The 2010 Tajikistan Poliomyelitis "epidemic" caused a media stir, as Tajikistan belongs to the European Region of the World Health Organisation (WHO), which – supposedly owing to vaccinations – has been free of Poliomyelitis for almost a decade. During the course of the year, 579 cases of acute flaccid paralysis (AFP) were reported, and in three-quarters of the cases the presence of the polio virus was confirmed.
WHO came to a disappointing conclusion when examining the vaccination history of the patients. Each of the eighty-seven patients with a traceable vaccination history had received oral polio vaccination previously (Sabin vaccine). Seventy-six, that is, 87.35% received three or more doses, and eleven (12.64%) received fewer than three doses. Considering that a large proportion of the patients were children under 5, and therefore there could not have been a long time before they received the last vaccination, this proportion is of concern.
Since they had undergone multiple immunisation, how could they become paralysed?

To this day it has not been proven indisputably that Poliomyelitis is a disease caused by a virus, and therefore it could be prevented by the use vaccination.
While the polio virus is easily spread, only 6% of those infected will become ill, and only 1% of those who become ill will be temporarily or permanently paralysed. In the meanwhile, there are several other diseases which produce identical symptoms and pathology to poliomyelitis, where the presence of the polio virus is unconfirmed. These diseases are called non-polio AFP, i.e. acute flaccid paralysis which is not caused by the polio virus.
Ralph R. Scobey, infantile paralysis researcher, has already pointed out in the 1950s that the cause behind all cases of AFP might actually be agricultural and industrial pollution, and any viral infections that might occur would be the consequences of this, as the virus would be attacking the already weakened tissues. His theory is supported by many experimental and everyday observations: certain pesticides and metals have long been known to cause paralysis. Furthermore, polio epidemics have only been known since the end of the 19th century, when the first persistent pesticides, such as the infamous DDT, appeared on the market. The fact that many patients' recovery was aided by heavy metal extracting agents also supports his theory.

A number of experiments have proven that certain metals - primarily lead, tin, arsenic, aluminium, and mercury - cause poliomyelitis-like symptoms when they are accumulated in the body. These symptoms include diarrhoea, ailment of the cerebrum, general muscle paralysis, but primarily paralysis of the legs, and respiratory paralysis.
Pesticides which inhibit the acetyl-cholinesterase enzyme are especially dangerous to human health.They cause the nerve cells to stop communicating with each other, neural coordination is damaged and the following symptoms occur: shaking, nausea, weakness, or even paralysis and death.
These toxins generically pose a higher risk to children because of their smaller body size, different metabolism, their fast growing, developing organs, and because of their rudimentary blood-brain barrier. This might explain why most victims of polio "epidemics" are children under 5.

In general, pesticides are used in an irresponsible way in Tajikistan. The result of the strained pace of cotton production in the Soviet era is that a high concentration of toxins can still be detected in the soil to this day. As a consequence of current illegal trade in these chemicals, the environment continues to be polluted with pesticides rated "highly dangerous" by the WHO.
If we take a look at the epidemiological map, it can be clearly seen that the highest number of paralyses occurred around the town of Kurganteppa. Kurganteppa is the centre of Tajik cotton production. It lies in the Vakhsh Valley, where the highest pesticide concentration was measured in the soil in the whole country: 48 kilograms per hectare. Furthermore, the largest pesticide dump in Tajikistan is located near the town. In the Soviet era, around 7500 tons of withdrawn or expired hazardous chemicals were buried here. This landfill is unmarked and unenclosed, it is washed by rain and windblown, which means that nothing stops the waste from polluting the soil and the air. And the locals are free to enter and dig up the containers for their own use, or in order to sell them.
The maintenance of pesticide storage facilities is similarly haphazard. Many of these are dilapidated, and some of them are also used as residential buildings. Rainwater trickling from the direction of these facilities often kills cattle by poisoning them. Most of the paralysis cases that occurred in industrial areas took place in the areas around the Takob and Tursunzade metallurgical plants, and on the lower sections of the rivers which pass by them. In Takob, situated North of the capital, lead and zinc are regularly let into the Varzob River. The Tursunzade aluminium plant is perhaps the largest in the world and it pollutes its environment mostly with fluoride. (This does not cause paralysis.) However, it can be stated that the Tajik metal processing industry leaves their sludge untreated, in general, and stores it in reservoirs, not complying with international regulations. These reservoirs contain mercury, antimony, aluminium, and lead. They pose a danger to the purity of air, soil, underground waters and surface waters, especially in extreme weather conditions.
Another common problem is the storage of used or expired strip lights containing mercury, which are dumped in illegal sites or ordinary rubbish dumps in cities. The discarded mercury strip lights pose such a high risk that the Asian Development Bank lists them amongst the most dangerous toxic waste in Tajikistan.

The above detailed sources of danger pose a constant threat of chronic poisoning to the population of Tajikistan. However, they could not have caused the temporary or permanent paralysis of nearly 600 people by themselves in the space of a mere few months. That could only have been acute (one-off, high dose) poisoning.
The direct cause was most likely the series of heavy rainfall between April and June 2010, which led to mudslides, landslides, and floods in the country's South-West. This has been the worst disaster in the region for over a decade. At least 40 people lost their lives, the roads became impassable, bridges collapsed, water pipes were damaged, the food reserves and growing seeds perished, and about 5,000 acres of agricultural land was flooded. And the possible cause of the "epidemic": about 70 thousand people remained without safe drinking water.
The most detailed reports of the events came from the city of Kulob. The number of paralysis cases were not especially high here, but this region was the worst hit by the floods, and this is the poorest region of Tajikistan, and of all the post-Soviet states. Half a kilometre of water pipes were destroyed, which meant that the 100 thousand residents of the city remained without regular access to safe drinking water for over a month. Two and a half weeks after the disaster began, a humanitarian news website reports that the city of Kulob is on the verge of an epidemiological crisis. In the middle of June they report simultaneously about the repaired water pipes, and a spectacular drop in the number of AFP cases. In the critical period, the population was most likely forced to drink settled river water, which contained heavy metals and pesticides residues stirred up from the riverbed mud.
The connection between the rains and the disease can be clearly seen on the chart and the map. (pics. 2-3). The number of paralysis cases suddenly went up at the end of March, at the start of the heavy rainfalls. The polio cases peaked in the middle of May, and after the weather normalised at the end of May, the number of new cases of paralysis fell back to normal. According to the map, the centres of the epidemic were the more densely populated counties situated by the polluted rivers, which suffered in the floods.

• Figure 1.
• Figure 2.
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Processing the data from an April 2010 report clearly shows that a vast majority of cases happened along the Varzob and Kafirnigan rivers. These patients were registered to display the following symptoms: mainly diarrhoea and limb paralysis, fewer numbers of respiratory paralysis and facial nerve paralysis, or a combination of all of the above.
Takob lies at the upper section of the Varzob River. As we have seen, zinc and lead are regularly let into the river from the Takob metallurgy plant. We know that industrial reservoirs and rubbish dumps are unenclosed and uninsulated, so it is likely that during the heavy rainfalls these metals entered the river water in much higher quantities than usual, through the consumption of which they entered the systems of the local inhabitants.
The above listed symptoms seem to support this theory, as the consequences of lead poisoning are generally diarrhoea, and, in more severe case, ailment of the cerebrum (while it is not listed in the report, it is a typical AFP symptom), and limb paralysis, but there have been reports of facial nerve paralysis and respiratory paralysis, too. So all of the reported symptoms could suggest lead poisoning.
Interestingly, the map shows that in areas of flooding where pollution was not as significant, the number of "polio" cases was infinitesimal. This is most surprising in the Kulob area, as this was the region worst affected by the heavy rainfalls, it is a relatively densely populated area (Kulob is the fourth largest city in Tajikistan), and also the poorest. Despite all of the above, not only the April map, but the summary map also shows a relatively small number of cases.