ISLAMABAD: Pakistan on Friday reported its second case of wild polio virus case this year, health authorities said, in a two-year-old girl in the northwestern Khyber Pakhtunkhwa province.

Pakistan and Afghanistan are the only countries where the disease is still endemic. The highly infectious disease causes paralysis or even death. Children under five are the most vulnerable, but people can be fully protected with vaccines.

Spread through faeces and saliva, the virus has historically thrived in the blurred borderlands between the South Asian nations, where state infrastructure is weak.

“Today, the Pakistan National Polio Laboratory at the NIH (National Institute of Health), Islamabad, has confirmed the detection of Type-1 Wild Poliovirus from the stool specimen from a 24-month-old girl from district North Waziristan, Khyber-Pakhtunkhwa,” the National Emergency Operation Center (NEOC) said in a statement on Friday.

“The girl had an onset of paralysis on 14 April 2022.”

Pakistan reported its first polio case of the year on April 22, when a 15-month-old boy from Mir Ali area of the same district was found infected with the virus.

It was reported after a gap of more than a year.

To formally eradicate the disease, a nation must be polio-free for three consecutive years — but even 12 months is a long time in a country where vaccination teams are in the crosshairs of a simmering insurgency.

Since the Taliban takeover of neighboring Afghanistan, the Pakistan version of the movement has become emboldened and its fighters frequently target anti-polio teams.

Pakistan anti-polio drives have been running since 1994, with up to 260,000 vaccinators staging regular waves of regional inoculation campaigns.

But on the fringes of the country, the teams often face skepticism.

“In certain areas of Pakistan, it was considered as a Western conspiracy,” Shahzad Baig, a national polio eradication program official, said in January.

The theories ranged wildly: polio teams are spies, the vaccines cause infertility, or contain pig fat forbidden by Islam.

The spy theory gained currency with the killing of Osama bin Laden in 2011, whose hideaway in Abbottabad was revealed to the United States — unwittingly or otherwise — by a vaccine program run by a Pakistani doctor.

“It’s a complex situation,” said Baig. “It’s socio-economical, it’s political.”

The porous border with Afghanistan — a strategic crutch for the Pakistani Taliban — can also keep polio circulating.