Smitha Mundasad
Health reporter

Most people who get polio do not have any symptoms.

But some people feel like they have the flu, with a high temperature, extreme tiredness, headaches, vomiting, a stiff neck and muscle pain. These usually clear up in about 10 days.

According to the World Health Organization, around one in 200 infections can lead to much more serious problems.

The virus can invade the brain and nervous system, resulting in paralysis within in a matter of hours. It usually affects the legs and can be irreversible.

Some 5 to 10% of people who are paralysed will die because the virus can immobilise the muscles we use to breathe.

There is no cure for polio but there are supportive treatments, including help with walking and breathing and regular stretches. People who recover can sometimes develop symptoms again.

The polio vaccination campaign in Gaza today has gotten off to a positive start, Unicef says, but the agency warns it would be a "catastrophe" if they fail to meet their vaccination target.

Speaking to BBC News earlier, Salim Oweis confirms that the inoculations in Gaza - the only way to prevent polio - is "going well".

He notes that to be successful at fending off the "highly contagious" and "fast spreading" disease, healthcare workers must vaccinate 90% of the population in Gaza that is under the age of 10.

With about 2,700 healthcare workers on the ground - either based at centres or at one of over 300 mobile teams - Oweis says he is "very hopeful" that they will meet that target.

A second dose of the vaccine is needed in about four weeks' time, Oweis says, adding he hopes further negotiations can be made to ensure another rollout can happen in time.

There are three strains of wild poliovirus that cause polio (poliomyelitis) – a disease that can have mild symptoms or lead to paralysis or death.

Since 1988, after the World Health Assembly adopted a resolution for the worldwide eradication of polio, wild poliovirus cases have fallen by more than 99%.

Wild poliovirus type 2 was eradicated in 1999 and type 3 in 2020, according to the World Health Organization (WHO).

The last strain – wild poliovirus type 1 – remains active in only two countries: Pakistan and Afghanistan.

In Gaza, where polio has not been detected in more than 25 years, a strain was recently detected in a 10-month-old child who became paralysed in the lower part of one leg.

According to samples collected from the territory’s wastewater, it was detected as an early variant type 2 poliovirus (cVDPV), the Global Eradication Initiative reported, external in June. This variant is itself a mutated virus from an oral polio vaccine.

The WHO says there is a high risk for the spread of this strain within Gaza and internationally, citing the ongoing pressures on public health services in the region and their inability to contain it without international assistance.

Alice Cuddy
Reporting from Israel

Image source, Reuters

Back in Deir al-Balah, a journalist at Al-Aqsa hospital tells me there has been a "huge amount of people" bringing their children in for vaccinations today.

She says she has seen a constant stream of mothers arriving with babies and children for the oral vaccine since the morning.

"Everyone cares about vaccinating their children in these poor health conditions," she says.

"In the cramped, unsanitary conditions we’re living in, it’s easy for everything to spread."

Gaza registered its first case of polio in 25 years last month.

As our health reporter Smitha Mundasad explained in an earlier post, polio is a serious and very infectious disease that mostly affects children under the age of five.

It is caused by a virus that can spread very easily through contact with an infected person’s faeces or less commonly through contaminated food or water.

The World Health Organization says 90% of children under 10 in Gaza must be immunised for the campaign to be effective.

Almost a year after the war in Gaza began, life for many remains bleak.

Since Hamas attacked Israel on 7 October, about 1.9 million people - or nine out of ten - have been forced to flee their homes, according to latest UN figures on internally displaced people in Gaza, external.

That’s nearly the entire population, UN Secretary General Antonio Guterres said in a statement last month.

People face severe food shortages as the amount of humanitarian aid entering the territory is restricted by the ongoing conflict.

According to OCHA - the UN office for Humanitarian Affairs - an average of 69 humanitarian trucks entered the Gaza Strip per day between 1 to 25 August, well below the pre-crisis daily average of 500 trucks.

Today’s polio vaccine rollout comes amid warnings from health experts on the spread of open sewage and diseases across the territory.

A quarter of Gaza's population have already become ill because of waterborne diseases, according to Lama Abdul Samad, a water and sanitation expert at Oxfam.

Sanitation infrastructure has been so badly damaged that “people are basically living adjacent to puddles of sewage," she told BBC Arabic.

And earlier this month, UNRWA, the UN agency for Palestinian refugees, reported 40,000 cases of Hepatitis A – which can be transmitted via contaminated water - in Gaza since the war, compared to only 85 cases in the same period before.

Gaza's Hamas-run health ministry has just released the latest figures on the number of people killed and injured in the region since 7 October.

The ministry says 40,738 Palestinians have been killed and 94,154 wounded since the deadly Hamas attacks on southern Israel were carried out last year.

• Learn more about the war in Gaza here

Image source, EPA

Today marks the first day of a polio vaccination campaign across Gaza, which aims to vaccinate 640,000 Palestinian children against the disease.

• It comes amid a war that has destroyed the region's healthcare system - and caused massive damage to water and sanitation systems. Israel says Hamas uses hospitals for military purposes
• A "humanitarian pause" for three consecutive days was agreed to by Israel and Hamas for the vaccination rollout - lasting between 06:00 and 15:00 local time
• The campaign is being rolled out in three separate stages, across the central, southern and northern parts of the strip
• The first polio case in 25 years was reported in Gaza last month in a 10-month-old baby and according to the World Health Organization, the presence of paralysis indicates there could be hundreds more who have been infected but aren’t showing symptoms

Meanwhile, the Israel Defense Forces (IDF) says it recovered the bodies of six hostages held by Hamas in Gaza

• They've been named as Carmel Gat, Eden Yerushalmi, Hersh Goldberg-Polin, Alexander Lobanov, Almog Sarusi and Master Sgt Ori Danino

• The Hostages Families Forum, a group representing relatives of those held hostage in Gaza, has said their deaths were a "direct result of failing to sign a deal"
• Israeli Prime Minister Benjamin Netanyahu says "whoever murders hostages - does not want a deal" - whilst senior Hamas officials, external say Israel, in its refusal to sign a ceasefire agreement, was to blame for the deaths

Image source, Reuters

The UN hopes about 156,000 children in the "middle area" of Gaza - where the vaccine campaign began this morning - will get their first dose against the poliovirus over the next few days.

Speaking from Gaza, Louise Wateridge tells BBC News that the vaccine rollout is being carried out in three phases - the first in the central area of Gaza before moving to the south and then finally finishing in the north.

Each phase will last three days, with a fourth “catch-up” day on merit, she says.

“We are hopeful these humanitarian pauses will hold while we’re issuing this campaign," she says.

“There’s a lot of anxiety, there’s a lot of excitement," she says about the teams already in position at health centres and mobile medical checkpoints in the region.

“We’re hopeful that we will see some positive news coming from this vaccination campaign."

As a reminder, Israel and Hamas agreed to three "humanitarian pauses" to allow health workers to administer the polio vaccine after the first reported case of the disease was detected in Gaza in 25 years.

Yolande Knell
Middle East correspondent, in Jerusalem

Image source, Getty Images

This is an ambitious programme which relies on the humanitarian pauses in fighting holding.

Both Israel and Hamas have agreed to them.

“You cannot lead and implement a polio vaccination campaign in an active combat zone. It’s simply impossible,” says Unicef spokesperson, Jonathan Crickx.

He says families bringing children and healthcare workers must feel safe.

If all goes to plan, UN agencies and their local partners will have three sets of three days (with an extra day possible in each location) to vaccinate 640,000 children against polio.

To be effectively immunised, each child must also receive a second dose after four weeks.

A short timeframe is key to prevent the virus from mutating and becoming resistant to the vaccine and to halt transmission.

The World Health Organization says 90% of children under 10 must be immunised for the campaign to be effective.

There are many logistical obstacles: Gaza’s roads are largely destroyed, most of the population is displaced, making a door-to-door vaccination campaign unworkable, and hospitals and clinics have been badly damaged.

Asked about the chances of success for this effort, Dr Rik Peeperkorn, local WHO head, said: “It is feasible if all the pieces of the puzzle are in place.”

Alice Cuddy
Reporting from Israel

A mother in Deir al-Balah says she was initially reluctant to get her two-year-old son vaccinated today because she feared there may be complications, but was convinced by those close to her that it was a good idea.

“A lot of people advised me that I should get him vaccinated because of the current situation, so I took him today,” Baraa Abu Hussein says over the phone.

She says there were lots of other families there but the process was quick.

“I feel relieved that I did it,” she says.

We've recently received an update from the United Nations - one of the organisations that's been tasked with overseeing today's massive vaccine campaign - which has called today's efforts a "race against time".

Philippe Lazzarini, the Commissioner General of UNRWA, the UN agency for Palestine refugees, has said in order to reach the goal of vaccinating over 600,000 children across the Gaza Strip, "parties in the conflict must respect the temporary area pauses".

"For the sake of children across the region a lasting ceasefire is overdue," he adds.

The rollout relies on a series of localised pauses in fighting between Israeli forces and Hamas fighters, with the first window starting today between the hours of 06:00 and 15:00 local time.

Image source, Reuters

We've just received these pictures from central Gaza, where thousands of children are receiving doses of the polio vaccination today.

As we have reported, the vaccine rollout relies on a series of localised pauses in fighting between Israeli forces and Hamas fighters.

Around 1.26m doses of the novel oral polio vaccine type 2 (nOPV2) are already in Gaza, with an additional 400,000 doses set to arrive soon.

They are being administered orally to children, and health workers have told us that queues are continuing to form outside centres where the vaccine is available.

Image source, EPA

We're now hearing from Prime Minister Benjamin Netanyahu, hours after it was reported that Israeli forces have recovered the bodies of six hostages held by Hamas in the Gaza Strip.

The prime minister says Israel will not "rest" until it catches those responsible for killing the six hostages.

Military spokesperson Rear Admiral Daniel Hagari told reporters in a briefing earlier that the hostages died "a short time before we reached them", according to an "initial estimation".

Senior Hamas official Izzat El-Reshiq claims that Israel, in its refusal to sign a ceasefire deal, was responsible for the deaths, Reuters news agency reports.

In a message to Hamas, the prime minister adds "whoever murders hostages - does not want a deal".

Humanitarian pause an important milestone - but not a full ceasefirepublished at 10:07 British Summer Time 1 September

10:07 BST 1 September

Jon Donnison
Reporting from Jerusalem

The area-specific pause in fighting in central Gaza to allow a mass polio vaccination programme to begin is significant. It is the first serious break in hostilities since last year.

However, both Israel and Hamas have stressed it is not the comprehensive ceasefire and hostage release deal that diplomats have been pushing for for months.

An agreement has been made to pause the fighting for three days in central Gaza between 06:00 and 15:00 local time.

After three days, the much needed vaccination roll out will move to a different part of Gaza with a pause in fighting there.

While this is far from a full ceasefire for Gaza, optimists say it could act as a confidence measure towards a more comprehensive deal between Israel and Hamas. But the optimists are few and far between.

Alice Cuddy
Reporting from Israel

Image source, Reuters

A nurse in central Gaza who is assisting with the polio vaccination campaign there says large crowds have been gathering since early this morning with their children.

At the clinic she is working out of in Deir al-Balah, the nurse estimates that they have administered about 1,000 vaccines so far today.

“It’s very crowded here. It’s very good,” she tells me over the phone in a quick call before returning to her work.

Children under the age of 10 are receiving two oral doses of the polio vaccination in this first round before they need a repeat round in four weeks’ time, UN officials have said.

Smitha Mundasad
Health reporter

There are two main types of vaccine.

One comes as drops which are swallowed. It is effective and easy to administer and is the kind being used in Gaza in this recent vaccine campaign. This version contains a live but weakened form of the polio virus.

This replicates in the gut for a short time and activates the immune system so the body is ready to fight off polio if it encounters it again.

The other main type is the injected vaccine that contains inactivated polio. This type has been offered in the US and UK for the last two decades.

Polio vaccines need to be given multiple times to protect a child for life.

In the UK, the National Health Service, external offers five doses from the ages of eight weeks to 14 years as part of routine childhood jabs.

The chance of getting ill from polio is higher if you are not fully vaccinated. Different forms of the vaccine are used in different parts of the world depending on the infrastructure available and resources.

Image source, afp

Here are some more details on how this morning's massive vaccine campaign - which health officials in Gaza say is off to a positive start - is being organised.

Around 1.26m doses of the novel oral polio vaccine type 2 (nOPV2) are already in Gaza, with an additional 400,000 doses set to arrive soon.

UN staff and other local health workers are administering the vaccines, which the Reuters news agency reports will take place at medical centres and via mobile teams.

An agreed temporary humanitarian pause in fighting (between the hours of 06:00 and 15:00 local time) is enabling the rollout to take place.

For the next few days, vaccines will be administered in the Deir Al-Balah region - one of two regions where wastewater tests taken in June showed the disease was present.

This will be the first of three, three-day campaigns – one for the centre, south and north of the Gaza Strip.

An agreement is in place for an additional fourth day of vaccination and humanitarian pause if needed.

Alice Cuddy
Reporting from Israel

Image source, Reuters

A senior health official in Gaza says the polio vaccination rollout has got off to a “very positive” start.

Dr Moussa Abed, director of primary health care at Gaza’s Hamas-run health ministry, says that “a lot of people are queuing at several vaccination points and there are crowds forming”.

“Nobody is leaving until their child gets the vaccination - this is a very positive thing,” he tells us.

Dr Abed says he hopes the vaccination drive “will reach as many as possible today”.

He adds that Israel has been honouring the "humanitarian pause" to allow vaccines to be administered in central Gaza.

“We hope it will continue like this,” he says.

The polio vaccine is being rolled out in three separate stages, across the central, southern and northern parts of the strip.

During each stage, fighting will pause for three consecutive days between 06:00 and 15:00 local time.

Turning our attention back to the polio vaccine rollout, the Palestinian health ministry in Gaza has just released new pictures from the central governorate.

Thousands of Palestinian children have begun queueing to get the vaccine this morning, in a rollout that relies on a series of localised pauses in fighting between Israeli forces and Hamas fighters.

Image source, Palestinian Ministry of Health in Gaza

Image source, Palestinian Ministry of Health in Gaza

Image source, Palestinian Ministry of Health in Gaza

Image source, Reuters

Three Israeli police officers - two men and one woman - have been killed after their vehicle was shot at near the city of Hebron in the occupied West Bank, Israeli authorities say.

Speaking at the site of the shooting, Israeli police commissioner Daniel Levy says the three officers had been serving in the Judea and Samaria district, which is the biblical term that Israel uses to refer to the West Bank.

Two of the officers were declared dead at the scene near the Tarkumiya crossing. A third officer was taken to hospital by helicopter but later died.

Parts of the West Bank - which has been under Israeli occupation since the 1967 Middle East war - have been targeted in a wide, coordinated Israeli "military operation" this week, leading to calls for de-escalation from the United Nations.