IT was In the Spring of 1989 that Ameena of Faridpur, was to complete the first year of her life when she felt a strange stiffness in her legs, followed by a numbness and fever. The village doctor confirmed that It ■ was a disease called polio that was to cripple little Ameena for life.

The disease that sealed Ameena s fate so cruelly Is a vaccine preventable disease whicN. if contracted causes Hie-long physical disability. Although polio Is virtually nonexistent in advanced countries, it is still prevalent in many developing countries including Bangladesh.

The target of eradicating polio In Bangladesh bv the year 2000 call for World Health Day on April 7th. may seem a little too ambitious in a country where basic health care Is so poor. But Dr Salim Shakur, a well-known child specialist attached to the Shishu Hospi tai in Dhaka, believes that this target Is very much an achievable one. A survey conducted in 1983 showed that every year 10.000 children in Bangladesh suffered from diseases related to polio. The same figure In 1993. says Shakur, has came down to 235 cases ol flaccid paralysis, a condition of polio, with 138 confirmed polio cases.

This dramatic reduction explains the child specialist, is largely a result of the nationwide polio prevention campaign that has begun in the last few years. Polio is a viral disease. transmitted by oral faecal route. In other words a child suffering from polio will pass stool that is infected by the polio virus, which4 in turn may infect other children. Once contracted there is no cure anti the child must live with permanent handicap ol the

legs

As with many other li-eases prevention, say- Shakur who is an associate professor of Bangladesh Institute of Child Health is the best way to deal with this dreaded disease. The polio vaccine, administered orally and in three doses with one month intervals gives lifelong Immunity to children. Usually the polio vaccine Is given along with the injectable vaccine for diphtheria, pertussis and tetanus (DPT) It is belter", says Shaker. "If it can l>e given Immediately after birth and along with measles vaccine at 9 months of age.

The symptoms of the disease are clear enough although, warns Shakur they could imitate those of other diseases not related to .polio. The usual indication of polio he says. Is a stiffness In the Itmbs followed by severe weakness, with the muscles becoming flaccid, often leading to paralysis." "This is because the virus damages the nerve cells which keep the muscles active and powerful". The

weakness, adds $hakur is asymmetrical, that is not affecting both sides equally.

"Parents, however", he says, 'should not get paranoid as soon as such symptoms are detected since, they could be conditions of some other less dreadful illness and it is best to consult a doctor first".

Prevention of the disease, therefore, cannot be stressed enough, according to Shakur and the strategy for polio eradication on a nation-wide basis Includes three steps : 1) high coverage with polio vaccine; li) effective surveillance systems to Identify and Investigate all possible polio cases; and III) conducting supplementary Immunization.

Having a national immunization day or NID. Sakur stresses, is one of the most effective ways of eradicating polio since a very large number of children get Immunized at one go. NID has been very successful in other parts of the world such as Central and South America where polio Is now non-existent. "Bangladesh is not lagging behind", says Shakur, "the Bangladesh gov ernment (Ministry of Health and Social Welfare), took a decision to conduct a national immunization day on March 16th and April 16th his year and this will be repeated in 1996 and 1997" About 20 mil lion children are expected to

benefit from this nation-wide programme

So far wtth the NID pro grammes 80 per cent of urban children under two years have been Immunized with 75 per cent of all children in Bangladesh being brought un der the Immunization programme. NID, has been imple mented by the Rotary Founds tlon of Rotary International. USAID. UNICEF. WHO and several NGOs with the Ministry of Health and Social Welfare being the initiator of the programme.

But what about those children who have already been vaccinated, are there any harmful side effects if they re celve the vaccine again as will be inevitable in NID programmes?

"The objective of NIDs". says Shakur, "is to administer oral polio vaccine to all chil dren under five years, irre spective of earlier vaccine or resident status, in one single day. It Is very unlikely that a child who has aireddy been vaccinated according to schedule will be harmed by another dose". Rather, he adds, this will ensure that every child tn the community, and eventually in the entire nation. is covered

Moreover. points out Shakur, the polio Vaccine produces both ' humoral and gut Immunity, that Is. it removes the carrier of polio and dis places the virus preventing tlie spreading of the disease

Having National Immunlty Days once or twice a year, therefore, by providing mass immunity and preventing the spread of the disease can make the target of eradicating polio by the year 2000. a realistic goal for Bangladesh. Shakur concludes.