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Post-Polio Health (ISSN 1066-5331)

Vol. 9, No. 1, Winter 1993

Polio Outbreak

In September 1992, the Netherlands reported an outbreak of polio among members of a religious group that refuses immunization services.

Since this religious group also exists throughout the Americas and its members frequently travel back and forth, countries of the Western Hemisphere are on alert for importations. Attempts to educate and immunize members of this religious group are being made. The 1979 outbreak in the United States and Canada clearly illustrated the risk for unvaccinated members of religious groups who have direct or indirect contact with members of Dutch religious groups among whom poliovirus is circulating.

UPDATE. The outbreak in the Netherlands of poliomyelitis among unvaccinated persons who are members of religious groups that generally do not accept vaccination is continued (1). From September 17 through December 5, 1992, 54 cases of poliomyelitis were reported to the Netherlands' Office of the Chief Medical Officer of Health. All of the reported cases have occurred among unvaccinated (n=53) or inadequately vaccinated (n=l) persons belonging to a religious denomination that routinely does not accept vaccination. Patients range in age from <1 month to 56 years (mean age: 18.9 years). Of the 12 provinces in the Netherlands, seven have reported cases of poliomyelitis; the most severely affected provinces are South Holland and Gelderland.

The risk for acquiring poliomyelitis while in the Netherlands is considered small because of the excellent sanitation in the country and because transmission of the poliovirus has been limited primarily to unvaccinated religious groups. Nonetheless, the polio immunity of travelers to the Netherlands should be evaluated, and persons with inadequate protection should complete a primary vaccination series with three doses of poliovirus vaccine before departure, especially if extensive travel in the Netherlands or contact with persons in the affected religious groups is anticipated.

SOURCE: Morbidity and Mortality Weekly, 1992; 41:775-8; 41:917-9.

Polio in the US

No cases of suspected poliomyelitis have been reported in 1993. Four cases of suspected poliomyelitis have been reported in 1992; 6 of the 9 suspected cases with onset in 1991 were confirmed, and 5 of the 8 suspected cases with onset in 1990 were confirmed; all were vaccine associated.

The US Vaccine Distribution Debate

Fewer than 60% of U.S. children are properly immunized by age two. Federal health objectives for the year 2,000 say 90% should be vaccinated.

Some blame rising vaccine costs and propose a national vaccine program with a single, government purchaser. It would reduce costs to private physicians. Currently, half the children who receive vaccination get them from private physicians who pay manufacturers' catalog prices, or get small discounts. The other half are vaccinated in public clinics that receive substantial discounts through a Centers for Disease Control and Prevention grants program. (The oral polio price through the grant program is $2.09 per dose; manufacturers' catalog price is $9.91).

Physicians and child advocates argue that lower costs would improve access and boost immunization rates. The drug industry counters that forced discounts would curtail research and development and low costs do not always yield higher vaccination levels. The government is investigating.\

SOURCE: Extracted from American Medical News, January 18, 1993.

National Library Service

The National Library Service for the Blind and Physically Handicapped of the Library of Congress publishes books and magazines in Braille and in recorded form on discs and cassettes for readers who cannot hold, handle or see well enough to read conventional print because of a temporary or permanent visual or physical handicap.

Through a national network of state and local libraries, the materials are loaned free to eligible readers in the United States and to US citizens living abroad. Materials are sent to readers and returned by postage-free mail.


Readers may borrow all types of popular-interest books, including bestsellers, classics, mysteries, westerns, poetry, history, biographies, religious literature, children's books and foreign-language materials. Readers may also subscribe to more than 70 popular magazines in Braille and recorded formats.

Special equipment needed to play the discs and cassettes, which are recorded at slower than conventional speeds, is loaned indefinitely to readers. Headphones are provided on request. An amplifier is available for blind and physically handicapped readers who are also certified as hearing impaired. Other devices are provided to aid readers with mobility impairments in using playback machines.


You are eligible for the Library of Congress program if:

Or, you are certified by a medical doctor as having a reading disability, due to an organic dysfunction, which is of sufficient severity to prevent reading in a normal manner.


You may request an application by writing NLS or calling toll-free 800-424-9100, and your name will be referred to your cooperating library.

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