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The World Health Organization is gearing up to fight a potentially devastating polio outbreak in Syria. Almost two dozen possible cases are under investigation. And the WHO has issued a polio alert for Syria's neighbors. While WHO officials wait for confirmation that what they are dealing with is, in fact, polio, they're mass immunization to try to contain the outbreak.

NPR's Jason Beaubien reports.

JASON BEAUBIEN, BYLINE: Over the last two decades polio has been eradicated from most of the world except a few remaining hotspots. Health officials had thought that they were on the verge of wiping it out completely. If these cases of paralysis in Syria are confirmed as polio, this will mark the first time that the virus has emerged in Syria in 14 years.

DR. HAMID JAFARI: The government of Syria is responding to it like it is an outbreak of polio, and so are the countries immediately surrounding Syria.

BEAUBIEN: Dr. Hamid Jafari is the director for polio eradication operations and research with the World Health Organization in Geneva. He says the WHO is investigating a cluster of 22 paralysis cases among children in the Deer Ezzour Province in Eastern Syria.

JAFARI: Subsequently we've heard that there are two or three additional cases. So the information is still coming in. This area is a severely contested area so the information flow is not smooth and regular.

BEAUBIEN: Syria used to have one of the best polio immunization programs in the region. Prior to the start of the civil war two and a half years ago, 83 percent of Syrian kids were fully immunized against polio, according to the WHO. By last year that number had fallen to just 52 percent. Dr. Jafari says the WHO and the Syrian government are scrambling to launch emergency polio vaccination campaigns possibly as early as next week around the area where the suspected cases were found.

Additional immunization campaigns are being organized in neighboring Iraq, parts of Turkey, Lebanon, Jordan, the Palestinian territories, and even as far away as Egypt, these are all places that are currently considered polio-free.

JAFARI: In the initial response in these neighboring countries, these will be nationwide campaigns so that all people will be vaccinated, because the risk of spread is high.

BEAUBIEN: Carrying out those additional vaccination campaigns may be far easier outside of Syria than inside the country itself. There's been fierce fighting in the area where these cases were found. In addition, much of Syria's once vaunted health care system has collapsed.

TARA NEWELL: The conflict has affected the entire country and I don't think anyone is immune to it.

BEAUBIEN: Tara Newell, the head of mission for Doctors without Borders in Syria, says the health needs of Syrians are vast and the humanitarian response inside the country has been minimal.

NEWELL: Generally speaking, the vaccination programs haven't been functioning. Doctors have fled. And medicines aren't arriving on their routine schedules because supply systems aren't functioning.

BEAUBIEN: She says carrying out mass polio immunizations campaigns inside Syria to try to contain an outbreak will be equally difficult.

Jason Beaubien, NPR News.

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