“The recent detection of a polio case in Iraq after a 14-year absence is a reminder of the risk currently facing children throughout the region,” said Maria Calivis, Regional Director for the Middle East and North Africa of the UN Children’s Fund (UNICEF).For Iraq, this is the first nationwide vaccination campaign since a case of polio was confirmed by the Ministry of Health on 30 March in Moossa Hezam, a baby from Al-Rusafa, in northern Baghdad. “It is now even more imperative to boost routine immunisations to reach every child multiple times and do whatever we can to vaccinate children we could not reach in previous rounds. That’s the only way we will prevent this outbreak from spreading further,” she added.The current vaccination rounds are part of a comprehensive response to the announcement, in October 2013, that a wild poliovirus of Pakistani origin had found its way to war-ravaged Syria. Recognizing the risk of further international spread, Governments of seven countries across the Middle East, with the assistance of local non-governmental organizations, civil society groups and UN agencies, are endeavouring to reach 22 million children multiple times with polio vaccine. Since October, 25 polio vaccination campaigns have been completed across the region, including five rounds in Syria and six in Iraq. A UNICEF team visited the polio-affected baby’s home in in of the poorer neighbourhoods of Baghdad’s northern suburbs. They were told by a local doctor that “neither Moossa nor any of his four siblings received polio vaccination despite the advice of the health workers who came to the family’s house several times.”Abood Hezam, Moossa’s father, is a mini-van driver and the sole breadwinner for his family of seven. “I am working so hard to support my family and had no time to think about taking my children to the hospital for vaccinations. I truly regret this now. If only Moossa was vaccinated he would have been polio free now,” Mr. Hezam told the UNICEF team, adding that he is now working to sensitize friends and neighbours to the importance of polio vaccination. Polio, whose virus enters the body through the mouth and multiplies in the intestines attacking the nervous system, is highly infectious and can cause total paralysis in a matter of hours. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis and among those paralyzed, five to 10 per cent die when their breathing muscles become immobilized.Since the detection of Moossa’s case in Iraq, the Iraqi Ministry of Health supported by UNICEF, World Health Organization (WHO) and other health partners conducted a mop up covering the entire location around the area where Moossa lives, covering more than 8,000 children. “Midway into the implementation of this outbreak response plan, we’re reaching the vast majority of children across the Middle East,” said Chris Maher, WHO Manager for Polio Eradication and Emergency Support. “In the second phase of the outbreak response we must work with local partners to reach the hardest-to-reach – those pockets of children who continue to miss out, especially in Syria’s besieged and conflict areas and in remote areas of Iraq. We won’t stop until we reach them.”Health teams in Lebanon and Turkey will also join the campaign on 10 and 18 April. As of end of March 2014, 27 children have been paralyzed by polio in Syria: 18 of these children are in the contested governorate of Deir Ez Zour, four are in Aleppo, two in Idlib, two in Al-Hassakeh and one in Hama. Prior to this outbreak, no polio cases have been recorded in Syria since 1999. The risk of spread to countries in the region and beyond is considered high, and health authorities from 21 countries have declared a public health emergency. In Syria, immunizations campaigns will be carried out at monthly intervals until at least May 2014. Since the outbreak was announced in October, UNICEF has delivered 14 million doses of polio vaccines to Syria.