31 jul. 2014

Taliban In Pakistan Derail World Polio Eradication


Taliban In Pakistan Derail World Polio Eradication

A health worker gives a child the polio vaccine in Bannu, Pakistan, June 25. More than a quarter-million children in Taliban-controlled areas are likely to miss their immunizations.
A health worker gives a child the polio vaccine in Bannu, Pakistan, June 25. More than a quarter-million children in Taliban-controlled areas are likely to miss their immunizations.
A. Majeed/AFP/Getty Images
Last January Salma Jaffar was shot while she was going door to door in Karachi, giving children drops of the polio vaccine.
"Even when they took out the pistol, I couldn't understand why he was taking out the gun," Jaffar says of the two men who pulled up on a motorcycle and started shooting at the vaccination team.
Salma Jaffar was shot four times while vaccinating children in Karachi last January. She survived. But more than 60 polio workers have been killed in Pakistan over the past two years.i
Salma Jaffar was shot four times while vaccinating children in Karachi last January. She survived. But more than 60 polio workers have been killed in Pakistan over the past two years.
Jason Beaubien/NPR
"But when he opened fire, that is when I thought it was the end of the life," she says. "My first thought was that I won't be able to see my children again."
Jaffar was shot four times: twice in her arm and twice in her chest. She spent the next three weeks in an intensive care unit.
Three of her colleagues weren't as fortunate and died in the attack. They are among the more than 60 polio workers who have been killed since the Pakistani Taliban banned polio immunization in 2012.
Today the militant group continues to threaten to kill not only vaccinators but also parents who get their children immunized. That threat has had a chilling effect on anti-polio efforts nationwide. And it completely halted vaccination drives in some Taliban-controlled areas. It's in these places that the crippling virus has come roaring back — and threatened to stymie global efforts to wipe out polio.
The worldwide campaign to eradicate polio has been going on for more than two decades. It has cost more than $10 billion. Now the success of the campaign hinges on whether Pakistan can control the virus.
At its peak in the 1950s, polio paralyzed about 350,000 people a year around the world. This year, so far, there have been only 128 cases recorded. Ninety-nine of them have been in Pakistan. And the South Asian nation is the only country in the world where the number of polio cases is rising significantly.
The edict by the Islamic militants to ban immunization was in response to the CIA's setting up a fake hepatitis vaccination campaign in Pakistan. The covert operation was part of an attempt by the U.S. spy agency to verify whether Osama bin Laden was holed up in the city of Abbottabad.
A polio vaccination booth in Rawalpindi.i
A polio vaccination booth in Rawalpindi.
Jason Beaubien/NPR
The polio problem in Pakistan right now is a result of the CIA's actions in the country, saysMufti Muneeb Ur Rehman, a prominent and moderate cleric in Pakistan. He personally accepts the polio vaccine. He encourages people at his mosque to get their kids vaccinated.
"But there are certain areas in Pakistan where the people resist [the polio vaccine] because the CIA used the polio campaign for intelligence purposes," he says.
Like many Pakistanis, Ur Rehman erroneously says the CIA operation against bin Laden used a polio campaign for cover, even though it actually used a fake hepatitis B campaign. "The one who can use hepatitis for intelligence," he says, "they can use polio for intelligence."
And the CIA's actions were an insult to Pakistan, he says. As a result, more children are now being paralyzed by polio in Pakistan than anywhere else in the world.
Before the Taliban prohibited polio vaccinations, the country was on the verge of eliminating the disease. In 2012 it notched only 58 cases. "The whole thing just then got reversed when vaccinators started to be targeted and killed," says Elias Durry, who leads the World Health Organization's polio operations in Pakistan.
The Pakistani government is doing what it can to keep the outbreak from spilling out of the Taliban-controlled area and into the rest of the country, Durry says.
The Health Ministry runs mass immunization campaigns that involve about 200,000 vaccinators, trying to reach millions of kids. There are polio roadblocks on major highways, where vaccinators immunize kids passing through in cars and trucks. Vaccinators also ply bus stations, railway stops and even airports immunizing any child that appears to be under age 5.
But all this hasn't been enough to wipe out the disease. As long as the Taliban blocks vaccinations in the territory it controls, Durry says, the virus can't be defeated either in Pakistan or the world.
The immunization ban is in the North and South Waziristan districts, along the Afghanistan border. Officials think about 250,000 kids there are missing their vaccinations.
In the regions under government control, the country is doing all the right things to curb the polio outbreak, Durry says. "But to win the war," he warns, "we have to be able to access children who are currently not available for vaccination."
And there’s no indication when the armed conflict between the Taliban and the government will subside — or when the Taliban will allow vaccinators to reach all the children of Pakistan.

26 jul. 2014

Clerics demand accountability as Polio incidence grows


By
 Editorial

Updated a day ago
Polio vaccine.— File photo
Polio vaccine.— File photo
AN issue that has been over a decade in the making is now reaching critical levels. But not even that troubling reality has prodded the state and society into treating it with the necessary urgency and seriousness of purpose. A substantial period of time has passed since the World Health Organization placed Pakistan on the list of those poised to re-infect the world with polio. The country responded with an outpouring of good intentions from several government and administrative departments. Regrettably, the hollowness of their promises is now in evidence. In addition to the regular discovery of new polio cases in areas such as Karachi and Fata, Thursday saw the virus take crippling effect in Balochistan, too — until this case, Balochistan had held out hope that it would remain the sole polio-free province. The same day, two more children were reported to have fallen victim to the virus in Fata. The steepness of the trajectory of this crippling disease is obvious from the numbers: so far this year, the countrywide tally of polio cases stands at 102; during the same period last year, there were only 21. During 2012, 58 new cases were reported; the following year, this figure stood at 93.
In this context, the statement by a group of clerics in Peshawar on Thursday is of much significance. A gathering of over 100 scholars expressed concern over the issue and demanded accountability of all those who have been associated with the eradication programme since the early ’90s. Some might be tempted to take this as somewhat ironic, given that the campaign to convince people to resist the administration of the vaccine was started by certain mischief-making members of the clergy itself. Nevertheless, the hard fact is that the controversy over polio immunisation has taken on religious hues and, as such, scholars can play a vital role in reversing the trend. Thursday’s gathering paid a well-deserved tribute to the fact that over 7,000 clerics participated in a Unicef-sponsored polio communication programme from 2009 to 2012, as a result of which vaccination refusals reportedly went down in parts of Khyber Pakhtunkhwa. That said, Pakistan’s state and society need to recognise that polio is first and foremost an urgent domestic concern, and all stakeholders in the future — be they clerics, politicians or others that possess the power to mould public opinion — are still far from putting in all-out efforts to eradicate the scourge.
Published in Dawn, July 26th, 2014.

21 jul. 2014

Five new cases of Polio reported in Pakistan


In this photo taken on Friday, June 27, 2014, Pakistani displaced tribal children suffering from dehydration and gastroenteritis lie on beds at a local hospital in Bannu, Pakistan. The rugged Pakistani region of North Waziristan emerged as a hotbed of polio infections after Taliban militants in the isolated area banned immunizations. Photo:AP

Pakistan’s fight against polio has faltered yet again with five new cases reported in the country, raising the number of victims affected by the crippling virus this year to 99.
“Five new polio cases were reported in different areas of the country, taking the total number of this year’s cases to 99,” Express News reported Saturday.
One of the identified victims is 21-month-old Hamza from Karachi whose parents reportedly refused to give him polio drops during the campaign.
The other four victims are 24-month-old Jaul Haq, 18-month-old Mariam from North Waziristan, 18-month-old Fayyaz from South Waziristan and Maya from Lakki Marwat in Khyber-Pakhtunkhwa province.
The number of polio cases is rising due to the relocation of the internally displaced persons (IDPs) in North Waziristan, where military operation has dislocated nearly one million people.
The World Health Organisation slapped travelling restriction on Pakistan this year after it was declared as one of the countries posing a threat of exporting polio-virus.
Pakistan government had announced measures to curb the disease but there are no indications signalling the trend has been reversed.


Along with neighbouring Afghanistan and Nigeria, Pakistan is a country struggling to contain the disease.
Post Polio Litaff, Association A.C _APPLAC Mexico

13 jul. 2014

The year Polio won

Everyone must take responsibility for the epidemic of scientific mistrust and ignorance gripping the world and returning polio to the most vulnerable, writes Lauri Zoloth.
A model of the polio virus.CREDIT: MARTIN MCCARTHY/GETTY IMAGES
My aunt Martha had polio because there was no medicine in 1932 to prevent it and because she was poor – a child of an immigrant family who spoke little English. The children’s noses ran, their heads ached, and so it went. They did not take this middle child of five to the doctor until she awoke one morning in the bed she shared and said, “Papa, Papa, I am so stiff, I am stiff as a board.” She returned home months later, with public-issue crutches and braces which she wore for the next 90 years. They fascinated me as a child, the shining silver circles on her ankles that she hated so deeply; she would close her eyes and duck her head and turn away from my gaze. She is why my mother signed my brother and I up to be test subjects for the polio vaccine clinical trials. She is why I attend very closely to news about polio. This year, the news is the worst in decades, the worst since we stood in lines waiting for our shots from the white-coated nurses at school.
A decade ago polio was all but eradicated everywhere except in Nigeria and Pakistan. Today it is spreading again. The latest outbreak is in war-torn Syria where the government stopped its vaccination program. And now, as a result of the chaos and the flood of over a million homeless refugees, unvaccinated Syrian children live in tents near open sewage drains from which the virus spreads.
The story of how polio has made its comeback is not simple. It began in 2003 when radical Muslim clerics in northern Nigeria issued a ruling to block polio vaccination claiming it was a Western effort to sterilize Muslim girls. As Muslim clerical councils shut down the program, isolated cases spread. Villagers who made the Hajj, the religious pilgrimage to Mecca, took the disease back home with them to India, Cameroon, Equatorial Guinea, Iraq, Ethiopia, Israel, Afghanistan, Sudan, and Somalia.
But let’s not just blame Muslim extremists. The opposition to polio vaccination is astonishingly widespread. There are leftwing websites such asVacTruth that, remarkably, blame polio vaccines for the epidemic. TheLiberty Beacon, a rightwing website, tries to convince readers that the epidemic is a plot by the UN and the drug companies to make profits. Anti-vaccination natural healing websites advise parents to avoid all vaccines: “who needs ‘em,” they say. It is odd to find Hollywood actors weighing in, inadvertently agreeing with Pat Robertson, the conservative politician, that vaccines are dangerous. These views line right up with Taliban theories that vaccination campaigns are a cover for CIA plots, and with some Pentecostal Church ideas about vaccines “interfering with God’s plan for healing.” In fundamentalist communities, regardless of ideology or which scripture is read, a shared praxis of suspicion has emerged.
Polio eradication is a moral question: what do we owe to the most vulnerable?
Suspicions were deepened by the CIA’s Osama Bin Laden hunt going under cover as a polio vaccination campaign, a cruelly careless tactic.  In Pakistan, 40 nurses have been killed in the past two years. And large pharmaceutical companies have indeed hidden data to increase profits. One can credit both these organisations with creating a world in which nutty firebrands fan the flames of conspiracy on the internet and men with guns track and shoot aid workers.
Bioethicists, social scientists and journalists need to shoulder some blame as well for we helped sell the idea that the proper way to view the world was through a suspicious lens - until we reach the point where no authority, even one operating according to the proven facts of medical science, is believed. Should we be surprised when leftwing critics attack genetic research, or when rightwing critics attack climate change data, or when people from across the political spectrum mistrust science itself? Polio vaccination, one of our clearest collective duties to the children of the world, is now a casualty of the philosophical struggle for truth.
Polio eradication is a moral question: what do we owe to the most vulnerable? In this sense, it is a theological question, something well understood by the leading Islamic scholars who met this February. Their conclusion, as stated by the Grand Imam of the Holy Mosque of Mecca, was “that protection against diseases is obligatory and admissible under Islamic Sharia, and that any actions which do not support these preventive measures and cause harm to humanity are un-Islamic”. In May, authorities in London declared polio a public health emergency and made it clear that not only must the viral epidemic be stopped, the epidemic of ignorance and mistrust must be tackled as well.
Truth, said philosopher Hannah Arendt, is a fragile statement that must be spoken, heard and answered. It must be defended or it will be silenced. It is hard to believe that a world that has seen breakthroughs in stem cell science and cloning is also a world where children still wake up “stiff as a board” from polio, not because we did not have the science to know  what to do, but because we did not defend the right to do it. 
Laurie Zoloth is a professor of medical ethics and humanities at Northwestern University, Chicago

11 jul. 2014

Crowds turn up for Polio vaccinations in Nigeria’s north-east


In Nigeria’s Borno and Yobe states, a major polio vaccination campaign is being carried out by state governments and partners, including UNICEF. Residents are also being provided basic health care services, including treatment for malnutrition.
UNICEF Image
© UNICEF Nigeria/2014
Mothers wait to get their children vaccinated at the Kachalla comprehensive health centre in Maiduguri, north-east Nigeria.
ABUJA, Nigeria, 26 June 2014 – Young women hold their little ones as they sit patiently on wooden benches, waiting their turn at a health camp that provides polio vaccination and much-needed health care in north-eastern Nigeria, where increasing violence has led to displacement of local populations.
Many of the patients at the clinic in Bolori, a ward in Borno’s state capital of Maiduguri, have fled the violence, and quite a few of them show signs of malnutrition.
The health camps have been set up with UNICEF support as part of a major polio immunization campaign in Borno and Yobe, which have been worst-affected by violence.
Covering basic needs
Across the two states, health workers set up makeshift stands – sometimes just a few mats set out in the shade of a tree – to provide vaccinations to children, as well as basic health care services, including treatment for malnutrition.
Many of the children leave with smiles on their faces as they clutch the sweets they are given. Grown-ups receive soap, sugar and instant noodles, and medicines for those who need them.
In assisting Nigeria’s National Primary Health Care Development Agency (NPHCDA) and local authorities to run the campaign, UNICEF has sent more than 1,000 basic health care kits for use at the health camps, enough to cover the basic health needs of more than 400,000 people.
UNICEF Image
© UNICEF Nigeria/2014
Many of the patients at the clinic in Bolori have fled the violence, and quite a few show signs of malnutrition.
One woman said the health camps are the only place mothers like her can get drugs to treat malaria, skin infections and diarrhea. “God bless UNICEF,” she said with a smile.
Well and strong
The vaccination drive, which runs for six days, is part of a wider campaign targeting all under-5 children in 14 northern states.
Volunteers have been going door-to-door to let residents know they can get their children vaccinated and receive free treatment and medicine at the health camps.
One mother said she took her children to be immunized “because I heard that they will be protected against disease”. The woman, who declined to give her name, added, “I want my children to be well and strong.”
Major progress
Nigeria, one of three countries – with Afghanistan and Pakistan – where polio remains endemic, has made major progress in battling the disease. The number of confirmed cases has dropped from 122 in 2012 to 53 in 2013, and three so far this year.
But continued violence and instability in the region pose a major threat to the government’s goal of stopping transmission in Nigeria this year. Nearly 50 per cent of the polio cases in 2013 were from Borno and Yobe, where some areas could not be reached because of insecurity.
During a polio vaccination campaign in May this year, more than 295,000 children, or 18 per cent of the under-5 population, could not be immunized in Borno because they live in inaccessible areas. In Yobe, access improved significantly, and only 9,343 children, or 1 per cent, were not reachable.
Insecurity in the region has escalated since 2013 . Numerous health facilities have been destroyed and health workers have been killed, forcing some local doctors to flee.  As a result, access to health care has become even more difficult.
But wherever possible, immunization campaigns are held regularly, with strong involvement from the community, including polio survivors and religious and traditional leaders.
UNICEF continues to collaborate closely with the World Health Organization (WHO), Rotary International and other partners in the final push to achieve the global eradication of polio.



10 jul. 2014

Old-fashioned vaccine fights Polio resurgence


A child receives a vaccine in a makeshift field clinic of the Doctors Without Borders (MSF) organisation in Bangui on January 7, 2014
.

Paris (AFP) - A jab to protect children against polio that fell out of favor in the 1960s should be given a frontline role to help stamp out the disease, doctors reported in The Lancet on Friday.
The injection can provide better and long-lasting protection against the polio virus when used to supplement oral vaccine, which replaced it in most countries, they said.
Oral polio vaccine (OPV) protects individuals against contracting the disease, but they can still be infected by the virus.
It replicates in the gut and can then be passed to others through faecal-contaminated water, thus imperilling unvaccinated children.
Scientists at Imperial College London and the Christian Medical College in Vellore, in southern India's Tamil Nadu state, investigated whether the old-fashioned vaccine still had a part to play.
Their study involved 450 children from a poor urban area of Vellore, all of whom had received the oral vaccine as part of a standard innoculation programme.
Half of the children were then given a dose of the injected vaccine, which contains an inactivated virus, and the other half given nothing.
A month later, the children were given a dose of live oral vaccine, whose formula includes a tiny amount of live polio virus, the goal being to safely simulate re-infection.
A week later, their stools were tested to see if the polio virus was present -- specifically the two strains of the virus, serotypes 1 and 3, which are resisting eradication.
Among children who had received the injected vaccine, there were 38 percent fewer who had traces of serotype 1, and 70 percent fewer with serotype 3, compared to those who did not get the jab.
"Because IPV (injected polio vaccine) is injected into the arm, rather than taken orally, it's been assumed it doesn't provide much protection in the gut and so would be less effective at preventing faecal transmission than OPV," said Jacob John of the Christian Medical College.
"However, we found that where the children already had a level of immunity due to OPV, the injected vaccine actually boosted their gut immunity," he said in a press release.
He added: "In the 1960s there was extensive rivalry between the scientists who developed the two vaccines, with OPV eventually becoming the most popular.
"But it looks as if the strongest immunity can be achieved through a combination of the two."
- Tried and trusted -
Also called the inactivated polio vaccine or the "Salk vaccine," after its inventor, Jonas Salk, who developed it in 1955, the jab has long been considered an astonishingly safe and effective weapon against polio.
It is still used in dozens of countries, but in more than 120 others, oral vaccine is the exclusive choice, as it is cheaper, easier and quicker to administer.
The new findings add support to guidelines issued in February by the UN's World Health Organization (WHO).
The agency recommended that all children receive at least one dose of injected vaccine in countries that solely use OPV, in order to broaden the attack on all serotypes of the virus.
Polio, a crippling and potentially fatal disease that mainly affects children under the age of five, has taken a beating from a quarter-century vaccination effort.
In 1988, the disease was endemic in 125 countries, and 350,000 cases were recorded worldwide, according to the WHO.
Today, the virus is considered endemic in only three countries -- Afghanistan, Nigeria and Pakistan, where the vaccination campaign has been attacked by Islamists and tribal leaders.
The refugee crisis in Syria is considered another potential source of infection, as the vaccination programme there has been disrupted by war.
Health watchdogs are worried for unvaccinated children in those countries and in neighbouring countries where the vaccination guard may have slipped.
In May, the WHO declared that polio had returned as a "public health emergency" after three cases of cross-border transmission of polio were detected between January and April -- from Pakistan to Afghanistan, Syria to Iraq and Cameroon to Equatorial Guinea.
Post Polio Litaff, Association A.C _APPLAC Mexico

3 jul. 2014

Post-polio syndrome affects some who overcame polio in childhood


Emanuel Poznanski dealt with polio for most of his childhood. He overcame it, but he now suffers from PPS, a disease that can take over his life.
By LEIGH ZALESKI
Daily Record/Sunday News
1

Emanuel Poznanski stands briefly in his room at the Cross Keys Motor Inn in New Oxford as he transfers himself from his scooter, right, to his power
Emanuel Poznanski stands briefly in his room at the Cross Keys Motor Inn in New Oxford as he transfers himself from his scooter, right, to his power wheelchair. Poznanski has post-polio syndrome, a disease that affects 25 to 40 percent of polio survivors years after initial onset of polio. He lives in Las Vegas, but he graduated from York Suburban High School, and comes to York County every summer to visit friends for two months. (DAILY RECORD/SUNDAY NEWS - CHRIS DUNN)

Click photo to enlarge
Emanuel Poznanski sits in his scooter by the therapy pool... (DAILY RECORD/SUNDAY NEWS - CHRIS DUNN)
Emanuel Poznanski had 21 surgeries in the first 16 years of his life.
He received muscle transplants and joint fusions, each procedure followed by months of recovery.
During one of his last surgeries, a doctor broke his left leg -- which was an inch and a half longer than his right -- in an effort to decrease the difference.
Poznanski, 62, was born in Israel, where he contracted paralytic polio when he was 4 months old. He said his mother rushed him on a plane to the U.S. to save his life. She took him to the Mayo Clinic in Minnesota and then to Children's Hospital Boston.
In his earliest memories, hospitals were his home. There, he lived and received most of his early education.
"I never realized I was handicapped," Poznanski said.
He's thankful for that.
About 25 percent of his muscle had been destroyed by the disease. By the time he was a teenager, he had a slight limp, but said he could walk for miles. The confinement he felt from the disease and hospitals had ended. He was ready to start living.
In 1964, when Poznanski was 14, his family moved to York County, where he attended York Suburban High School. Poznanski, who now lives in Las Vegas, visits friends in York County for two months every summer. He stays at the Cross Keys Motor Inn in New Oxford.
"It was the most formative time in my life," Poznanski said of living here. "It was the time I was the happiest."
He thought he had overcome the debilitating disease and one-time epidemic. Decades later, he would again feel the effects.
Poznanski has post-polio syndrome, a condition that affects 25 percent to 45 percent of polio survivors years after initial onset of the disease, according to Post-Polio Health International. From 1937 to 1950, 226,306 cases of paralytic and nonparalytic polio were reported.
Symptoms of PPS -- a chronic, degenerative disease -- include pain, fatigue, and breathing and swallowing problems, and can worsen over time.
After staying in the pool for about an hour, Emanuel Poznanski inches his way to the aquatic lift that will carry him out of the therapy pool at the Cross
After staying in the pool for about an hour, Emanuel Poznanski inches his way to the aquatic lift that will carry him out of the therapy pool at the Cross Keys Village retirement community. Poznanski said it takes him two to four times to do what he used to because of post-polio syndrome. (DAILY RECORD/SUNDAY NEWS - CHRIS DUNN)
Some PPS patients say they have difficulty getting the right care because their symptoms are similar to aging -- and because modern doctors don't know a lot about the disease that is no longer prevalent thanks to a 1955 vaccine.
"We're dying off," Poznanski said. "Pretty soon, there won't be any of us left."
More than a year ago, Deborah Stambaugh started a post-polio support group that meets monthly in Hanover. She said about 20 people participate to share their post-polio-related problems and resources.
Stambaugh met Poznanski this summer and said he has a wealth of knowledge.
"He's really gifted in all this," she said.
Poznanski has watched his body decline for the last 14 years, as he searches for answers beyond his reach.
In 1998, he lived in Brazil, where he ran English schools. He felt fatigued and started falling every few months. By 2003, he felt too tired to work and moved back to the U.S. with his wife. Though he knew about PPS, he didn't seek a diagnosis.
"I was in a funk," Poznanski said. "I was aloof and probably didn't want to admit it."
In 2006, he stopped walking and needed a scooter to get around. A year later, he started researching the condition, spending three to four hours a day online trying to learn more.
He was diagnosed with sleep apnea and started gaining weight because his mobility was limited. At his peak, his 5-foot-7-inch-tall frame weighed 220 pounds. He has Type 2 diabetes, and high blood pressure and cholesterol. To maintain his weight of 190 pounds, he said, he can eat only 1,200 calories a day because his body doesn't easily burn energy.
Prescription medicines fill two plastic bags in Emanuel Poznanski’s room at the Cross Keys Motor Inn in New Oxford, where he stayed for a month while
Prescription medicines fill two plastic bags in Emanuel Poznanski's room at the Cross Keys Motor Inn in New Oxford, where he stayed for a month while visiting friends in York County. Poznanski said he takes about 15 pills a day and has 10 more he takes when needed. ( DAILY RECORD/SUNDAY NEWS - CHRIS DUNN)
His neck, joints and left side ache, and his breathing is getting worse. He uses his right arm almost exclusively and has learned to swing it into certain positions so he can use it because he has no muscle in his shoulders.
Poznanski rested his left hand on his protruding stomach as he gestured with his right at a diner in New Oxford. He leaned his forearm on the table to reach his sandwich before leaning in to take a bite.
To perform everyday tasks, it takes him two to four times longer than it used to -- 15 minutes to move his body out of bed, two and a half hours to shower and 45 minutes to get dressed.
"It bores me," he said.
He brings literature about PPS to his doctors and travels to clinics and wellness camps throughout the country.
"I have to watch out for what's ahead of the curve," he said.
Dr. Andrew Schutzbank helps Poznanski manage his condition. Schutzbank, assistant medical director of Iora Health in Cambridge, Mass., said he never came across a PPS patient before Poznanski. Poznanski met Schutzbank in Las Vegas, where Schutzbank sometimes works. They communicate mostly by phone and email.
"Everything I know about PPS, I learned from Manny," Schutzbank said.
He said there's not many good resources for the condition, yet the needs of PPS patients can be great.
Schutzbank helps Poznanski take care of his general health and connects him to specialists who might be able to improve his PPS. It's his job to keep Poznanski in the fight.
He said his patient's prognosis is "some variety of poor" and that he's going to get weaker over time.
"It's a race against the clock," Schutzbank said. "Manny's key is his tenacity. He's unwilling to accept that there's no help."
Poznanski can feel his body slowing down. He said he's a 62-year-old with a 90-year-old body, yet his brain is still sharp.
This summer, he ended his trip to York County more than a month early because traveling had become too much.
"It's coming to an end," Poznanski said. "It's becoming physically difficult to keep going."
He said because people who had polio conquered so much, many feel they can overcome anything. But, he said, PPS is not something to go at alone -- patients need to seek adequate care.
"The wall, this time," Poznanski said. "It's insurmountable."
717-771-2101; @leighzaleski

Post-polio support

People who had polio can develop post-polio syndrome decades after they first developed paralysis or weakness. Polio patients might develop more weakness, atrophy or paralysis.
Deborah Stambaugh of Spring Grove runs a post-polio support group that meets once a month. She said the group provides an outlet for former polio patients to talk about problems they might experience today as a result of the disease.
The group will meet 2 p.m. Sept. 23 at Hanover Church of the Brethren, 601 Wilson Ave., Hanover. For details, call 717-259-9594.
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