallpox globally (the last case was detected in 1977) and now it is confident that polio and the virus which causes it can be eliminated, too.

Since 1988, the global incidence of polio has declined by over 80 percent because of the success of mass immunization programs. The Americas were declared polio free in 1994, but in Central Asia, Russia and parts of Europe the disease still claims victims.

The WHO says the "sudden and deadly" outbreak of polio in Albania is linked to poor hygiene and sanitation; to a recent migration of people towards towns; to failures in previous health programs; and to increased contacts with other countries since Albania opened up in 1991.

Albanian health officials are organizing another nationwide immunization campaign in a bid to stop the outbreak, to ensure the population is protected, and to prevent the disease from crossing borders. It involves the distribution of 3.2 million doses of oral polio vaccine.

WHO officials presently advise people traveling to Albania to ensure they are adequately immunized against polio before departure.

Earlier this year WHO and Albanian officials immunized 350,000 children under the age of five. The spring campaign played a big role in protecting children (only 5 of the 66 reported polio cases were in young children: the majority occurred in adults and teenagers).

The immunization program is part of the WHO's ambitious drive to eradicate polio from the Mediterranean region, the Caucasus and the Central Asian Republics -- a program known as MECACAR.

The polio problem is most serious in the Transcaucasus and Central Asian countries. Of 215 cases detected in 1994, 117 occurred in Uzbekistan, 26 in Tajikistan, 17 in Azerbaijan and 6 in Turkmenistan.

In Uzbekistan, only 46 percent of children under 12 months were immunized in 1993 because the country could not afford to buy enough vaccines. As a result, an upsurge of polio occurred in 1993 and 1994.

In Tajikistan, civil war damaged the country's health services and hindered the procurement and distribution of vaccines.

Other figures for polio cases in 1994 were Armenia (5), Kazakhstan (5), Romania (5), Russian Federation (5) and Belarus (1).

Even so, the WHO is winning the fight against the disease. In 1994, 7,121 cases were reported globally compared to 35,255 cases in 1988.

Operation MECACAR received a big boost on April 7 last year when 18 countries in the Mediterranean, Caucasus and Central Asia conducted a national immunization day. On that day, 63 million children under five were immunized with the oral polio virus vaccine (OPV). The operation was one of the largest public health events in history.

The operation, coordinated by the WHO, UNICEF, Rotary International, the United States, and the affected countries, will see almost 60 million children under four immunized with OPV in 1996 and 1997. A WHO statement said: "Eradicating polio is feasible and achievable...It will die out once every infant and child which is at risk or living in an endemic area is protected."