Polio, which paralysed and killed thousands of small children during its peak in the UK in the late 1940s, was yesterday finally declared to have been eradicated from Europe.
Two-year-old Melik Minas was the last child in Europe to be infected by an indigenous strain of the poliomyelitis virus. Melik, who lived in south-eastern Turkey and had never been vaccinated, was paralysed in November 1998.
Last November, Europe passed the goal of three years without an indigenous case, but official certification by the World Health Organisation was in the balance to the last moment because of cases of polio imported into Georgia and Bulgaria from India in the past couple of years. However, the regional certification commission, which met yesterday, was satisfied that the virus had quickly been eliminated.
Sir Joseph Smith, the British chairman of the commission, said: "We are satisfied that all measures were taken to ensure that wild poliovirus imported into the region did not lead to ongoing circulation. All evidence confirms that. However, our work does not stop here. Ongoing vaccination and surveillance is vital."
Two other regions of the world have been certified polio-free: the Americas in 1994 and the western Pacific in 2000. But no country can protect its children completely from polio until it disappears from the planet. A decade ago, there was an outbreak among a religious community in the Netherlands who were opposed to vaccination. Two died and 71 people were paralysed. The virus was then found in a similar community in officially polio-free Canada, although nobody became ill.
The WHO's target date for a polio-free world is 2005. Massive progress has been made. In 1988 there were 350,000 cases a year in the world, but in 2001 just 480. The 125 countries in which polio was endemic have dropped to 10: Afghanistan, Angola, Egypt, Ethiopia, India, Niger, Nigeria, Pakistan, Somalia and Sudan.
But the last part is the hardest, because of the difficulties in reaching children in remote areas or war zones. Most of the cases (96%) are in northern India, Pakistan/Afghanistan and Niger/Nigeria. Extraordinary efforts have already been made to reach the children, including ceasefires in areas of conflict to allow national immunisation days. The WHO hopes that transmission of the virus can be halted in all 10 countries this year.
Polio is a highly infectious disease caused by a virus that invades the nervous system. It can cause total paralysis within hours. One in 200 infections leads to irreversible paralysis. About 5% to 10% of those will die because the breathing muscles have been paralysed. There is no cure, but multiple doses of cheap oral polio vaccine given to young children will protect them for life. A vaccine was discovered in the late 1950s.
The sight of children wearing callipers on their legs was common in the UK in the postwar years. The number of cases of paralytic polio - as opposed to another form which causes brain swelling - peaked in 1947 with 7,095, and 688 deaths.
"It was the Aids of its day," said Dorothy Nattrass, the national welfare officer of the British Polio Fellowship which helps many of the estimated 30,000 people in the UK living with the damage it caused.
Although Europe is now officially polio-free, Steve Wassilak, the WHO's polio eradication team leader for the region, said. "Immunisation must continue, particularly for vulnerable minority children."
The incidents involving a five-year-old boy in Georgia and three Roma children in Bulgaria were reassuring because there was good surveillance to pick up the cases and a rapid response, he said. Children in the areas were re-immunised and the virus disappeared.
He was confident it would be eradicated from the world. "The problem now is the funding gap until 2005," he said. The WHO says it needs $1bn (£670m) more, but has only received pledges of $725m.
