Epidemiologists in Israel’s Health Ministry had thought that the poliovirus was wiped out here a few decades ago. Still, they had a rude awakening when a four-year-old girl who had never been vaccinated against the virus and lives in Jerusalem’s ultra-Orthodox Jewish (Haredi) neighborhood of Mea Shearim was diagnosed with it Hadassah-University Medical Center a couple of weeks ago. 

The toddler suffered severe weakness on one side of her body and is now undergoing rehabilitation to restore her muscular function to prevent permanent paralysis. This was the first case of poliomyelitis in Israel since 1989 when the ministry initiated a mass oral polio (Sabin) vaccination of people under 40. In 2013, traces of the poliovirus were identified in sewer systems across the country, but no paralysis victims were diagnosed.

In this case, the source of the disease is a mutated strain of poliovirus that can cause illness in unvaccinated people. Polio is still endemic in three countries – Pakistan, Nigeria, and Afghanistan and is eradicated from the rest of the world. Other countries besides Israel that have reported a single case of temporary or permanent paralysis over the last year months are Yemen, Malawi, Guinea, Liberia, and Burkina Faso. If Israel confirms another clinical case, it will rank with Somalia, Ukraine, Mozambique, Pakistan, and South Sudan.

Since the girl’s diagnosis, the ministry sent teams to test sewage systems around the country for the wild poliovirus and found it in many cities and towns with large numbers of Haredi residents, including Beit Shemesh Modi’in Illit and Tiberias. Rates of all kinds of vaccinations have been lower among Haredi families, which tend to be large, than in the general population.   

Since the announcement about the one case of poliovirus infection with symptoms, the ministry has placed numerous advertisements in newspapers read by the Haredi public urging parents to take their children who had not been vaccinated against polio to well-baby (tipat halav) centers for the Sabin oral vaccine. Fortunately, 12,412 babies and toddlers in the Haredi community were vaccinated by Sunday morning, and the ministry has ordered tens of thousands more vaccinations from abroad. 

The polio vaccine is administered in four doses – at age two months, four months, six months, and one year, and another booster shot is given as part of second-grade vaccinations around age
seven.