Polio Eradication

From The Hindu

  • In 1978, India launched the Expanded Programme on Immunisation (EPI) with BCG and DPT vaccines. The oral polio vaccine (OPV) was introduced the next year.
  • In 1988, India joined the global movement for polio eradication
  • Natural polioviruses are called ‘wild’ to distinguish them from vaccine polioviruses that constitute OPV.
  • By 1988, diphtheria, whooping cough and neonatal tetanus had declined to control levels (Control status required at least 95 per cent reduction) as a result of EPI’s efforts.
  • From 1994, India began nationwide OPV campaigns (called pulse immunisation) — two per year — to give additional doses to all under-five children irrespective of the number of doses already given. That resulted in effectively controlling polio by 2000.
  • One of the three types of polioviruses, wild type 2, was eradicated by 1999 w
  • The trivalent OPV (tOPV), containing types 1, 2 and 3, attacks all three viruses simultaneously. (blunt weapon)
  • Also developed OPV containing just type 1 to make the tool sharper against the type 1 wild virus. That is called ‘monovalent OPV’ (mOPV-1)
  • Eventually, India made ‘bivalent OPV’ (bOPV) with types 1 and 3.
  • We succeeded in stopping the transmission of type 3 in 2010 and type 1 in 2011.
  • The last child with wild virus polio was detected in Howrah, West Bengal, with the onset of paralysis on January 13, 2011.
  •  All hospitals and clinics that attend to sick children have been networked to report any illness that even remotely resembles polio.
  • Risks against importation: We cannot lower our guard and must continue pulse immunisations as though importation is imminent. India has five points of border-crossing with Pakistan: two in Jammu-Kashmir, two in Punjab, and one in Rajasthan. At every point, individuals are given one dose of tOPV when they enter India.
  • Was polio worth eradicating? Many have questioned the wisdom of spending such large amounts on one childhood disease. From a humanitarian viewpoint as well as human rights angle no child deserved to be paralysed by a preventable disease. We know the struggle we had to go through merely to keep polio under control. Eradication is the best form of control. Once affected with polio, many children are neglected, do not complete high school, take up simple jobs like bicycle repair, managing telephone booths, etc.
  • The National Polio Eradication Certification Committee will confirm eradication of wild viruses and review the secure containment of laboratory storage of wild poliovirus strains or specimens likely to contain them before certifying India free of wild viruses. The Committee will wait for three years from the last virus detection before certification procedures, expected after January 2014. Thereafter, India will use only bOPV; later that will also be withdrawn, globally, synchronously. These rules of polio eradication ‘end game’ have been drawn up by the World Health Organisation and were endorsed by the World Health Assembly in 2012.

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