With suspected cases of polio, hepatitis A and haemorrhagic fever with renal syndrome being registered in Kosovo in recent days, the need to rebuild public health systems capable of containing the spread of communicable diseases has now become urgent, the World Health Organization (WHO) warned today.

In the past few days, one case of suspected polio, 24 cases of suspected hepatitis A and one case of haemorrhagic fever with renal syndrome have been registered in the province. These are the first cases registered in Kosovo since the end of the conflict.

The suspected polio case was detected in Pristina hospital on 11 August 1999. The three year-old boy lives in a deprived urban area and had not been vaccinated against polio. Samples are being taken for confirmation and the area is being investigated for possible additional cases.

Over the past four years immunization rates in Kosovo have been very low. According to the most recent study, conducted by UNICEF in 1996, only 53% of two year olds in Kosovo in 1996 had received the full vaccination course against diseases such as polio and measles. While polio vaccination campaigns were implemented in 1996 and 1997, many children born since then are unvaccinated. As a result, the risk of a major outbreak is high, should wild poliovirus be re-imported. A major polio outbreak involving Albania and Kosovo occurred in 1996.

Dr Máire Connolly, Medical Officer with WHO's Department of Emergency and Humanitarian Action, who has just returned from Kosovo, said, "There is an urgent need to implement immunization programmes as soon as possible. WHO is working with UNICEF, the Kosovo Institute of Public Health (IPH) and non-governmental organizations to mount an immunization programme to protect all children under five against polio, measles, tetanus, diphtheria and whooping cough." WHO is leading the global campaign to eradicate polio by the end of the year 2000, in collaboration with UNICEF, Rotary International, CDC (the US Centers for Disease Control and Prevention) and other partners.

Twenty four cases of jaundice were admitted to the Pristina hospital between 4 and 11 August 1999 with suspected Hepatitis A. This disease is transmitted by faecal contamination of the water supply. Nine cases were reported from the village of Podujeva and are aged between 10 and 18 years. Samples have been taken for laboratory testing.

A case of haemorrhagic fever suspected to be caused by a hantavirus has been diagnosed in a 19 year-old woman in Pristina hospital. This disease is transmitted to humans by airborne particles from excreta from infected rodents. The woman, who had been living in a forest near the Albanian border since March, became ill in mid-July. There are no other clinical cases reported to date. The woman is now recovering.

"Low vaccine coverage rates, poor water and sanitation, lack of proper waste disposal, continued mobility of the population and a weakened health system means that people are at serious risk of major communicable disease outbreaks. While WHO is working closely with the Kosovo Institute of Public Health (IPH) to fight these threats, more needs to be done if we are to stop the spread of communicable diseases," said Dr Tom Grein, Medical Officer with WHO's Communicable Disease Surveillance and Response Department.

For further information, journalists can contact Gregory Hartl, Office of Press and Public Relations, WHO, Geneva. Telephone (41 22) 791 44 58. Fax (41 22) 791 48 58. E-Mail: hartlg@who.int