To ensure South Africa remains free of polio the Department of Health oversees a monitoring programme to ensure that any case would be identified early.
Through this surveillance system, a young child in Gauteng, with a very rare and severe congenital immune system problem, has been confirmed by the National Institute of Communicable Disease (NICD) division of the National Health Laboratory Service (NHLS) to have developed a case of paralysis as an extremely rare complication of polio vaccination.
This complication has been shown to occur in only 23 cases worldwide since the introduction of Oral poliovirus vaccine (OPV) in the previous century.
In these extremely rare cases a polio-like picture arises in individuals and especially in babies or young children who have received OPV and are not able to produce antibodies that effectively protect against infections.
These babies have a rare genetic defect and the condition is called agammaglobulinaemia and those infected cannot make antibodies to fight infection. The diagnosis of agammaglobulinaemia is difficult to make and is not always obvious at birth and generally only suspected when the children present with recurrent infections.
Evidence has shown that breast milk has the ability to prevent childhood infections as it is rich in antibodies. Breast milk has also been shown to neutralise the polio virus.
It is therefore recommended that breast milk be fed to infants with agammaglobulinaemia. In cases where mothers are unable to breast feed, as in this particular case, breast milk can be obtained from breast milk banks.
However, breast milk banks have a particular short supply of milk as very few people are aware of them and make donations of breast milk. Mothers who have excess breast milk are encouraged to make donations to banks such as the South African Breastmilk Reserve (SABR), who may be contacted at 011 492 1209.
Oral poliovirus vaccine is the cornerstone of the World Health Organisation (WHO) Global Polio Eradication Initiative. The vaccine is highly effective in interrupting poliovirus transmission.
The effectiveness of the vaccines is demonstrated in South Africa where the last wild-type polio case was laboratory-diagnosed in 1989 and the country remains polio-free.
Nevertheless, South Africa must remain vigilant and ensure high vaccine coverage in the population because of the risk of re-introduction of polio into this country.
It is essential the country maintains high polio vaccine coverage and conduct effective surveillance to detect for importation of poliovirus.