Health officials in Malawi diagnosed polio last month in a 3-year-old girl who is now paralyzed, in the first wild polio case in southeastern Africa in 30 years. “And yes, you should care,” Joanne Kenen writes in Monday’s Politico Nightly newsletter. Malawi’s small outbreak is an important reminder that “diseases that we scarcely think about and no longer fear, like polio or measles, can and do re-emerge.”

Polio, an incurable virus that can kill or paralyzed unvaccinated children, was declared eradicated in Africa in 2020, and Malawi’s outbreak was genetically traced back to Pakistan, one of two countries, along with Afghanistan, where wild polio had not been eradicated. 

“The rule of thumb is that if Malawi has diagnosed one child with paralysis, another 200 have been infected, somewhere, with less severe or asymptomatic polio cases,” Kenen says, and how and when the virus got from Pakistan “to Malawi and who it affected along the way are not yet known.” UNICEF last week started a huge vaccination drive to inoculate 20 million children against polio in Malawi and three neighboring countries. 

“The Malawi case should underscore two things to a U.S. audience,” Kenen writes, citing public health experts in and out of government. First, the COVID-19 pandemic “interfered with many ordinary — and necessary — primary and preventive health services at home and abroad. That includes routine childhood immunizations, like the polio vaccine.” And second, she adds: “Vaccination.”

“Vaccine hesitancy did not begin with the coronavirus,” but “fear of vaccines has intensified and become more politicized during the pandemic,” and “even before the pandemic, groups of conservative lawmakers in a few states attempted to weaken vaccination requirements for kids to attend school,” Kenen reports. “Precisely because vaccines have been so successful in eliminating these childhood diseases, people have forgotten how dangerous those illnesses can be. … That amnesia, that complacency, is a public health risk.” Read more about polio and vaccinations at Politico.