“People are very surprised when I say ‘it wasn’t a car accident, it was infantile paralysis’”, explains doctor Rivia Ferraz, 51 years old, when asked why she uses a prosthesis on her right leg? “People seem to have forgotten what infantile paralysis was”, she says, referring to the disease that has worried health authorities, since poliomyelitis, known as infantile paralysis, is falling in coverage in Brazil. Polio vaccination rates have been falling since 2016, the last time the country surpassed 90% vaccination coverage for the target audience. The goal of the National Immunization Program (PNI) is to vaccinate between 90% and 95% of children under 5 years of age. But protection has never been lower. In 2022, the percentage of vaccination was 72%. In the previous year, it was even lower, just under 71%, according to the Ministry of Health. The numbers bring concern because, despite Brazil having registered the last case of the disease in 1989, 34 years ago, other countries still have not eradicated the disease, which could make the virus circulate here again. The doctor said that she was born without any pathology. “But at 9 months I contracted polio and it was due to lack of vaccination”. She explains why she has not received the polio vaccine. “That was in 1971, a few decades ago, we didn’t have the SUS [Sistema Único de Saúde]. I’m from the Northeast, from Maceió, a beautiful city, but there weren’t many resources there and at that time there were only campaigns, it wasn’t like today, that in any health unit you take your child and get vaccinated. When there was a campaign, I had a fever and was vomiting, I couldn’t take the vaccine, then when I was fine, the vaccine was not available”. In the meantime, she ended up contracting the polio virus. “It is a virus that in some children may not even cause symptoms, as is the case today with covid 19, some people do not even develop symptoms, with polio it is the same way. But children developed the severe form, which was my case, which has an attack on the spinal cord, which ends up having consequences on the motor nerve cells, which ends up causing a flaccid paralysis”. Rivia was just at the stage of taking her first steps when her mother noticed that she would stand up, but then fall. “She took me for a medical evaluation and was diagnosed with paralysis. I underwent 14 surgeries to be able to walk a little, now I have this orthosis which is very good at giving me confidence to walk, I went through several phases with and without orthoses, with and without canes, to have greater stability and more security”. According to the Pan American Health Organization (PAHO), the vast majority of infections do not produce symptoms, but five to ten out of every 100 people infected with this virus may have flu-like symptoms. In one to 200 cases, the virus destroys parts of the nervous system, causing permanent paralysis in the legs or arms. There is no cure. The main effects of the disease are the absence or decrease of muscle strength in the affected limb and pain in the joints. Although very rare, the virus can attack the parts of the brain that help you breathe, which can lead to death. For 30 years, polio has paralyzed nearly 1,000 children a day in 125 countries around the world, including countries in the Americas, PAHO said. Zé Gotinha In 1994, Brazil was certified by the World Health Organization (WHO), along with the other countries in the Americas, as free of poliomyelitis. The fight against the disease gave rise to one of the best-known characters in national medical culture, Zé Gotinha. The name refers to the attenuated oral vaccine (OPV), applied as a booster dose from 15 months to 4 years of age. But the vaccination schedule starts earlier. The National Immunization Program recommends that the inactivated vaccine, in the form of an injection, should be applied at 2, 4 and 6 months of age and then the booster. The vaccine is available at all public health centers and can be administered simultaneously with the rest of the Ministry of Health vaccination schedules. Strategies In São Paulo, the Municipal Health Secretariat prepared actions to be carried out this year to reduce the risk of reintroduction of poliomyelitis and strengthen vaccination in the largest city in the country. The nurse and coordinator of the Municipal Immunization Program (PMI), Mariana de Souza Araújo, explains how the actions will be developed. “The vaccination rooms have extended hours, they are open from 7am to 7pm and on Saturdays we also vaccinate at the integrated AMA/UBS, for those parents who cannot take their child during the week”. Another action is the Updated Vaccination Statement (DVA), to be completed and delivered to the school where the student is enrolled, which aims to increase vaccination coverage among students. “All parents have to take the certified DVA to the school, so, for children who do not return the DVA, we carry out an active search, with community agents from the UBS, who go to the child’s house and vaccinate them on the spot”. Still in partnership with the Municipal Department of Education, PMI has carried out actions in schools. “For parents who are unable to take their children to the UBS, we vaccinate them in schools. We also disseminate information about vaccines on our social networks, but if parents still have any doubts, look for any health service that professionals will be able to guide”. The coordinator reinforces that the only way to prevent the virus from returning to the country is to maintain high coverage. “In São Paulo, we have coverage close to the target, with 80%, but we need to vaccinate more and that all children have the complete schedule to be protected”. A recent case of the disease was confirmed in Loreto, Peru, which increased the risk in Brazil, recalls the PMI coordinator. “We are at risk because Brazil is a country with open doors, we receive immigrants and refugees, so we need to maintain our vaccination coverage for exactly that reason, because we receive people from other countries that have cases and we know that where there are polio cases are the countries with low vaccination coverage. So our high vaccination coverage is the only way to prevent the virus from reintroducing itself in the country”. Further information on vaccination is available on the Vacina Sampa page. The polio virus is transmitted from person to person by the fecal-oral route or, less frequently, by a common means, contaminated water or food, for example, and it multiplies in the intestine. For those who hesitate to vaccinate their children, doctor Rivia has a warning and advice. “I went through a lot of pain and I still feel them, I had to overcome barriers and accessibility, all because of non-vaccination. Although people today are unaware of infantile paralysis, it is a completely preventable disease with the vaccine that is available, easily available in health units. Vaccinate your children, our wish is that children remain healthy”. * Collaborated with Priscila Kerche, from TV Brasil
Agência Brasil
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