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LATEST NEWS UPDATES | ‘Endgame’ for polio by GS Mudur

‘Endgame’ for polio by GS Mudur

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published Published on Oct 23, 2011   modified Modified on Oct 23, 2011

India will henceforth treat even a single case of polio anywhere in the country as a public health emergency requiring unprecedented rapid response, the health ministry announced today after the longest polio-free period in the country.

Health authorities have so far detected a single patient with paralysis caused by the wild polio virus this year ---- from Howrah in Bengal on January 13 ----- according to the latest counts from the National Polio Surveillance Programme.

Uttar Pradesh has been free of polio since April 2010 and Bihar since September 2010, surveillance data suggest. Health officials view this as significant because the polio virus has persisted in these two states for years despite intense immunisation campaigns.

“This is clearly the endgame towards polio eradication,” said T. Jacob John, a senior virologist formerly with the Christian Medical College, Vellore, who has been tracking the nation’s war on polio for nearly four decades.

The health ministry said all states had been asked to draw up emergency preparedness and response plans to identify high-risk districts and launch local immunisation campaigns should any new case of polio emerge.

Children entering India from Pakistan are being vaccinated against polio, the health ministry said amid concerns that the wild polio virus may slip in from Pakistan, which has experienced a spurt in polio this year.

The ministry has also asked Indian states bordering China to step up their polio surveillance efforts after reports earlier this year that the virus from Pakistan had been detected in China.

India will have to be free of the wild polio virus for at least three years to claim eradication of the wild virus. Many public health experts believe this could happen in 2014 if there are no more new cases. India had hoped it could eradicate polio by 2005 or by 2010.

But John and other doctors involved in polio immunisation campaigns caution that India will eventually also need to develop strategies to eradicate even the polio resulting from the live virus in the oral polio vaccine used in the immunisation programme.

Although Howrah is the only site so far this year with a wild polio virus, surveillance figures show that at least five cases of vaccine-derived polio virus (VDPV) have been detected elsewhere in the country over the past 10 months.

The VDPVs are mutated versions of the live but weakened viruses used in the oral polio vaccine that have regained the ability to cause paralysis in humans. India had 42 cases of wild polio virus last year and five cases of VDPV. In 2009, India had 19 cases of VDPV.

Almost as significant as the absence of polio caused by the wild virus is the absence this year of the wild polio virus in sewage samples picked up from Mumbai, Delhi and Patna, John told The Telegraph.

Municipal sewage samples have traditionally reflected circulation of the virus, which can spread through contaminated water. “It’s encouraging that this year, these samples have remained free of the polio virus,” John said.

Although VDPV cases are rare and occur mainly in people with compromised immunity in areas where immunity against the polio virus is low, doctors have pointed out in the past that for vulnerable children, a wild virus as well as a VDPV can cause paralysis.

Sections of polio experts and paediatricians have for nearly half a decade urged the Indian health ministry to consider introducing an injectible, inactivated polio vaccine (IPV) that contains the killed virus and thus does not pose a risk of vaccine-derived polio.

The Union health ministry has so far not used IPV in its efforts to eradicate polio, although its own technical advisory body on polio had nearly five years ago recommended the introduction of IPV.


The Telegraph, 24 October, 2011, http://www.telegraphindia.com/1111024/jsp/frontpage/story_14660575.jsp


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