Health officials are worried.
After being free of polio for nearly 15 years, Equatorial Guinea has reported two cases of the disease.
The children paralyzed are in two distant parts of the country. So the virus may have spread widely across the small nation.
The outbreak is dangerous, in part, because Equatorial Guinea has the worst polio vaccination rate in the world: 39 percent.
Even Somalia, teetering on the brink of anarchy, vaccinates 47 percent of its children.
The World Health Organization encourages countries to keep polio vaccination rates above 80 percent. Most nations' rates are above 95 percent.
The Equatorial Guinea outbreak can be traced to neighboring Cameroon, where seven children have been paralyzed by polio since October.
"This is actually an outbreak from
Cameroon that has been ongoing and has spread ," says Oliver Rosenbauer, a spokesman for the WHO's polio eradication initiative in Geneva. E fforts to contain the Cameroon outbreak, he says, have fallen flat.
Controlling the disease in Equatorial Guinea will also be challenging. One of the current polio cases is in the capital, Malabo, located on an island off the country's Atlantic coast. The other is more than 100 miles away on the mainland, adjacent to Cameroon.
The disease could spread even further, to the troubled Central African Republic. The country has been rocked by violent clashes between Christians and Muslims. And hundreds of thousands of people have been displaced from their homes. Polio thrives in areas with this type of social unrest.
Last week the United Nations approved sending 12,000
peacekeepers to the country to try to stem violence.
Nigeria remains the only country in Africa where new cases of polio have been reported continuously over the past century. It's also
the primary reservoir of the virus on the continent.
But this year Nigeria appears to be making progress against polio, Rosenbauer says. Only one case has been recorded in 2014 in the country. And the strain of the virus flourishing in Cameroon came by way of Chad rather than Nigeria.
"We are actually concerned that [the] virus is going to spread from Cameroon back into Nigeria, and that you're going to see an outbreak in a polio-free area of Nigeria," Rosenbauer says.
When polio is on the move in Africa, the toll is tragic. A deadly outbreak that hit the region in late 2010 sickened more than 500 people in Congo Brazzaville and Gabon. Many of the victims were adults, and 190 of them died.
KELLY MCEVERS, HOST:
There are new fears that polio is on the move in Central Africa. Polio cases in Cameroon have spread to the tiny country of Equatorial Guinea and there is concern it could spread even further in the region. Significant progress against polio has been made in most parts of the world this year. But global efforts to eradicate the virus could face a setback if polio gets a foothold in Central Africa. Here's NPR's Jason Beaubien.
JASON BEAUBIEN, BYLINE: The problem with polio cropping up in Equatorial Guinea is that polio vaccination rates for kids in that country are the lowest in the world. Despite being Africa's third largest oil producer, Equatorial Guinea only manages to vaccinate 39 percent of its children against polio. The World Health Organization pushes countries to keep polio vaccination rates above 80 percent and most nations are in the high 90s.
One of the cases in Equatorial Guinea is on the mainland next door in Cameroon and the other is in the capital of Malabo, which is on an island off the coast.
OLIVER ROSENBAUER: This is actually an outbreak from neighboring Cameroon which has been ongoing and has spread, and so for sure it's a concern.
BEAUBIEN: Oliver Rosenbauer with the WHO's polio eradication initiative in Geneva says that efforts to contain the Cameroon outbreak have fallen flat. Seven kids in Cameroon have been paralyzed by polio since October. The number of actual cases is just the tip of the iceberg in terms of how far the polio virus has spread.
Rosenbauer says the Cameroon outbreak is expanding and this could have grave consequences for other countries in the region.
ROSENBAUER: Notably Central African Republic right next door to Cameroon. There's a large influx of vulnerable population movements, refugees. So the risk is very, very high that this outbreak is going to spread even further. It's absolutely critical that the transmission of the virus in Cameroon is stopped as quickly as possible.
BEAUBIEN: The Central African Republic also had terribly low child vaccination rates even before ethnic violence erupted there recently. Last week the United Nations approved sending 12,000 peacekeepers to the country to try to stem violence between Christians and Muslims. Unfortunately this is exactly the type of social unrest in which polio thrives.
Nigeria remains the only country in Africa where polio transmission has never been fully stopped, and it's the primary source of the virus on the continent. But Rosenbauer says Nigeria this year appears to be making significant progress against the disease. Only one case has been recorded in 2014 in the country, and even the strain of the virus that's flourishing in Cameroon right now came by way of Chad rather than Nigeria.
ROSENBAUER: We're actually concerned that virus is going to spread from Cameroon back in to Nigeria and that you're going to see an outbreak in a polio free area of Nigeria due to an importation from Cameroon. That's our concern at the moment.
BEAUBIEN: A deadly polio outbreak that hit the region late in 2010 sickened more than 500 people in Congo, Brazzaville and Gabon. Many of the victims were adults, and 190 of them died. Jason Beaubien, NPR News. Transcript provided by NPR, Copyright NPR.