Tuesday, July 1, 2008


Polio situation in the country is depressing. 275 polio cases have been reported in the country till the month of June which is also the highest in the world. Polio cases have not only been reported in remote areas but also in metro cities like Delhi.

Confirmed Wild Polio Cases, India, 2008

Total P1 cases-5
Total P3 cases-270
Total P1 + P3 Cases
Total polio cases-275
Total districts infected-60
Date and Location of the most recent case
P1 case-20th Feb 2008: Orissa
P3 case-1st June 2008: Bihar

Much has been said and done about the polio situation in the country but the results are not what the authorities aimed to achieve. Polio free India will remain a dream if serious introspection is not done. India is among the three countries including Pakistan and Nigeria where polio still exists and has also reported the highest number of polio cases in 2007 and 2008 till now.

India had launched the most expensive immunization program. First deadline to eradicate the crippling disease was the year 2000, extended to 2005, latest being 2008. India uses OPV (Oral Polio Vaccine) as its immunization therapy. But inspite of administering seven doses of OPV children are contracting polio. These lead to questions like “Is our immunization program not effective enough? What are the reasons behind failure of the immunization program?” There is also no agreement among the pediatricians on the number of doses required to prevent polio.

The other developed countries have achieved zero polio status. These countries include USA. OPV was found to be made of live virus, carrying with itself the danger that the attenuated form can revert to its virulent form and result in paralysis which can cripple the affected individual for life, thus the more the OPV drops, the greater the risk of VAPP (Vaccine-Associated Paralytic Polio). Hence these countries adopted IPV (Injectible Polio Vaccine) which is another available therapy option and has helped them eradicate polio.

IPV induces high levels of pharyngeal immunity and can induce total protection in places where oral-oral transmission predominates
IPV does not carry the risk of VAPP as it has inactivated polio virus
IPV triggers an excellent long lasting immune response to all the three types of polio virus strains that can stay effective even without a proper cold storage facility for a long time
IPV efficacy rate is higher than OPV
Countries such as Britain, the United States, France and Germany who have achieved zero polio status rely solely on IPV for polio immunization

India Expert Advisory Group has made a recommendation, proposed by and fully justified by IAP (Indian Academy of Pediatrics), to introduce IPV in western UP to begin with. IAP feels that use of IPV as an additional tool along with OPV needs urgent consideration..

An amount of Rs.1,042 crore has been allocated in 2008-2009 for the drive to eradicate polio with a revised strategy and a focus on the high risk districts in Uttar Pradesh and Bihar. Mere formulation of policies and strategies is not enough until they are implemented in efficient and effective ways .The State along with the Central Government needs to think of other possible measures/options available, one of which may be making use of IPV (Inactivated Polio Vaccine) which is strongly recommended by health experts as well as redefine its strategies as the current one seems to have reached a roadblock. This is a matter of utmost concern as the children are the future of the nation and the well being of nation’s future is in our hands.

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