Global Concerns Mount Over Polio Outbreak Risk in Gaza Amidst Severe Humanitarian Crisis

Humanitarian organizations and global health leaders are voicing significant alarm over the risk of a polio outbreak in Gaza following the detection of the virus in wastewater samples. The region, already devastated by ongoing conflict, inadequate sanitation, and a crumbling healthcare system, faces formidable challenges in managing this highly contagious disease.

Dr. Mithqal Abutaha, program manager at Project HOPE—an international health NGO active in Gaza—emphasized the gravity of the situation. “It would be a disaster,” Abutaha stated, highlighting the severe limitations of Gaza’s healthcare infrastructure in coping with a potential polio outbreak.

Although no human cases of polio have been reported, the situation remains precarious. The capacity for medical testing and treatment in Gaza is unclear. According to the Global Polio Eradication Initiative, an arm of the World Health Organization (WHO), 16 out of Gaza's 36 hospitals are only "partially functional," and less than half of the primary care facilities are operational.

“The healthcare infrastructure is ruined,” Abutaha explained, underscoring the systemic deficiencies that impede the ability to control an outbreak. Recent findings, disclosed on July 16, revealed that wastewater samples collected on June 23 from Deir al-Balah and Khan Younis tested positive for circulating vaccine-derived poliovirus type 2. Ayadil Saparbekov, WHO's team lead for health emergencies in Gaza and the West Bank, characterized the risk level as high, warning that without prompt and effective intervention, the virus poses a significant threat of spreading both locally and internationally.

The delay in reporting these findings has exacerbated concerns. “Imagine how much spread there could have been in that time,” remarked Sean Carroll, president and chief executive of Anera, a humanitarian organization focused on the Middle East. The strain identified in Gaza is linked to a polio vaccine that has been discontinued in the United States since 2000 but is still used in other parts of the world. This vaccine, administered orally, contains a weakened form of the poliovirus that can be excreted in feces, posing a significant risk in an area with severely compromised sanitation.

The crisis has been worsened by Israel's blockade of Gaza, imposed following an attack by Hamas on October 7, which has led to severe restrictions on water, electricity, and fuel supplies. Prior to the conflict, Gaza had achieved a high polio vaccination rate of 99% in 2022. However, this rate has since declined to 89%, leaving thousands of children vulnerable to infection.

Dr. Javed Ali, head of emergency response in Gaza for the International Medical Corps, highlighted the urgent need for action: “There are now thousands of kids who remain vulnerable to getting infected with this particular strain. It’s an absolute nightmare.”

Efforts to combat the outbreak face substantial logistical hurdles. Approximately 250,000 children under the age of 5 in Gaza will require vaccination to mitigate the risk of spreading the virus. The oral vaccines needed must be kept refrigerated, a significant challenge given the current scarcity of reliable power sources for refrigeration.

Saparbekov noted that WHO and UNICEF personnel are expected to arrive in Gaza to collect human stool samples and conduct a risk assessment. This assessment will inform recommendations for a potential mass vaccination campaign, including the type of vaccine to be used and the targeted age groups.

Polio vaccines are generally robust and highly effective. The Centers for Disease Control and Prevention (CDC) recommend a series of four vaccinations: at 2 months, 4 months, 6 to 18 months, and again around age 5. Three doses provide at least 99% protection, while the fourth dose helps ensure long-term immunity. Booster shots may be required for those traveling to regions where polio is endemic or if full childhood vaccination was not completed.

Dr. Abutaha from Project HOPE expressed profound frustration over the looming threat. “You know what is going to be happening in the next days or months, but you can’t do anything about it,” he said, reflecting the deep concern and urgency surrounding the potential polio outbreak in Gaza.

In summary, the detection of poliovirus in Gaza's wastewater amid an ongoing humanitarian crisis underscores the alarming risk of a potential outbreak. The convergence of inadequate infrastructure, reduced vaccination rates, and logistical challenges highlights the critical need for an immediate and effective response to prevent a public health catastrophe.