Polio, the destructive virus driven to the brink of extinction, could return to Europe. The disease’s re-appearance in Syria last month after a fourteen year absence raises the risk that the virus will travel with unsuspecting refugees fleeing the country and will return to areas, including Europe, that have been polio-free for decades, according to a letter published in the famous Lancet medical journal today. Syrian war refugees have begun arriving in Western Europe, including Sweden and Germany. Syria is not the only area where the disease, formerly known as poliomyelitis, is making a return. It has also resurfaced in the horn of Africa, Israel and Egypt.

So far this year, 322 cases have been reported worldwide, up from last year’s record low of 223. The virus, which is spread through feces, attacks the nervous system and can cause paralysis within hours, and death in as many of 10 percent of its victims and has no cure. Polio, which has paralyzed generations around the globe and crippled former U.S. president Franklin D. Roosevelt have dropped 99 percent since 1998, thanks to a worldwide vaccination campaign financed by Bill and Melinda Gates.

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More than $10 billion has been invested to wipe out the disease, according to the Global Polio Eradication Initiative, which is a partnership between the WHO, Rotary International, U.S. Centers for Disease Control and Prevention and the United Nations Children’s Fund. The Bill & Melinda Gates Foundation has donated or pledged nearly $2 billion, making it the biggest donor after the United States government. These efforts have helped to stop transmission in all but three countries, those being Nigeria, Afghanistan and Pakistan.

Around 180 cases have been reported in Somalia this year, and more in Kenya, Ethiopia and South Sudan. The virus was also found in sewage and feces samples in Israel, which represents a threat for Europe, said the European Center for Disease Prevention and Control in September. No actual polio cases have been reported in Israel. Two vaccines are used to prevent the disease from affecting children: an oral injection that contains the live pathogen and a shot that delivers an inactive version of the virus.

Read more about this threat at NBC News.

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