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Polio outbreak in Syria raises fears in region

10 children infected, more cases suspected

BEIRUT — A cluster of 10 young Syrian children has been infected with polio, the World Health Organization said Tuesday, sparking fears of a major regional outbreak amid mass migration and the collapse of Syria’s health services under the pressures of civil war.

WHO officials warned that there is a significant risk of the highly infectious disease spreading after the cases were confirmed in the eastern province of Deir al-Zour. Twelve more children suspected to be suffering from the virus are awaiting test results.

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In response to the outbreak, seven countries in the region, including Syria and its neighbors Jordan, Turkey, and Lebanon, said they are launching emergency vaccination programs over the next three weeks to cover 20 million children in a six-month period, the WHO said.

The war in Syria has created optimal conditions for the spread of communicable diseases. The country’s health care system has been devastated by the 2½-year-long conflict, with routine immunization programs disrupted amid the violence.

Health workers have warned that the unsanitary conditions in which many of the millions of displaced live are breeding grounds for diseases such as polio, which is spread through contaminated food or water supplies. With up to 4,000 refugees fleeing the country every day, the risk of the disease spreading is particularly serious.

Destruction of water treatment plants, electric power plants, and other infrastructure has left Syrians ‘‘on average with only one-third the daily water’’ available to them before the conflict, much of it contaminated, United Nations humanitarian chief Valerie Amos said in an interview in Washington on Monday.

Doctors and health care workers have fled the country in massive numbers, Amos said, while those who remain operate under threat and without supplies, as combatants on both sides have taken over or destroyed hospitals.

Amos said that at least 2,000 different groups are fighting in Syria, and that UN humanitarian workers have been unable to reach nearly 3 million Syrians in need because they are prevented by government or opposition checkpoints from traveling to some areas by road. More than 300,000 of those in need are in what Amos called ‘‘besieged communities,’’ occupied by combatants from one side or the other who stop civilians from leaving and block the entry of food and medical care.

The bulk of ‘‘besieged’’ civilians are in the same eastern Damascus suburb that has been surrounded by government forces since early this year and was the target of a government chemical weapons attack in August, Amos said. But in other areas, such as Aleppo, she said, rebel forces are preventing access.

With near-constant fighting, she said, ‘‘the numbers of those in need are going to go up . . . exponentially’’ in the next few weeks and months.

‘‘It’s the perfect storm into which to drop the polio virus,’’ said Bruce Aylward, assistant director general for polio and emergencies at the WHO. ‘‘It could explode.’’

The disease, which usually affects children younger than 5, can cause permanent paralysis within hours. Some cases result in death as breathing muscles freeze up. There is no known cure.

Just one in 200 polio cases result in paralysis, meaning the real number infected in Syria is in the thousands, Aylward said.

‘‘The confirmed cases are just the tip of the iceberg,’’ said Aylward, who estimates that the regional vaccination effort will cost at least $15 million. ‘‘This isn’t a Syrian problem. This is a Middle Eastern problem.’’ The outbreak in Syria marks the first confirmed cases there in 14 years. The immunization rate, which stood at 91 percent in 2010, has collapsed since war broke out, dropping to 68 percent today, according to the WHO.

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