[HN Gopher] Africa declared free of wild polio
___________________________________________________________________
Africa declared free of wild polio
Author : riffraff
Score : 490 points
Date : 2020-08-25 17:15 UTC (5 hours ago)
(HTM) web link (www.bbc.com)
(TXT) w3m dump (www.bbc.com)
| rmason wrote:
| My generation was the first to be spared from polio. But I had
| relatives that were not as lucky. I knew kids just a few years
| older than me who lived in iron lungs. This is a massive
| accomplishment that should be celebrated.
| tus88 wrote:
| Is there some other kind of polio still rampant?
| melling wrote:
| Now the world needs to go after malaria in Africa.
|
| Throughout the world a child dies every 2 minutes from malaria.
|
| https://www.weforum.org/agenda/2020/08/infectious-diseases-c...
|
| I've been to South Africa twice. Most other Subsaharan countries
| have large malaria problems.
|
| Looking forward to that not being a problem in my lifetime.
| mikorym wrote:
| I grew up in an area that forms part of the general malaria
| area of South Africa, but I have never had malaria. I know many
| people who have had malaria and the general observations that I
| have is:
|
| 1. Using malaria medication is advisable if you don't have
| access to good doctors and good hospitals. If you permanently
| live in a malaria area, it's not practical.
|
| 2. If you have quick access to a good doctors and good
| hospitals, it's often better to treat yourself once you are
| sick. ---> _NO_ this is not travel advice <---. The malaria
| medications have a lot of side effects to use permanently; the
| expensive ones have less side effects and I believe pilots
| generally use such ones since risking getting sick has the
| potential side effect of a plane crashing.
|
| 3. The key is detection and treatment. You can _easily die_ in
| an top EU or US or Singapore hospital if the doctor doesn 't
| ever see malaria and you happen to have it. You have to test
| until you get a positive---even if it is a false positive, and
| then you test again. I personally know people who's parent died
| of malaria in a good hospital in South Africa, but in an area
| that is far from the malaria areas, and hence has doctors who
| don't test for it. I am not a doctor so I am not sure how one
| is treated once tested positive, but I do know many people who
| recovered very quickly due to the doctors being acutely aware
| of how to treat malaria.
|
| 4. Taking into account said things above, malaria is not a
| major threat. If you read stories about game rangers in the KNP
| of South Africa, many of them died from malaria in their later
| life because they were somewhere deep in the bush/lowveld and
| far from hospitals and couldn't be bothered with having
| malaria, yet again, and stopping their fun bush activities to
| go to the hospital 200km away.
|
| 5. My grandmother had malaria 6 or 7 times and died rather
| healthy in her mid 90s. My family actually actively avoided the
| malaria areas in the summer back in the late 1800s and early to
| mid 1900s by living on the higher escarpment. You could also
| read about Dr. Annecke and the efforts back then to combat
| malaria.
|
| 6. The countries to the north of South Africa don't have the
| facilities to treat malaria, generally, and with proper
| treatment and selective DTT application, you should be able to
| limit the ranges of the parasite. Yes, DTT _is_ a bad chemical.
|
| 7. On that topic, malaria is caused by a parasite, so in terms
| of vaccines it's not clear what the mechanism behind it should
| be.
|
| 8. If you think about the Panama worm exclusion line that
| featured a while ago on HN, something like that would have made
| sense if Africa were a more developed continent. But in any
| case, the point is that the poor state of many things in Africa
| is part of the malaria problem.
|
| 9. Many other things about Africa is way cooler than the other
| continents. We still have lion and rhino, for one. There were
| many large predators on the other continents. So, "development"
| is something of a complicated word.
|
| 10. South Africa generally manages malaria well, so it is
| possible to contain it through holistic management. And no,
| holism is a word that belongs to Jan Smuts and you cannot steal
| it for your magic peanut oil business.
|
| 11. Yes, a silver bullet would be nice.
| coldpie wrote:
| > Now the world needs to go after malaria in Africa.
|
| They are. Take a moment to celebrate this victory :)
| melling wrote:
| We are so close to wiping polio out globally. Bill Gates has
| been trying hard. A few cases in Asia every year and we're
| done.
|
| Probably less than 100 globally in a few countries. Bill
| Gates will get it.
|
| Anyway, while it's great, and we should be happy, 400,000
| kids will die from malaria in Africa this year.
|
| We could do more to save millions of lives over the next 10
| years.
| MaximumYComb wrote:
| It's because he is looking long term. Once you eradicate
| polio then it's gone forever. If he stops now to save more
| children from malaria instead then polio will return and
| the work so far wasted.
| hu3 wrote:
| I often see citations of Bill Gates charity being downvoted
| to oblivion on HN and I can never figure out why.
|
| Would appreciate if someone could enlighten me. Surely
| there must be a good reason.
| spacephysics wrote:
| Without disclosing my opinions/take on Bill Gates, I
| think some see his charity as a means to gain power in
| specific regions to [insert conspiracy theory].
|
| A tangentially related matter I see cited more often than
| not in these circles, are about an uptick in vaccine-
| caused paralysis occurring in India, causing the
| foundation to be kicked out.
|
| The argument being that an uptick in "non-polio acute
| flaccid paralysis" (NPAFP) was recorded in areas where
| the oral vaccine was distributed, and this subsequently
| got the foundation "kicked out of India" (quoted because,
| as source below states, this is false) [0]
|
| [0] https://fullfact.org/online/gates-polio-vaccine/
| AndrewBissell wrote:
| There's no need to refer to "conspiracy theories"
| (although Bill Gates's close ties to Jeffrey Epstein
| after his 2007 trafficking conviction did not do him any
| favors there). The ulterior purposes of the Gates
| Foundation are pursued mostly in the open:
|
| https://www.thenation.com/article/society/bill-gates-
| foundat...
|
| https://www.cjr.org/criticism/gates-foundation-
| journalism-fu...
| mullingitover wrote:
| That The Nation article seems to be implying that Gates
| is dodging his civic duties to pay taxes and support nice
| things like public infrastructure, but at the same time
| he's also avoiding paying for terrible things like
| funding the military which bombs things like weddings and
| Medecins Sans Frontieres hospitals.
|
| Gates has done some shady things in his day, but I can't
| fault him for that one. His fortune is a drop in the
| bucket of the federal budget, but being able to control
| and target his charity makes a hell of a lot of
| difference in the world. It's not like the federal
| government was going to cure polio in Africa, but for a
| few billion more dollars in tax revenue.
| koonsolo wrote:
| It has everything to do with people's perspective of the
| world: rich people cannot be good people. If you gain
| something, somebody else needs to lose something. So for
| a rich person to get rich, he must have taken a lot from
| other, "nicer" people.
|
| Bill gates must really love swimming "uncle
| scrooge"-style in his billions. That's all he cares
| about. Everything he does must be to gain more billions,
| so he can swim in a bigger pool.
|
| Bill was also super competitive, so let's focus on that
| and forget that he made his money providing value to
| users and businesses. It's better to act like he stole
| the money in an unfair way.
|
| I personally feel very sad for a person that can't
| imagine that someone else could feel happy and satisfied
| by helping others, by having a huge impact on peoples
| lives in a positive way. I'm sure Bill and Melinda get
| more satisfaction of helping other people than looking at
| numbers on their bank account. But hey, that's not
| possible because he's rich, and therefore evil.
| phenkdo wrote:
| It is at its core, the issue of the perfect being the
| enemy of the good. Bill might be an imperfect angel, but
| he is an angel nonetheless in spending his fortune to
| help millions/billions out of abject poverty and
| suffering. That dwarfs almost any effort by other people.
|
| You could psychoanalyze this as acts of redemption,
| guilty conscience, seeking further world domination or
| whatnot, However it's undeniable he's helped many, many
| people and far, far,far more than his keyboard detractors
| ever would or could. And that's a very good thing IMHO.
| _jal wrote:
| People dislike him for a number of reasons. I despised
| his actions through most of his tenure at M$. He
| destroyed some things I cared about and tried hard to
| destroy others, and I was nowhere near them and didn't
| use their products.
|
| I'm not really big on the idea of 'redemption' - my
| actions today do not erase what I've done in the past.
| But he has lived a pretty decent life since then, and
| tried to do good things. So good on him.
|
| Others hold grudges longer.
| dylz wrote:
| My assumption is that there are people that dislike how
| Gates earned his money.
| woodruffw wrote:
| I didn't downvote this (and don't generally do so), but
| here's a line of reasoning that might explain it:
| something has to go _seriously wrong_ in the world for
| the lives of millions of people to be contingent upon the
| charitable sentiments of one obscenely wealthy man. Put
| another way: regardless of whether he 's doing good, it
| _shouldn 't_ be the case that polio eradication _depends_
| on his material wealth.
|
| Celebrating the beneficial outcomes of Bill Gates'
| charity without reflecting on _why_ he 's able to give
| away billions of dollars without breaking a sweat invites
| us to ignore the fact that the system that enriched Bill
| Gates doesn't actually encourage him to do any good (and
| actually involved him doing quite a lot of _harm_ ).
| rowanG077 wrote:
| I have the opposite sentiment. Things have been going
| extremely right for a single person to be able to go out
| and destroy issues that literately thousands upon
| thousands of people are affected by. Since governments of
| the developed world are mostly democratic no action to
| fix those issues in other countries is taken. This would
| have not otherwise been possible.
| abraae wrote:
| Bill gates did indeed do "quite a lot of harm" to many
| businesses and I have cursed his name many times while
| wrestling with some Microsoft chicanery.
|
| But that harm was done to competitors, on the business
| field. The people who became collateral damage could
| always go and get jobs at some other company. The
| companies suffered and sometimes died but such is the way
| of capitalism.
|
| If the upside was that his money gets redistributed to
| the genuinely poor and needy, who don't have any
| opportunity to earn for themselves in some cushy IT job,
| then I'm personally OK with it.
|
| (I forget the specifics, but a piece of ancient code we
| wrote included a dummy assignment to a variable called
| BILLGATESBOLLOCKS, to get around some MS devilment).
| pm90 wrote:
| It's good that he's a billionaire that uses his wealth
| for truly great humanitarian causes. However, he is an
| exception and most billionaires don't do this. And they
| probably shouldn't have to, if we created a system that
| doesn't allow for this kind of obscene enrichment of
| individuals.
| petra wrote:
| Given the incentives, isn't this a Robin Hood story ?
| Bill Gates, Robbing the rich to give to the poor ?
|
| But the problem is that we are those rich people. We as
| tech people have suffered under the microsoft monopoly.
| Heck, we still suffer, from the horrors of windows 10, to
| browser incompatibilities, etc.
|
| So we hate Microsoft. So it's hard to love Bill.
| vlunkr wrote:
| Never has the phrase "first-world problems" been so
| applicable.
| monetus wrote:
| I would assume there to be a multitude of bad reasons,
| but as for a good one.. If you forced me to pick one
| driving one, the perception that he is laundering his
| reputation through philanthrophy would hopefully be it.
|
| A good act does not wash out the bad, nor a bad the good.
| strictnein wrote:
| His reputation didn't really need "laundering". He ran a
| software company, sometimes aggressively, but people act
| like he ran a private military corporation and trafficked
| in blood diamonds.
| vlunkr wrote:
| Agreed, outside of unix-like tech circles, I don't know
| that his reputation was ever that bad.
| soperj wrote:
| Because it doesn't just do good. It's completely screwed
| up public education in the states for instance.
| brudgers wrote:
| Bill Gates got involved with polio via $100 million
| matching fund to Rotary International about a decade ago.
| It was one of the foundation's early healthcare initiatives
| and leveraged several decades of work by Rotarians around
| the world...polio eradication was the major project of
| Rotary at the time.
|
| Malaria is different in that there was not the same level
| of eradication infrastructure to leverage and different
| because it touches on drinking water and food chains in the
| non-human environment. Malaria is not mostly a vaccine
| distribution problem.
| strictnein wrote:
| Bill Gates is also very, very heavily involved with
| defeating Malaria in Africa.
|
| His foundation has spent $2.9 Billion so far on it.
|
| https://www.gatesfoundation.org/what-we-do/global-
| health/mal...
| jacobwilliamroy wrote:
| I dont know how heavily involved he is. The man is a
| signature on a check. He has no medical credentials. All
| his fortune is built on stolen ip. He just writes checks.
| ehsankia wrote:
| > I dont know
|
| Well good thing you started with that since you are
| clearly not familiar with him at all. He is very very
| well read and highly involved with the charity.
| jacobwilliamroy wrote:
| Whatever. The man runs a vertically integrated monopoly
| which has been evading taxes for decades. You all need to
| quit with this blind hero worship for rich people. Sure
| he's saving Africa, but he fucked america first, and that
| makes all his spending and reading very underwhelming to
| me.
| dctoedt wrote:
| > _but he fucked america first_
|
| I dunno: He played a crucial role in a long-term,
| industry-wide collaboration that resulted in practically
| every household having _at least_ one computer. And for
| years he 's been devoting his fortune and his intellect
| to solving global-scale problems. That has gotta be worth
| _some_ redemptive value for past sins, yes?
| jacobwilliamroy wrote:
| Im not catholic, so I dont believe in redemption through
| third parties. The courts dont either. Jus ex injuria non
| oritur. Just acts do not follow unjust acts. Even if we
| do good with our ill gotten gains, we are still
| accountable for our own actions. The sentence for tax
| evasion is not "Donating to malaria research" and anyone
| else who had microsoft's numbers would have been
| destroyed.
|
| Oh and that "computer in every home" crap? That's the
| monopoly! Microsoft is so big it competes with its own
| products. That's why it's untouchable. How are you going
| to audit microsoft when the IRS runs office 2010 on
| legacy copies of windows 7? This humanitarian stuff is
| just smoke and mirrors. A glamour cast on the american
| people.
| EGreg wrote:
| All these anti vaxxer people are also pushing HCQ ... but
| it actually does prevent Malaria. If not for the side
| effects that compound over time, if the body was able to
| flush it out somehow, it could be very useful, no?
|
| That or finding ways to sterilize all anopheles
| mosquitoes, or do other mosquitoes carry it also
| dnautics wrote:
| IIRC malaria in africa is basically totally resistant to
| HCQ by now. There's places where resistance to
| Artemisinin is a thing.
| robbiep wrote:
| It's called the advancement of science and it's one of
| the reasons it is not generally a frontline treatment
| (because we have more effective treatments now, as well
| as resistance).
|
| You might as well say that a person is too phlegmatic and
| needs bleeding when they have gallstones.
|
| The world moves, move with it
| tonfa wrote:
| > A few cases in Asia every year and we're done
|
| We also need to get rid of a vaccine-derived polio in
| Africa (and some places in Asia).
| HiroshiSan wrote:
| Not to take anything away from Bill, but why isn't Melinda
| mentioned just as much in these types of conversations?
| JamesBarney wrote:
| Are you really curious?
|
| It's the same reason that if Oprah took her billions to
| try and solve some global problem with her husband
| Stedman, many mentions of the work they were doing would
| not mention Stedman.
|
| One is a famous individual who built up an obscene
| fortune, and the other person is married to them. And
| despite how involved their partner is deploying that
| wealth for the good of the world, people are just not
| going to mention the less famous one who didn't build up
| the fortune as often.
| graeme wrote:
| There are many reasons, but one specific to Hacker News
| is that Bill Gates writes articles that are posted on
| Hacker News.
|
| Bill Gates also regularly gives speeches. I checked and
| Melinda doesn't have any on youtube since 2013.
|
| So Bill is very much the public face of the foundation,
| even though Melinda is equally active and her name is in
| its name.
|
| Not the only reason, but worth pointing out a prominent
| benign one.
|
| For instance, a parallel example is how ycombinator is
| often mentioned as being founded by Paul Graham, and
| Jessica Livingstone is left out. Why? Partly sexism of
| course. But Paul also was the public face of YC with his
| essays.
|
| And we have evidence it's not just sexism, because YC had
| _four_ founders
|
| > by Paul Graham, Jessica Livingston, Trevor Blackwell,
| and Robert Tappan Morris.
|
| I think the second two are even less well known than
| Jessica Livingstone, and this correlates with how much
| public writing and speaking she's done as the face of YC
| and about startups.
|
| (There's a whole other discussion to be had about whether
| women are chased out of the public sphere, but this
| comment is long enough)
| zapdrive wrote:
| Why should she be?
| pm90 wrote:
| He is the public face of the foundation, giving ted talks
| and tweeting about it etc.
| mrmonkeyman wrote:
| "The world" doesn't need to do shit.
| [deleted]
| Symmetry wrote:
| Hey polio, hope you can say hello to smallpox for us soon.
| sparrish wrote:
| This is the best news I've heard in weeks. What a great milestone
| and a wonderful world we live in. Congrats to all the NGOs,
| African and international, that worked so hard.
| lucb1e wrote:
| For more uplifting news, I spent a few hours today diving into
| figures about human development for a small project about
| greatest differences between neighbouring countries. They're
| basically all going up. Aside from countries at war (e.g.
| Syria) and minor setbacks like 2008, we're doing better all the
| time. I actually made a wallpaper from one of them:
|
| https://lucb1e.com/tmp/hn-whatsthisgraph.png What does this
| show?
|
| Answer in rot13: Rnpu yvar vf n pbhagel, fubjvat yvsr
| rkcrpgnapl ng ovegu. Gurer ner fbzr boivbhf bhgyvref ohg
| 'orgjrra gur yvarf' vf nyfb n pbhagel gung qrpyvarq funecyl:
| Flevn. Yrg'f whfg abg qb jne ntnva, 'xnl?
|
| You can find this graph interactively on the United Nations
| Development Programme website: http://hdr.undp.org/en/data
| (this graph can be found in (rot13) urnygu -> yvsr rkcrpgnapl
| ng ovegu).
| tsewlliw wrote:
| Here's hoping we double down on Polio efforts and ensure it is
| entirely eliminated. Finishing is super important, and this
| milestone shows this is something humanity can finish.
| baybal2 wrote:
| Especially in light of what is happening in Pakistan, and India
| now. Polio was "almost" done there in all, but a few most
| remote, and backward areas.
|
| And it was exactly because these tiny reservoirs were left, it
| came back to Karachi, and Mumbai.
| yyyk wrote:
| Good, but I am unaware of any good solution to the endemic AfPak
| area. This is IMHO a mirror of world trends: Africa seems to be
| getting better (if slowly), but parts of Asia are slipping
| behind. It's possible that the program is in an undeclared race:
| Can we eliminate polio before these areas get even worse?
| microcolonel wrote:
| Massive congratulations! Let's see about malaria next.
|
| I have heard that it might not be crazy to apply DDT sparingly
| and appropriately to this problem. To my knowledge, it was a big
| part of how mosquito-borne disease was virtually eradicated in
| North America.
|
| Wetland habitat destruction is a real concern, but so is the
| untimely deaths of hundreds of millions of people.
| tempsy wrote:
| more children had been getting polio from polio vaccines than
| getting it in the wild for a long time
| renewiltord wrote:
| Well, yes, that's what it means to get close to eradicating a
| wild disease. There's a sort of hysteresis effect so it's hard
| to instantly swap to not vaccinating and you want to ensure
| that there are no local populations with wild transmission.
| gus_massa wrote:
| Oversimplifying, after some years without cases, you change
| from the oral (attenuated virus) vaccine to the injectable
| (totally inactivated) vaccine, to solve the risk of the
| vaccine derived cases.
| celticninja wrote:
| I don't know about 'for a long time' but for a certain time
| frame this is true[0].
|
| However we are talking about there being 21 cases of this
| occurring compared to pre-eradication infection levels in the
| 100's of thousands per year. So whilst your statement is sort
| of true, it is willfully misleading.
|
| [0]https://www.npr.org/sections/goatsandsoda/2017/06/28/5344030
| ...
| yokaze wrote:
| If you consider three years a long time... [1] Or are you
| speaking of a particular area with poor sanitation and low
| vaccination rates in the world?
|
| And to be clear about it, children are not getting it by
| getting vaccinated, unvaccinated people can get it from
| recently vaccinated ones.
|
| [1] https://en.wikipedia.org/wiki/Polio_vaccine#Vaccine-
| induced_...
| werber wrote:
| That just got a post COVID doomsday scenario playing out in
| my head, I had never considered being contagious due to being
| vaccinated.
| nsgi wrote:
| The coronavirus vaccine is unlikely to be a live attenuated
| one, or if it is it will most likely be one that cannot
| cause the disease.
| vanderZwan wrote:
| You are not going to be vaccinated by a weakened COVID
| virus, so worrying about that is absurd.
| dilippkumar wrote:
| My understanding is that the vaccination candidates are all
| taking some other virus and splicing it to add the
| coronavirus's spike protien to it.
|
| The idea is that the body will (hopefully) learn to
| identify the spike and mount an immune response to that
| spike protien.
|
| Then, when a real coronavirus comes along, the body
| responds to the spike protien on that virus.
|
| PS: I'm not in the field, I might have missed some
| vaccination effort that's using the real virus itself.
| est31 wrote:
| In the US it's been the case since the 70s, with the last
| wild type polio case in 1984 and vaccine derived polio cases
| up until 1999. [0] [1].
|
| Then in 2000, OPV was banned in the US. [2]
|
| But the statement, while true, is misleading because of its
| intention to discredit the use of vaccines at all. Just check
| the graphs linked before the introduction of the vaccine.
| Night and day, as horrible as the vaccine caused cases are.
|
| [0]: https://www.cdc.gov/mmwr/preview/mmwrhtml/00045949.htm#0
| 0001...
|
| [1]: https://www.virology.ws/2015/09/10/why-do-we-still-use-
| sabin...
|
| [2]: https://www.cdc.gov/vaccines/vpd/polio/public/index.html
| SketchySeaBeast wrote:
| This feels like a "Less people are dying in the car crush, but
| now people are getting hurt from seat-belts" kind of problem.
| eloff wrote:
| Possibly, but the vaccines have prevented many orders of
| magnitude more cases: "Since 2000, more than 10 billion doses
| of OPV have been administered to nearly 3 billion children
| worldwide. As a result, more than 13 million cases of polio
| have been prevented, and the disease has been reduced by more
| than 99%. During that time, 24 circulating vaccine-derived
| poliovirus (cVDPV) outbreaks occurred in 21 countries,
| resulting in fewer than 760 VDPV cases."[1]
|
| [1] https://www.who.int/westernpacific/news/q-a-detail/what-
| is-v...
| tboyd47 wrote:
| There were only 350,000 cases in 1988, when the vaccine was
| first deployed, and 5 billion people on Earth then versus 7
| billion now. How do 350,000 cases turn into 13 million,
| according to the WHO?
|
| [1] https://www.who.int/news-room/fact-
| sheets/detail/poliomyelit...
| DiogenesKynikos wrote:
| 350,000 cases/year * 32 years = 11.2 million cases, which
| is in the right ballpark, assuming we're counting from
| 1988.
| gus_massa wrote:
| 350,000 cases/year * 32 years = 11.2 million cases
|
| They may have some more precise method, but with this
| estimation 11 or 13 millions doesn't seams to be too off.
| vanderZwan wrote:
| You know what they say: extraordinary claims require
| extraordinary evidence. Based on what data do you make this
| statement?
| ars wrote:
| Data: https://en.wikipedia.org/wiki/Polio_eradication#2020
|
| In 2020 there were 102 wild cases, and 295 vaccine derived
| cases. You have to go back to 2016 for wild cases to
| outnumber vaccine cases.
|
| He's getting downvoted for the tone: People are assuming he
| is discrediting the vaccine by saying that. I personally
| don't see that implication, I just see a bare, and correct,
| fact.
| gus_massa wrote:
| Short version of the data: wild
| vaccine-derived 2015: 74 32 2016: 37
| 5 2017: 22 96 2018: 33 104 2019:
| 165 365 2020: 102 291
|
| >>> _more children had been getting polio from polio
| vaccines than getting it in the wild for a long time_
|
| I think that it is misleading to call the last four years
| "a long time".
| rowanseymour wrote:
| Many poorer countries have relied on cheaper forms of the
| polio vaccine with a weakened virus, which can sometimes
| cause small outbreaks.
|
| Ironically this fact is often used the anti-vaxxers as an
| argument against vaccines.. when it's only been true because
| polio vaccination has been so successful at eradicating the
| real virus which was causing considerably more problems.
| tialaramex wrote:
| The oral vaccine is not only cheaper it also works better.
| This means if you have endemic Polio it can make good sense
| to deploy OPV even knowing that there is risk of it
| reverting. The rich industrialised countries that switched
| to the boring inactivated vaccine don't have endemic Polio
| so the risk structure is different (as well as being able
| to afford the more expensive product).
|
| It's not entirely clear why OPV is more effective, but
| perhaps it matters that you eat it (when I was a child it
| was administered as a sugar lump) and so the attenuated
| virus is entering the body via the gut, exactly where a
| real working polio virus infects people. The more expensive
| killed vaccine is injected into a muscle instead.
| tgb wrote:
| I was surprised too, but the WHO backs up the existence of
| "vaccine-associated paralytic polio", though I'm finding some
| conflicting numbers it's on the order of 1 in a million
| paralysis cases per vaccine. That presumably outpaces wild
| polio paralysis cases due to the non-existence of wild polio,
| in certain regions. WHO evens says it's possible for others
| to catch the paralysis from close contact with a recently-
| vaccinated individual, though it's never spread beyond that.
|
| https://www.who.int/immunization/diseases/poliomyelitis/endg.
| ..
| nsgi wrote:
| cVDPV is the one that's the big problem. You can see how
| many cases are occurring here:
|
| http://polioeradication.org/polio-today/polio-now/this-
| week/
| makomk wrote:
| There are two similar but crucially different problems with
| the current live polio vaccine that both end in cases of
| paralytic polio. Vaccine-associated paralytic polio is a
| very rare complication where someone gets full-on paralytic
| polio as a result of being vaccinated; it can also happen
| to people who catch the vaccine virus from someone else
| rather than from vaccination, but it's just as rare there.
| Circulating vaccine-derived poliovirus is the one that's
| really nasty for elimination efforts - once the vaccine
| poliovirus circulates unchecked within a community for a
| while, it mutates and basically turns back into full-on
| real, unweakened polio in all its contagious paralytic
| awfulness, at which point anyone who's exposed to it is at
| much higher risk. As I understand it, cVDPV makes up the
| large majority of both polio cases and paralytic polio
| cases across the globe these days, and 100% of cases in
| Africa now the wild-type virus has been eliminated from
| there.
|
| If VAPP was the only problem it could easily be fixed just
| by eliminating polio and then ending the live vaccination
| program. Unfortunately, that would make the cVDPV problem
| worse because it's an actual, circulating virus that
| primarily infects people who haven't been vaccinated, and
| ending vaccination would increase the number of people at
| risk from it. As the document from 2015 you've found
| suggests, the folks trying to eliminate polio hoped that if
| they phased out the live oral polio vaccine carefully and
| in well-coordinated ways they could avoid major cVDPV
| outbreaks afterwards. This doesn't seem to have worked out
| as well as they hoped back then. In particular, this
| article and HN discussion from a few months ago which
| someone helpfully dug up is mostly about the failure of
| this endgame plan in Africa:
| https://news.ycombinator.com/item?id=21920406
| qwerty456127 wrote:
| Again?
| EGreg wrote:
| I show stuff like this to anti vaxxers and ask if there have ever
| been any vaccines they like.
|
| They say that about cowpox and polio sanitation played a major
| role, etc. And that we don't look at other variables.
| hermitcrab wrote:
| This is an amazing achievement and I salute everyone who worked
| so hard to get this far.
|
| My grandfather had polio and was lucky to survive. He spent quite
| a bit of time in an iron lung. Apparently it changed his
| personality significantly for the worse.
| actuator wrote:
| I know some people in tech don't like his Microsoft past but
| considering the role of Melinda and Bill Gates foundation in this
| and his continued funding for other such initiatives including
| Covid-19 vaccines, I think if someone deserves a symbolic award
| like Nobel Peace Prize(or whatever the equivalent would be in
| this case) it would be both of them.
| adaisadais wrote:
| This is the sort of news the world needs today. Let's keep the
| ball rolling. Keep making things happen, HN Community.
| tombert wrote:
| Finally, some really good news in 2020. This has brightened up my
| exceedingly crappy week :).
|
| I've read about polio a few times, and every time I do I feel
| grateful to be born after they started vaccinating every child in
| the United States. It's a terrible disease and it would be
| amazing if it went the way of smallpox and (hopefully soon)
| Dracunculiasis.
| makomk wrote:
| This is not the big, massive victory that the article makes it
| sound like. The caveat "wild" is doing a lot of work that isn't
| properly explained. What this means is that for the last several
| years, all the cases of polio in Africa have been from
| circulating vaccine-derived poliovirus - basically, a version of
| the weakened virus used in the vaccine which has circulated for
| long enough to reverse the mutations that weaken it. It spreads
| like wild virus and paralyzes like wild virus, but technically
| it's not wild-type virus. (As I understand it, the only practical
| difference is that we can tell from genetic sequencing that it
| came from the vaccine rather than being wild-type.) And this
| can't be fixed by stopping the vaccination program - in fact,
| that actually makes things worse, since it gives the deadly
| vaccine-derived poliovirus more people who don't have immunity to
| infect.
|
| Some of the other news coverage like the Reuters article is a
| little better at correctly pointing this caveat out:
| https://uk.reuters.com/article/uk-health-polio-africa/wild-p...
|
| It's not even clear that it's poasible to actually eliminate
| polio in developing countries with this vaccine or any existing
| vaccines. The developed countries managed it but they had far
| better infrastructure to roll out first the oral vaccine and then
| the inactivated vaccine to everyone, and also far better
| sanitation, and it's likely both of these things mattered -
| under-vaccination makes this problem a lot worse, and whilst the
| inactivsted vaccine protects people from polio there's some doubt
| as to whether it can stop them spreading it via the oral-fecal
| route due to poor immunity in the gut. The current hope seems to
| be developing and deploying a new, better live vaccine which
| cannot easily regain its original virulence.
| yyyk wrote:
| CVDPV still is weaker than "wild" polio - only about 1000 cases
| ever (out of billions of vaccinations), and outbreaks are
| controlled quickly (if slower than the original expectation).
| Apparently both due to remaining mutations and since it's
| nearly all polio type 2 - which was otherwise eradicated a long
| time ago, apparently that type is a bit less "fit".
|
| It's a problem, but one that can be managed by the existing
| tools which brought polio down to this level - many countries
| switched from trivalent OPV or removed OPV2 precisely to avoid
| this scenario, and a new OPV2 vaccine will hopefully eliminate
| the problem in the affected areas:
|
| http://polioeradication.org/wp-content/uploads/2020/07/cVDPV...
| vilhelm_s wrote:
| Right. There was some previous discussion on Hacker News about
| this under the headline "Polio eradication program faces hard
| choices as endgame strategy falters"
| [https://news.ycombinator.com/item?id=21920406].
| aazaa wrote:
| The BBC article doesn't explain what "wild" means in detail. This
| NPR article does:
|
| > And there's another type of polio that's problematic. Sixteen
| African nations are currently battling outbreaks of what's called
| "vaccine-derived polio." This is a form of polio that stems from
| the oral polio vaccine used in lower income countries because it
| is cheap and easy to administer.
|
| > The oral vaccine contains a live but weakened version of the
| polio virus. The virus replicates inside the child's intestine
| and eventually is excreted. In places with poor sanitation, fecal
| matter can enter the drinking water supply and the virus is able
| to start spreading from person to person.
|
| https://www.npr.org/sections/goatsandsoda/2020/08/25/9058847...
| mleonhard wrote:
| A concise explanation of vaccine-derived polio:
|
| https://www.who.int/westernpacific/news/q-a-detail/what-is-v...
| george120 wrote:
| Well good thing you started with that since you are clearly not
| familiar with him at all. He is very very well read and highly
| involved with the charity.
| https://www.bloggerzune.com/2020/06/what-is-negative-seo.htm...
| https://www.bloggerzune.com/2020/06/How-to-improve-your-blog...
| https://www.bloggerzune.com/2020/06/whatsapp-web-scan.html?m...
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