Pulse Polio focuses on Bihar

New Delhi, July 16: Despite a high-profile campaign to eradicate the polio virus from India since 1995-96, a total of 66 confirmed cases were reported in 2005, mainly from western Uttar Pradesh and Eastern Bihar.

In spite of extensive coverage during National Immunisation Days (NIDs), the slippage of children below the age of five years from even the nationwide Pulse Polio Immunisation (PPI) Programme which had celebrity endorsement, political patronage and multi-media reach has forced the health authorities to plug the loopholes.

Based on the advice of World Health Organisation (WHO) and other experts, the Government of India has revised the strategy for use of monovalent Oral Polio Vaccine 1 (OPV 1) in the two states and in Delhi and Mumbai to tackle the threat posed by Type 1 Polio virus which is the predominant and main cause of poliomyelitis.

Monovalent OPV 1 vaccine was indigenously made available in a record time in these areas as the authorities gear up to eliminate the disease by this year-end, official sources here said.

Due to these lapses, India has missed the target to become polio-free by 2000-end under a global initiative which incidentally is the largest international disease control effort to be launched.

At present, polio is prevalent in just three other countries in the world namely Pakistan, Afghanistan and Nigeria. The disease has been eradicated in all the other countries through intensive immunisation programmes.

Even after 11 years of starting the pulse polio programme, the preventable disease that wastes away limbs has not been totally eradicated in the country.

Till February 28, 2006, 30 cases were detected from Bihar and 29 cases from Uttar Pradesh -- the geographical spread limited to only 39 districts mainly in western Uttar Pradesh and Eastern Bihar.

Of the three strains of polio virus, B1, B2 and B3, two strains have already been eliminated. During 2004 and 2005, Type 3 virus has been restrained and localised in four districts of Western Uttar Pradesh -- Moradabad, Rampur, Shajahanpur and Bareilly.

Since May 2005 immunisation rounds, efforts have been made to reach every single child below the age of five years during the pulse polio round held all over the country on one single day, apart from the strategy of vaccinating children at fixed booths and house-to-house visit. Efforts at vaccinating children in transit at railway stations, inside long distance trains, major bus stops, market places, religious congregations and major road crossings throughout the country have been intensified.

In all five million children in transit have been effectively administered polio drops from the May 2005 round.

In 2005, from 10 cases reported in January, there was a sharp drop to one case reported in March until September when the infection peaked with 14 cases.

In all, a total of 17 crore children are vaccinated during each NID round under the mommoth exercise undertaken in the country, the sources said.

Since the initiatives to eradicate polio from India started in 1995, significant success has been achieved in reducing the number of polio cases in the country. As against 1,600 cases in 2002, 134 cases were detected in 2004 -- a whopping 92 per cent decline in polio cases in just two years.

The geographical spread also reduced from 159 districts in 2002 to 87 in 2003. By 2004, the virus was restricted to only 43 districts in western UP and Eastern Bihar.

In pursuance of the WHO Resolution of 1988, in addition to administration of routine OPV through the Universal Immunisation Programme, the Pulse Polio Immunisation (PPI) Programme was launched in 1995-96 to cover all children below the age of 3 years. From 1996-97 the target age group was increased to all children under the age of 5 years to accelerate the pace of polio eradication.

The PPI Programme till 1998-99 consisted of vaccination of children at fixed booths on two National Immunisation Days (NID), separated by six weeks, during the winter season. But in spite of extensive coverage during the NIDs, 5 to 6 per cent slippages occurred even in the PPI Programme.

To rectify this, in 1999-2000, in addition to booth immunisation, a house-to-house search of missed children in the critical age group and vaccinating them was undertaken as a follow up of each NID. Under this, 2.3 crore children who had never been vaccinated before were identified and vaccinated.

UNI