In an unusual cautionary step, the Health Ministry has decided, after consulting
with foreign experts, to give an advanced type of oral polio vaccine (OPV) to
150,000 children in the South.
The ministry will spend “several million
shekels” to order up to a million doses of the “live attenuated” vaccine – in
drop form – for vaccinating children and even adults elsewhere in the country,
In a last-minute press conference in a Knesset committee room
on Wednesday, Health Minister Yael German, ministry director-general Prof. Ronni
Gamzu, public health chief Prof. Itamar Grotto and medical branch head
Arnon Afek told health reporters about their decision.
stressed that there was “no reason to panic,” as not a single person had
actually come down with the clinical form of poliomyelitis that causes
The live virus has only been detected in routine samples of
sewage taken since February in the Negev, specifically in the Beduin town of
Rahat, they said.
The decision came at the end of a three-day visit from
four senior experts – three from the World Health Organization and one from the
US Centers for Disease Control – who came here to observe what the ministry was
doing to prevent the possible spread of the virus.
Only about four or
five countries in the world – most of them with low vaccination rates –
routinely text stool samples (Israel does so regularly at 16 sewage-treatment
centers around the country). Polio, which has been nearly eradicated around the
world, occasionally turns up in various places. According to the WHO, from an
estimated 350,000 actual cases of the disease in 125 endemic countries in 1988,
the number dropped to only 223 reported cases in those countries last
Gamzu noted that Israel is at the crossroads of Europe, Asia and
Africa and is located not far from Third World countries, but nevertheless has a
95-percent rate of injected, killed, “inactivated” polio vaccine (IPV) coverage
in the population. It also has computerized records that one can search within
minutes to find every individual child in the country who has not received his
or her regular vaccinations, he said.
At present, babies and young
children receive several doses of IPV (Salk vaccine) in well-baby (tipat halav)
clinics on a standard basis. Until eight years ago, children also received doses
of the Sabin OPV, but this was discontinued when the disease was considered
As such, Israeli children under the age of eight have never
Some 25 years ago, a woman came down with actual polio
paralysis, as did 14 other people, all of whom became disabled. As a result, the
ministry decided to give oral Sabin vaccine to everyone under the age of 40, and
the outbreak stopped. Since no one has actually shown clinical symptoms, the
current situation is less worrisome than the previous one and is not considered
an “outbreak,” Gamzu noted.
IPV is highly effective in preventing the
polio virus from spreading to the individual’s neurological system and causing
paralysis. OPV, first licensed as Sabin vaccine in 1962, is shed in the stool
and produces antibodies that prevent the wild virus from spreading through
society due to poor hygiene.
Grotto noted that the best way to prevent
the virus from spreading was to wash one’s hands with soap and water after using
the bathroom and diapering babies, and before eating.
Gamzu said the
ministry realized a month ago that there were vestiges of the wild virus in the
sewage from Rahat and half a dozen other places in the South, as far north as
Ashdod. However, the samples themselves were taken as early as February, so it
is still not clear whether the wild virus is still spreading or has been
contained, he said.
“We had to be careful, as viruses do not respect
borders,” he stated.
The strain of polio virus found in the sewage has
been identified as coming from Asia, he said.
Afek added that it wasn’t
clear how this had reached a resident (or several residents) in the Beduin
Children who have already received their full complement of IPV can
still spread the virus through their stool to others whose parents did not take
them to get their shots, even though the vaccinated children themselves will not
There are several scenarios, the director- general said. “We
will continue to collect data from sewage-processing plants around the country –
twice as many as we have been doing. We also want to test individual stools from
children in day-care centers, health fund clinics and hospitals – and maybe even
from adults to see if the problem is regional or broader or, it is hoped, will
just disappear,” the director-general said.
He added that the ministry
would be on the lookout for clinical symptoms of polio – besides paralysis,
which has not been reported at all – and try to find the individuals responsible
for the first cases in Rahat.
“We are prepared to vaccinate with OPV the
whole population in the relevant age groups in the South or even in the whole
country,” Gamzu said.
The new, improved type of OPV vaccine, manufactured
by eight companies abroad since 2010, is “very safe and only rarely causes side
effects,” Gamzu said. The ministry will prepare an information campaign to
explain why it is important for parents to take their children for OPV, even
though they have already received their IPV doses, he continued, since IPV
doesn’t prevent transmission to others.
In the unlikely scenario that
individuals actually develop the clinical disease, the ministry will go into
“Even though we are in a good situation, it could be – a
very small chance – that a person could get sick with polio,” Grotto
German will report to the cabinet on Sunday on the measures that
have been taken.
She noted at the press conference that no drinking water
had been affected, as the pipes supplying such water are strictly separated from
One of the foreign experts, who comes from Germany, told
the Health Ministry that the delegation was highly impressed with the handling
of the sewage scare and the computerization of all well-baby center
“You do it better than we do in Germany,” the WHO official
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