Every day, hundreds of Syrians flee their country, seeking shelter in neighboring countries. Some are traveling farther, to Europe, bringing what few belongings they have. What the refugees don’t know — what their host countries don’t either — is that some of their possessions may be dangerous.
Late last month, the World Health Organization confirmed in Syria 10 cases of polio, a crippling disease largely eradicated in the developed world. As the stream of Syrians pouring into other parts of the world continues, experts say, the risk of an outbreak in polio-free countries climbs.
Government health officials are scrambling to vaccinate young children in refugee camps, where close quarters and poor hygiene create breeding crowds for any communicable disease, including polio. Although Syria’s last polio case surfaced in 1999 thanks to a rigorous national public-health campaign, the country’s vaccination rates have dropped to 60 percent during the ongoing civil war.
In a memo published Thursday in the the medical journal The Lancet, two German public-health experts warn that Syria’s outbreak may threaten Europe. “Vaccinating only Syrian refugees — as has been recommended by the European Centre for Disease Prevention and Control — must be judged as insufficient,” they write. “More comprehensive measures should be taken into consideration.”
“The likelihood of poliovirus spreading from Syria to neighbouring countries hosting Syrian refugees is high,” an Oct. 23 report from the European Centre for Disease Prevention and Control read. The organization advised Middle Eastern countries hosting Syrian refugees to “assess the level of transmission” of the disease and European nations to “assess [refugees’] vaccination status on arrival and provide polio vaccination” as needed.
Today, according to WHO, polio is endemic in only three countries: Afghanistan, Nigeria, and Pakistan. Most European countries, free of the disease for decades, use inactivated polio vaccine, or IPV, administered through an injection, rather than oral polio vaccination, taken by mouth, which was discontinued because it caused, in rare cases, acute flaccid paralysis, the main symptom of polio.
According to the Lancet letter, IPV is very effective in preventing the disease, but does not provide complete protection from infection. Transmission of the disease can only be stymied, the experts write, if IPV coverage remains widespread and routine. In polio-free countries, that’s not always the case. Countries like Austria, Ukraine, and Bosnia and Herzegovina, where vaccination rates are low, are most at risk, the experts say.
Because only one in 200 people infected with the virus exhibit symptoms of the disease, many carriers don’t know they’re infected, nor that they’re putting others at risk. The virus can circulate through a population for up to a year before a single case of the acute paraylsis appears, the memo explains. By then, hundreds of people could already unknowingly infected.
Only some countries within the European Union still offer the oral vaccination, Lancet reports, and none have a stockpile of it for emergency use for a possible outbreak.
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As Congress continues to bicker on riders to a continuing resolution, federal agencies have started working with the Office of Management and Budget to prepare for a government shutdown, which will occur if no continuing resolution is passed by 11:59 p.m. on Friday night. The OMB held a call with agencies on Sept. 23, one that is required one week before a possible shutdown. The government last shut down for 16 days in 2013, and multiple shutdowns have been narrowly avoided since then. It is expected that Congress will reach a deal before the clock strikes midnight, but until it does, preparations will continue.
President Obama's Clean Power Plan, a large pillar of his efforts to leave a lasting environmental legacy, "goes before the full U.S. Court of Appeals for the D.C. Circuit today." The plan "imposes the first national limits on carbon pollution from power plants." A number of consolidated cases finds 27 states challenging this plan, which was blocked by the Supreme Court in February pending decisions from lower courts. The states will argue that the government doesn't have the right to impose restrictions requiring them to shutter plans and restructure full industries.
There seems to be a clear consensus forming about Monday's debate: Hillary Clinton was the winner. One focus group of undecided Pennsylvania voters, conducted by GOP pollster Frank Luntz, found 16 favored Clinton while five picked Donald Trump. In a Florida focus group organized by CNN, 18 of 20 undecided voters saw Clinton as the winner.
As both candidates walked off the stage, Donald Trump lauded himself for being restrained and for not bringing up Bill Clinton. "I didn’t want to say—her husband was in the room along with her daughter, who I think is a very nice young lady—and I didn’t want to say what I was going to say about what’s been going on in their life," Trump said. Trump claims he stopped himself from hitting Bill Clinton because daughter Chelsea was in the room.
At the end of the debate, moderator Lester Holt asked Donald Trump if he stands by his statement that Hillary Clinton didn't have the look of a president. Trump responded by saying Holt misquoted him, instead saying that Clinton "doesn't have the stamina." Clinton responded by saying that when Trump visits 112 countries as secretary of state, he can talk to her about stamina.