A nationwide polio immunization campaign in Iraq was today launched by the World Health Organization (WHO) with the United Nations Children Fund (UNICEF) and the Iraqi Government to protect children under five from a polio outbreak there. Widespread transmission of wild poliovirus in Iraq is posing a growing health threat not only in the country but in the region as a whole, warned WHO. Cross-border transmission of wild poliovirus is one of the most difficult obstacles facing the campaign to eradicate the disease by the end of the year 2000.

Two rounds of National Immunization Days targeting 3.5 million children under five years of age in 4 - 6 October and 8 - 10 November 1999 will be conducted, followed by two more rounds scheduled for Spring 2000.

"It is crucial to the global eradication effort to control the outbreak in Iraq and prevent polio spreading to neighbouring polio-free countries," said Dr Harry Hull of the WHO Expanded Programme on Immunization.

Declining routine immunization coverage in many areas as well as insufficient NID coverage in southern and central governorates, especially among high-risk populations, are major factors contributing to the eruption of the disease, according to WHO. The migration of minority populations across national boundaries, civil unrest and poor infrastructure have created the perfect conditions for poliovirus transmission. Iraq borders with Iran, Jordan, Kuwait, Saudi Arabia, Syria and Turkey.

Since May, 16 cases of paralytic poliomyelitis occurring in nine out of 18 governorates have been confirmed. An additional 19 cases are currently being investigated. Nine of the original 16 confirmed cases belong to nomadic cattle-herding families. Most cases reported since August are among children of resident families. Eighty-eight percent of all cases are children aged two years or younger; the majority have not been properly immunized.

WHO also expressed concern about reports from the Ministry of Health in Iraq of 1,985 cases of cholera and 30 cholera-related deaths in southern and central Iraq for the period from April to August 1999.

Poor sanitation, contaminated water supply, power failures and impoverishment of the population are the main reasons behind the outbreak of cholera, which is a water-borne disease. WHO officials in Iraq described raw sewage seeping into leaking and corroding pipes.

To control the outbreak, WHO is providing drugs, IV fluids, transport and financial and technical assistance for health education, training, supplies, water quality control and strengthening of surveillance systems. WHO's Global Task Force on Cholera is working with the Ministry of Health to develop an action plan for cholera and other epidemic diarrhoeal disease prevention and control to include setting up district level treatment centres.

In the 10 years since WHO launched the polio eradication initiative, the number of reported cases worldwide has fallen by 85% and polio is now restricted to parts of sub-Saharan Africa and the Indian sub-continent.

Major partners in the Global Polio Eradication Initiative are Rotary International, UNICEF, the US Centers for Disease Control and Prevention, the UN Foundation, the Gates Foundation, the governments of Australia, Belgium, Canada, Denmark, Germany, Japan, the UK and the US, private sector partners and millions of volunteers.