-Caveat Lector-

Volunteers conduct house-to-house polio vaccines in Dominican Republic

By SUSANNAH A. NESMITH
The Associated Press
12/16/00 5:52 PM


SANTO DOMINGO, Dominican Republic (AP) -- Volunteers went from house to
house in poor neighborhoods Saturday, vaccinating children against polio in
the wake of an outbreak here that has left at least six children paralyzed
and alarmed health officials.

"Tomorrow, I need to be able to grab a child on the street, any child under
5 years old, and ask his mother if he was vaccinated, and she's going to
tell me yes," said Jose Beltre, the volunteer coordinator in La Cienega, a
squatter neighborhood in the center of the capital.

"We have to get everyone," he told a group of 15 volunteers before they set
out, armed with thermoses of the oral vaccine and chalk to mark the houses
they had visited.

Health care experts thought polio was eliminated from the Western Hemisphere
in 1991, when the last case was reported in Peru. Then in November, an
unusual strain of the virus appeared, first in the remote mountain town of
Constanza. Six cases have been confirmed in the Dominican Republic and a
seventh has been reported in neighboring Haiti.

The countries have 8 million people each and share the island of Hispaniola.

In response to the outbreak, health officials in the Dominican Republic
launched the three-day vaccination campaign Friday. The goal is to vaccinate
2 million children either at stations or by sending volunteers house to
house in poorer and remote areas.

Experts from the Pan American Health Organization say the outbreak was
caused not by the wild virus, but by an unusual mutation of the vaccine.

The oral vaccine, a relatively safe form of the live virus, is preferred in
part because it is contagious and can give what experts call "herd
immunity." But that only works if most children are vaccinated directly. If
too many children are left unvaccinated, the virus can circulate in the
population long enough to mutate back into a virulent strain, as apparently
happened here.

None of the children who contracted the virus had been vaccinated, PAHO
officials say. The only other similar outbreak occurred in Egypt in the
1980s, when 30 people contracted the disease.

Polio is a crippling and sometimes fatal disease that attacks the central
nervous system and usually strikes children younger than 5. Fewer than 7,100
cases were reported worldwide last year, confined to Africa and Asia.

A handful of mothers lined up Saturday morning at the clinic in La Cienega.
A few others followed the teams around, waiting for them to reach their
homes.

"I get every vaccine they'll give me for him," said Maria Altagracia, as she
waited for the team to reach her house, and her 2-year-old son Jose. "The
children all get so sick here, but a lot of that is because the mothers
neglect them."

The volunteers picked their way through garbage strewn alleys, knocking on
doors and wandering through houses looking for children.

Coordinating the vaccinations was complicated. The vaccine has to be kept on
ice and must be given to at least 80 percent of the children to prevent the
mutation. A safer injected vaccine that can't mutate isn't used here because
it's more expensive, it has to be given by professionals and it doesn't
offer the herd immunity effect.


Copyright 2000 Associated Press. All rights reserved. This material may not
be published, broadcast, rewritten, or redistributed.

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