The World Health Organisation has recorded the first suspected outbreak of polio for 14 years in Syria, sparking renewed alarm at the collapse of health care caused by the country’s civil war.

Doctors in Syria are also seeing a flare-up of typhoid, hepatitis, and the flesh-eating parasite, leishmaniasis, blamed partly on the inability to administer a proper vaccination programme and partly on poor living conditions and a much-reduced access to health care.

Some 22 people in the northeastern province of Deir Ezzor are now showing symptoms that are “very likely” to be polio, Oliver Rosenbawer, from the WHO Global Polio Eradication Initiative told The Telegraph.

“We still need final confirmation from a laboratory, but all the indicators show that this is polio,” said Mr Rosenbawer.

For centuries, epidemics of polio, a highly infectious disease that invades the nervous system and can cause paralysis within hours, blighted countries across the globe, leaving hundreds of thousands of children and adults permanently incapacitated.

Vaccination programs have dramatically reduced the number of cases, and the disease is now targeted for global eradication. In the past century the number of cases around the world has fallen from 350,000 in 1988 to 223 reported last year, according to the WHO.

Until this outbreak in Deir Ezzor, in Syria the last recorded case of polio was in 1999.

“We are worried about the suspected outbreak [in Syria],” said Mr Rosenbawer. “As long as there is polio in one place, countries around the world are at risk. The tragedy is that there is no cure; once you have polio, it is for life. So the only way is to tackle it is through vaccination.”
Immunisation, already insufficiently widespread in Syria before the civil war, is almost impossible to carry out in Deir Ezzor and other parts of the country that are subjected to near constant shellfire and airstrikes, or are rife with lawlessness and kidnappings.

A study by WHO earlier this year found that least 35 per cent of the country’s public hospitals had been damaged or destroyed in the conflict, and that in some areas, up to 70 per cent of health workers had fled.

In recent months the WHO has set up an “Early Warning and Response System” designed to identify possible outbreaks of dangerous diseases within Syria, said Tarik Jasarevic, a spokesman.

“We have 291 public health providers in government and opposition-held areas reporting suspected diseased that we then investigate. This network has detected hepatitis A, leishmaniasis, typhoid and measles.”

In war-riven Aleppo, the summer heat combined with streets filled with putrid, uncollected rubbish, allowed leishmaniasis to thrive. Doctors recorded tens of thousand of cases of the tropical disease, transmitted by sand flies, that causes skin ulcers resembling leprosy.
The mass exodus of Syrian civilians fleeing the war is also increasing the risk of conveying diseases that had mostly been eradicated through vaccination back to neighbouring countries.

Alla Karpenko, a communications officer with Medicins Sans Frontieres, said the organisation had recorded cases of leishmaniasis, usually endemic to Syria, whilst working in Lebanon.
A measles outbreak that started in northern Syria is now showing up among refugees in Lebanon.

The revelation of the polio cases came as western diplomats prepared to step up efforts to convince leaders of the Syrian opposition to take part in a planned peace conference in Geneva next month.
Meanwhile nine Lebanese citizens who were kidnapped by rebel groups in May last year arrived back in Beirut late on Saturday, after a hostage swap with two Turkish airline pilots who were held prisoner by gunmen in Lebanon.

Lebanon says the hostages were Shia pilgrims, but the rebel opposition accused them of being part of the Lebanese militia Hezbollah.
Murat Akpinar, one of the pilots, described facing despair and hardships while in captivity. “For the first 15 days, we were kept in a room and didn’t see the light of day,” he said, adding that and his colleague were guarded by dozens of gunmen. “It was impossible for us to escape,” he said.

Whooping crowds greeted the Lebanese men on their arrival at Beirut airport. One of them accused his kidnappers of not offering the hostages medical care.

“We wished that any of them had any kind of values,” he said. “We were with people who couldn’t tell a female camel from a male camel,” he said, referring to an Arabic proverb to describe an ignorant person.
Other pilgrims said they were kept in dark, humid rooms for most of their confinement and reported hearing heavy fighting nearby.

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