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| 2024 Gaza Strip polio outbreak | |
|---|---|
 A displaced child receives a polio vaccination in an UNRWA shelter inBeach camp, Gaza Strip | |
| Disease | Polio |
| Virus strain | Circulating vaccine–derived poliovirus type 2 (cVDPV2) |
| Source | Wastewater |
| Location | Khan Yunis andDeir al-Balah,Gaza Strip |
| First reported | CentralGaza Strip |
| Date | 16 July 2024 – present |
| Confirmed cases | 1[1] |
| Active cases | 1[1] |
| Suspected cases‡ | 3[2] |
| ‡Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out. | |
The2024 Gaza Strip polio epidemic is an ongoing outbreak of circulating vaccine-derivedpoliovirus type 2 (cVDPV2) in theGaza Strip, first discovered on 16 July 2024 and officially declared anepidemic by theGaza health ministry on 29 July.[3][4] The epidemic marked the first occurrence of poliovirus in the Gaza Strip since the virus was completely eradicated from the region 25 years prior.[5]
The Gaza health ministry stated that the epidemic presented a significant risk to Gaza's citizens and to bordering countries, and called the outbreak "a setback to the global polio eradication program".[6] TheWorld Health Organization reported that it was "very likely" that polio cases infected citizens of Gaza and were spreading among its population, although detecting cases would be very challenging due to the virus beingasymptomatic in most cases and due toIsraeli medical blockades preventing confirmation of cases.[4]
On 16 August, tests in Jordan confirmed the first polio infection in Gaza, located in the central Gaza strip.[1] So far the United Nations has confirmed one case of paralysis in a 10-month-old baby.[7]
On 29 August 2024, Israel made a "preliminary commitment" to comply to pauses in the fighting to facilitate a vaccination campaign.[8] 14 days later theWorld Health Organization reported that polio vaccination for children of the Gaza strip was achieved.[9]
TheGaza Strip is experiencing ahumanitarian crisis as a result of theGaza war.[10][11] The crisis includes both an impendingfamine and thedestruction of its healthcare system. At the start of the war, Israel tightened itsblockade on the Gaza Strip, which has resulted in significant shortages of fuel, food, medication, water, and essential medical supplies.[10][12] This siege resulted in a 90% drop in electricity availability, impacting hospital power supplies,sewage plants, and shutting down thedesalination plants that provide drinking water.[13] Widespread disease outbreaks have spread across Gaza as a result.[11]
Public health experts warned of the outbreak and spread of disease in Gaza. According toOxfam and the United Nations, Gaza's lack of clean water andsanitation would trigger a rise incholera and other harmful and potentially-deadlyinfectious diseases.[14] Oxfam stated Gaza'ssewage pumping stations andwastewater treatment facilities had ceased operations, so the buildup of solid waste andunburied bodies were likely vectors of disease.[14] Due to the lack ofclean drinking water, Gaza residents were drinking water contaminated withsewage,seawater, andfarm water, another major source of disease.[14]WHO egional emergency director Richard Brennan stated, "The conditions are ripe for the spread of a number of diarrhoeal and skin diseases".[14]
Raw sewage overflowed in the streets, causing a significant health andenvironmental disaster.[15] Flooding in Gaza spread sewage water, raising fears of the spread of disease.[16][17] On 19 January,Yahya Al-Sarraj, themayor of Gaza City, stated more than 50,000 tons of trash had accumulated in the city, further leading to the spread of disease.[18] Parents reported children falling sick after being exposed to raw sewage.[19] In May 2024, the UN stated, "Mosquitoes, flies and rats are spreading, and so are diseases."[20] Oxfam reported the threat of disease outbreaks due to an accumulation of "human waste and rivers of sewage in the streets".[21]
On 16 July 2024, an investigation of sewage sites in the Gaza Strip by the Global Polio Laboratory Network of theWorld Health Organization (WHO) discovered traces of circulating vaccine-derivedpoliovirus type 2 in all six test samples among two regions inKhan Yunis andDeir al-Balah.[3][22]Genomic sequencing of the isolated poliovirus traces by theCenters for Disease Control and Prevention (CDC) found that they had closegenetic linkage between each other, and were closely related to cVDPV2 that circulated in Egypt throughout the 2nd half of 2023 and was last detected in December 2023. Research into genetic changes present in the samples indicated that the poliovirus could have spread to Gaza as soon as September 2023.[23]
As of 23 July 2024, no tests had yet been conducted for polio cases or symptoms of paralysis in humans.[2] WHO andUNICEF planned to bring fifty human sample kits to the Gaza Strip on 25 July 2024 and investigate them at a lab inJordan.[22] In late-July, three cases of acute flaccid paralysis were diagnosed in the Gaza Strip with researchers determining that poliovirus was a potential cause, leading them to take samples of the cases and send them to Jordan for analysis.[24]
The WHO reported that Gaza immunization rates were at 99% in 2022, and fell to 89% in 2023 due to decimation of the Gazan health system in addition to "lack of security, access obstruction, constant population displacement, shortages of medical supplies, poor quality of water and weakened sanitation".[3]
Dr. Lior Nesher, the Israeli Infectious Disease Institute director at theBeersheba Soroka Medical Hospital, claimed that attempts to halt the "ecological movement" of the poliovirus would be "almost impossible", emphasizing that the virus "does not respect borders". He reported that the poliovirus could spread from sewage tounderground aquifers as a result of flooding during the rainy season. He stated that even though most Israeli soldiers were immunized against the virus, they could still carry it in their clothes, in mud, and in feces produced with bowel movements, which could cause the virus to spread throughout Israel. He also noted a marked increase in vaccine non-compliance in Israel compared to a few years ago, which could allow the virus to spread easier throughout non-immunized citizens and unvaccinated children. According to his statistics, rates of Israelimeasles vaccination were belowherd immunity percentages of 92–93%, which could indicate a lack of herd immunity towards polio in the Israeli population were the virus to circulate in Israel.[25]
On 29 July, the Gaza Health Ministry officially declared a polio epidemic in the Gaza Strip, stating that the circulating poliovirus throughout large deposits of wastewater posed a significant health threat to Gaza and countries bordering it. The ministry called the epidemic "a setback to the global polio eradication program" and placed blame on the destruction of hospitals and medical infrastructure by Israel.[6] On 30 July, the WHO reported that it was "very likely" that polio had infected and spread among citizens Gaza.[4]
On 16 August, thePalestinian Ministry of Health recorded the first confirmed case of polio in Gaza in the city ofDeir al-Balah.[26] The first polio victim was a ten-month old baby who "stopped crawling, stopped moving, stopped standing up, and stopped sitting."[27]
Head of WHO's Palestinian team Dr. Ayadil Saparbekov stated that organization workers were conducting risk assessments and distributing information about protection from polio to the Gazan population. He noted that it would be very difficult for citizens to be able to follow the guidelines recommended due to the lack of wastewater and sanitation treatment and the resulting buildup of waste and debris in densely crowded refugee encampments throughout the Gaza Strip.[3]
Efforts to limit the spread of the disease were significantly complicated by difficulties in moving humanitarian aid into Gaza including sanitation equipment and adequate nutrition. In addition, dangerous conditions in the Gaza Strip due to military assaults and airstrikes prevented safe allocation of resources across the territory to isolated regions and populations with the greatest susceptibility.[3]
On 12 September 2024 theWorld Health Organization reported reaching the target of polio vaccination for children of the Gaza strip.[9] One week later, the United Nations stated that its second round of polio vaccinations would include doses of micronutrients and a nutritional screening.[28] The W.H.O. began its second round of polio vaccinations on 14 October 2024.[29] It was delayed due to intensebombardment in northern Gaza, however, where the campaign had sought to vaccinate more than 100,000 children.[30]
In early-November 2024, WHO stated it would resume polio vaccinations in northern Gaza but only inGaza City.[31] The following day, however, an Israeli drone reportedly bombed the polio vaccination site, the Sheikh Radwan Clinic, wounding three children.[32] The World Health Organization later stated six people, including four children, were injured in the strike.[33] UNICEF condemned the strike, stating, "Health workers and other humanitarian staff cannot do their jobs in the midst of ongoing attacks."[34]
In February 2025, another polio vaccination campaign was held in the Gaza Strip, reaching nearly 603,000 children under age 10 with the novel oral polio vaccine type 2 (nOPV2). A ceasefire allowed health teams to operate simultaneously across all five governorates. The drive was part of an emergency measure to contain the ongoing poliovirus outbreak and limit further transmission.[35]
The IDF started a voluntary vaccination campaign for its soldiers.[36] It also announced it was cooperating with humanitarian agencies for vaccine delivery in Gaza, with ~300,000 vaccines delivered since the start of the conflict in October 2023.[3] The vaccine drive reportedly came afterUnited States Secretary of StateAntony Blinken pushedIsraeli Prime MinisterBenjamin Netanyahu in a meeting.[37]
Human Rights Watch stated that both Israel's attacks on healthcare and water infrastructure and obstruction ofhumanitarian aid were worsening the polio epidemic.[38]
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