Department of Disease Control joins the Prince of Songkla University team Visit the island of Sumatra Indonesia Preparing a surveillance system after the discovery of a mutant strain of “polio” from a vaccine outbreak in Sumatra ready to move forward with the vaccination campaign in Thailand especially the southern border Parents are invited to take their children to get vaccinated at hospitals near home for free!
“Polio” is a virus that is released from an infected person’s body through faeces. enter the body through the mouth by eating and drinking Part of the recipients are affected by the virus, the nervous system, spinal cord, and muscular disability are common, lifelong atrophy of the legs..
The good news is that the world is as close to eradicating polio as it is to eradicating smallpox. The most important way is to vaccinate children. From decades of continuous campaigning Only one of the three polio strains (types) remains in the wild. The second and third strains (Wild poliovirus types 2 and 3) have been extinct. But to ensure prevention until polio is completely eradicated. around the world including Thailand Therefore, the polio vaccine must continue during this period.
In 1954, the vaccine researcher was awarded the Nobel Prize in Medicine. It has been able to invent both inactivated poliovaccine (IPV) vaccines and live orally administered vaccines. which is a live vaccine (oral poliovaccine (OPV))
The OPV is easy to use because it does not require injection. Who can be a dropper? It is therefore more widely accepted by the public than IPV. It also has a higher protective effect both in vaccinated children and in the community. and then also out in feces spread to communities near the water Make other children in the Ploy community get vaccinated as well. For this reason, the use of OPV is a key strategy for polio eradication, especially in developing countries. which hygiene is not good
However, OPV may be dangerous for immunocompromised children. Countries without polio for a long time are turning to IPV, which is safer. but not as protective as OPV
Around the world helping to reduce OPV until the second and third strains are extinct. But there is a slight problem: if the vaccine is not continued, the virus from the community vaccine can mutate back to harm the recipient, known as circulating Vaccine-Derived PolioVirus type 2 (cVDPV2), as is the case with islands. Sumatra Indonesia now And be aware that this will happen in southern Thailand, where vaccine coverage is low and there is high traffic to Sumatra.
** Most recently, on February 17-18, 2022, a research team from the Faculty of Medicine Prince of Songkla University (PSU) in cooperation with the Department of Disease Control Ministry of Public Health (MoPH) with Prof. Dr. Weerasak Jongsoowiwatwong course chair Department of Epidemiology Faculty of Medicine, PSU and Dr. Chaninan Sonthichai, General Communicable Diseases Division, Department of Disease Control, visited Aceh province. of Indonesia to follow up on vaccine strains of polio The objective is to create cooperation in surveillance, prevention and control of disease between the two countries.
Prof. Dr. Weerasak Giving information to Hfocus after returning from Aceh Province, Indonesia that the PSU research team works with various universities. in Sumatra for about 30 years, in the past, southern Thailand and the province of Aceh They have been working together for a long time on improving the health of people in the area since 2005 after the new tsunami disaster, which made them very close.
The PSU team and the Department of Disease Control They jointly went to the area to track information about cVDPV2 in order to use such information to lay out surveillance guidelines. and prevention of polio in Thailand
“We have received great cooperation from Indonesian health workers in Aceh province. We went to the district of Pidie where a case of cVDPV2 was found, which gave us very useful information..”
Prof. Dr. Weerasak It added that as of 2020, more than one thousand cases of cVDPV2 have been reported globally. mostly in Africa During the COVID pandemic, the number of reported incoming cases was reduced to 362 as of October 2022. It is possible that cVDPV2 was more widespread during COVID. But the public health system is in disarray, so there are few reports coming in.
for patients in Aceh It was discovered in July 2022 in the district of Pidie. After it was confirmed as cVDPV2, a polio vaccination campaign was launched for all children under 12 in the province. It has been carried out 2 rounds, covering more than 95 percent of the goal and is about to campaign for the 3rd round.
“In Aceh’s Pidie district, the situation is somewhat similar to Thailand’s three southernmost provinces, where there were conflicts with the central government and losses on both sides. Very little vaccination has resulted in the spread of cVDPV2 and has now spread out of Pidie to other districts. The children infected in other districts do not have any symptoms, ”Prof. Dr. Weerasak said.
The outbreak of cVDPV2 was caused by OPV2 that had been circulating in the community for a long time until it became more virulent. If inoculation or complete vaccination is continued long enough, cVDPV2 will eventually localize and disappear from the community.
The campaign to vaccinate all children in the area is an important strategy in areas where villagers rarely get vaccinated on a regular basis. Because during the campaign there will be a process to follow children from every home and everyone. To receive OPV vaccine instillation through the mouth, no need to inject, health workers and volunteers can help instill instillation because instillation is more convenient than injection. Easily cover the target population. In addition, the cost of vaccines and wages are much cheaper than injecting IPV. In Indonesia, they call it a campaign week for children to pick up sweet drops (Sweet Drop).
back to Thailand We have run a nationwide polio vaccination campaign in the past. But due to the coverage of vaccines in Thailand, it works well. Currently, the campaign remains only in areas where vaccine coverage is low. in which the three southern border provinces are in this case During the 2-3 years of the COVID epidemic, campaign activities may be somewhat scrapped. Now it’s time for us to resume vigorous campaigning, especially in the wake of the cVDVP2 outbreak in neighboring countries.
Our campaign will continue to use OPV (types 1 and 3) because OPV2 has been phased out globally. We may wonder if it can prevent cVDPV2. Thailand now offers IPV (types 1, 2, 3) 1 dose each. I don’t think it protects as well as OPV2, but we have to use OPV (1st and 3rd strain) and IPV (1st, 2nd, 3rd) because there is no evidence of cVDPV2. in the area of Thailand
In Aceh and other cVDPV2 outbreaks, the campaign will use a special vaccine from the World Health Organization. Its abbreviation is nOPV2, which is also OPV2 but has an ‘n’ preceded by novel, meaning new and special. There are very few mutated cVDPV2 vaccines. Due to the high cost, it is limited to cVDPV2 endemic areas only. If cVDPD2 is available in the southern borders, then it will be time for us to obtain this vaccine from the World Health Organization to crush the outbreak.
However, there are additional questions about how to be sure that there is no cVDPV2 in the southern border right now. The answer is that it requires surveillance of the local health system. When a child is found with acute flaccid paralysis (AFP), feces must be collected for polio testing according to the Ministry of Public Health’s measures. Then we’ll know if it’s polio or not. and which species Normally, each province in each year must have some AFP sporadic. If no AFP report comes in then the surveillance system is weak. There’s an epidemic of polio, we won’t know or we’ll know when it’s too late.
Prof. Dr. Weerasak said that the situation in Indonesia Therefore, it is a warning sign that we must be vigilant and prevent by hastening to vaccinate Thai children as comprehensively as possible. In normal districts, parents are asked to bring their children to receive various types of vaccines as specified by the public health authorities. This includes the polio vaccine already. If we get all together, we don’t have to be afraid that polio will spread. As for the precarious areas like the southern border provinces where routine vaccination is low. There must be a polio day campaign as a special measure. Have to continue campaigning in the southern border for more than many years until the normal vaccination rate is as high as other parts of the country.
“ After this visit to Aceh There would be discussions in the Department of Disease Control. that the situation is like this and how to continue driving which of course in the three southern border provinces There must be more campaigns for polio vaccination. At least more than 90 percent like Indonesia did. But Thailand is different in that there is no special vaccine from the World Health Organization. Because we have been polio-free for over 20 years. Thailand’s scenery will change immediately..” Prof. Dr. Weerasak said.
side Chaninan Sonthichai, General Communicable Diseases Division, Department of Disease Control Says polio is preventable with a vaccine. But during the past COVID-19, it was found that worldwide polio vaccination coverage was declining. And found more polio cases in many countries. The latest from the area in the province of Aceh. In Indonesia, polio vaccination coverage was relatively low. The more during the COVID period, the less found polio patients which is a child with weak limbs Then sent for testing until it was found that he was sick with circulating Vaccine-Derived PolioVirus type 2 (cVDPV2) that was mutated type 2 (cVDPV2). Advised by the World Health Organization in issuing vaccination measures for children to have immunity the entire Aceh area and nearby areas
“Indonesia organized a polio vaccination system to cover as much as possible while Thailand We have always had a surveillance system in every province including border areas. and expedite polio vaccination measures in children who have not been fully vaccinated especially after COVID Because during the COVID period, the proportion of vaccination is less, ”said Dr. Chaninan.
Dr. Chaninan explains why fewer children receive the polio vaccine, saying that Thailand is similar to other countries. In the COVID period, parents will bring their children less to get vaccinated. which is the same all over the world Because during the COVID epidemic, the hospital will focus on taking care of COVID patients. While parents are concerned that If taking your children to get vaccinated, will there be a risk of getting COVID? But after the COVID epidemic has passed Most recently, in the middle of the year 2022, the Ministry of Public Health There is a policy for affiliated service units across the country to follow up on children who have not been vaccinated. or have not received all of the polio vaccination and other vaccines until complete
Therefore, ask parents and guardians whose children have not received the polio vaccination as scheduled. Please take him to get vaccinated immediately. Many people misunderstand that when not following the appointment will not be able to get vaccinated again despite the fact that you can contact the hospital near the house or sub-district health promotion hospitals (Hospital) all over the country or even government hospitals outside the Ministry of Public Health can provide services as well
There are 2 types of polio vaccines in Thailand: the drop vaccine is given 5 times according to different ages from 2 months, 4 months, 6 months, 1 year and a half, and the last dose is given at 4 years old. which, if exceeded, can still be accepted
“Even though Thailand has not seen patients for over 20 years, they still cannot be trusted. Because neighboring countries still see patients together with now opening the country have traveled in If there is an infection, it is considered at risk, so it is best to take your children to get vaccinated as scheduled. Or you can ask the village health volunteers (VHVs) or the nearby health hospital. to receive the polio vaccine.”
The reporter asked Currently, the Department of Disease Control must have guidelines for screening people in areas at risk of entering Thailand regarding mutant polio as well or not. Dr. Chaninan said that Thailand has already focused on the disease surveillance system. If we screen people who have symptoms and detect the infection, it will also help prevent the spread of the disease.
“The important thing is to ask the public that children have not been vaccinated against polio or incomplete Please get as many vaccines as possible. Before the COVID-19 outbreak, more than 90 percent of Thai children were vaccinated, but during the COVID-19 pandemic, fewer children were vaccinated. Therefore, the challenge from this is The coverage of polio vaccination must be increased to at least 90% in order to build immunity for all Thai children,” concluded Dr. Chaninan.
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