The coronavirus outbreak has stopped a large number of activities across the globe, including essential ones such as immunization campaigns – highly important in Africa to prevent the spread of a wide array of deadly diseases.

COVID-19 is the topic all around the world, and rightfully so. We haven’t been confronted with a pandemic of this scale in modern times, and many of the challenges we must face now are unprecedented.

But COVID-19 isn’t the only disease around — all the other culprits are still here.

Niger is currently affected by a new outbreak of polio. Two children were infected with the disease, one of them paralyzed.

“The poliovirus will inevitably continue to circulate and may paralyze more children as no high-quality immunization campaigns can be conducted in a timely manner,” Pascal Mkanda, WHO’s coordinator of polio eradication in Africa, said in a statement.

Back in December, Niger and a group of West African countries were able to end a polio outbreak that had lasted 24 months. Nevertheless, the new outbreak isn’t linked to the one that ended last year, according to the WHO.

The live virus in a polio vaccine can evolve into a form capable of starting new outbreaks among children that haven’t been vaccinated, and this is what happened here.

This is especially problematic now, as WHO halted this month all polio vaccination activities until June — recognizing that this would lead to more children affected. In other words, COVID-19 has delayed polio vaccination, and polio might be making a resurgence.

“Niger stopped the previous polio outbreaks by mounting high quality mass vaccination campaigns in 2019. Unfortunately, that will not be possible now as we have suspended the polio mass vaccination campaigns due to the novel coronavirus pandemic,” said Mkanda.

Alongside Niger, 14 other countries are struggling to contain their polio epidemics, caused by a rare mutation of the virus in the oral vaccine. The list includes Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Mali, Nigeria, Togo and Zambia.

Eradicating polio requires more than 90% of children being immunized, according to the WHO. But several factors have made immunization difficult, such as low-quality vaccines, weak routine vaccination coverage, and lack of access to some areas.

Affecting mainly children under 5 years of age, polio is a highly infectious disease that can cause paralysis in just a few hours. It’s transmitted person-to-person and multiplies in the intestine. Symptoms include fever, fatigue, headache, and vomiting. There’s no cure, it can only be prevented.

When children are immunized, the virus replicates in the intestines to build up the necessary immunity and is then excreted in the feces into the environment, where it can mutate. If the immunization coverage in the community is low, then the virus can be transmitted to susceptible populations.

Most African countries have implemented travel restrictions and suspended health activities that don’t fulfill WHO’s physical distancing recommendations — including mass immunization campaigns. Once the situation permits it, the polio eradication program will start again.