The Looming Threat of Poliovirus in Gaza

While the Israeli brutality continues, a new threat is propelling in the waters of Gaza. Where healthcare is perishing every passing moment, news of a potential poliovirus outbreak rattles the global health organizations.

According to a report published by Global Polio Eradication Initiative, on June 23rd 2024, six sewage water samples were collected from Khan Younis and Deir al Balah, where almost a million people relocated from Rafah. All samples resulted positive from a strain of poliovirus variant called cVDPV2 (circulating vaccine-derived poliovirus type 2).

As the name indicates, this poliovirus variant is derived from the poliovirus vaccine. It is rare but over recent years, an exponential increase in cVDPV2 cases is seen in various regions because of improper sanitization.

The very common OPV-Oral Polio Vaccine, successfully used for the eradication of Wild Poliovirus, gives rise to cVDPVs. OPVs contain active poliovirus strains which are excreted through the gut with other waste material. In communities with improper sanitation and waste disposal systems, this poliovirus containing waste infiltrates the water of use prompting the spread of cVDPVs in under-or-unvaccinated children.

Dr Balkhy says, “I witnessed at first hand living conditions that are highly favorable for the spread of polio and other diseases. This is an important time for the Subcommittee to come together to act swiftly and decisively to contain this outbreak, for the children of Gaza.”

Latest statistics from World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) show that poliovirus immunization rates in Gaza and the occupied west bank were estimated at 99% in 2022. But as of last year, this value declined to 89%.

Now, amidst the war, with a wrecked healthcare infrastructure, and lack of sanitization, children of Gaza are exposed to the grave threat of cVDPV2 epidemic. Out of 36 hospitals in the Gaza strip, only 16 are somewhat functional-offering limited services.

Whereas, 70% of the sewage disposal system has been destroyed and not even a single water treatment plant is operational. As a result, a surge in the spread of gut and respiratory diseases is seen in the displaced population.

WHO Regional Director for the Eastern Mediterranean region, Dr. Hanan Balkhy recently visited the disputed territory. She shared, “In the Gaza Strip, where garbage and sewage fill the streets, cases of acute respiratory infections, diarrheal illnesses, acute jaundice syndrome and skin infections are surging. The situation is indeed dire.”

Up till now, more than 100,000 individuals have come down with jaundice and hepatitis A complaints. These acute diseases usually take a few weeks to recover. However, in the middle of war when people are displaced frequently, and have unhygienic living conditions due to lack of incoming aid, these non-threatening diseases can take a dangerous turn.

Health authorities warned of a potential cholera outbreak, which could lead to rapid fatalities.
Thankfully, this prediction has not been realized yet. But if this siege continues, there’s not much time left for preventable diseases to spread like wildfire.

After her Gaza visit, Dr. Balkhy addressed the health ministers of member states of Middle Eastern regions, representatives of Global Polio Eradication Initiative and UNICEF over a virtual meeting. Here she stressed the need for joint efforts to avoid the spread of preventable diseases and save whatever little is left of healthcare in Gaza.

She stated, “I witnessed at first hand living conditions that are highly favorable for the spread of polio and other diseases. This is an important time for the Subcommittee to come together to act swiftly and decisively to contain this outbreak, for the children of Gaza.”

Since October 7th, over 39,000 civilians including 13,000 plus children have been killed. This death toll does not include the lives that are dusted in the rubble nor the ones slowly dying from hunger and famine. 45 physicians, clinicians, and medical experts from the US who volunteered in Gaza speculate that the actual number of casualties is more than twice of the reported one, that is over 92,000.

This staggering number will climb exponentially if a deadly infectious disease spurts. The situation will pose dire consequences not just for the people of Gaza but the surrounding Middle East.

To save Gazans from another catastrophe. WHO is pushing world leaders to call for a cease-fire. They have also announced to send over 1 million polio vaccines for the children of Gaza in coming weeks. However, administration of these vaccines would be a challenge for volunteers and aid workers unless a halt to Israeli atrocities is put.Israel has killed 500 healthcare workers including international volunteers and detained 310 healthcare workers since October 7th.

Since healthcare in Gaza is at the brink of collapsing, there is an urgent need to work on a framework to resuscitate the health sector. Around 1.2 million people in Gaza depend on humanitarian aid for basic necessities like food, drinking water, shelter, and healthcare. To ensure these facilities reach the desperate, we are obliged to put pressure on global stakeholders to end this oppression, through boycotts and protests. Engage in advocacy and support efforts for Gaza, because without humanitarian support and adequate funds it would be nearly impossible for life to suffice in the Gaza strip.