Armed conflict can lead to outbreaks of polio

An outbreak of wild polio virus began two years after the onset of the civil war in Syria and subsequently spread to Iraq, causing a total of 38 cases (36 in Syria). Factors leading to the outbreak included a decline in polio surveillance and in polio vaccination coverage (from 83% for 3 doses of oral polio vaccine pre-war in Syria to 47-52%).

Investment in disease surveillance in areas of conflict can prevent new outbreaks of vaccine-preventable diseases

The development and successful implementation of a coordinated, multi-country plan in response to a wild polio outbreak in Syria and Iraq halted the outbreak within 6 months. The response, which involved strengthening acute flaccid paralysis surveillance and more than 70 synchronized mass polio vaccination campaigns in 8 Middle Eastern countries (reaching >27 million children), could serve as a model for responding to disease outbreaks in areas affected by conflict and political instability.