WHO says polio virus detected in four countries was from western Uttar Pradesh, India
DARSHAN DESAI
Posted online: Thursday, September 14, 2006 at 0000 hrs IST
LUCKNOW, SEPTEMBER 13
The news is not just that Uttar Pradesh accounts for as many as 255 polio cases out of the 283 reported across the country this year. The news is that Moradabad and five neighbouring districts in western UP, which account for 70 per cent of India?s cases, have emerged as the exporter of the polio virus, according to the World Health Organisation (WHO).
?In 2006, western UP is the only area in the world with a geographically expanding polio epidemic that is actively exporting polio to previously polio-free countries, like Namibia, Democratic Republic of Congo, Bangladesh and Nepal. The virus originating from here has also been detected in polio-free area like Madhya Pradesh in India,? states the WHO website relating to polio eradication.
What WHO indicates is that the virus strain found in those countries and in Madhya Pradesh has a lineage linked to that found in western Uttar Pradesh. Nine countries? Somalia, Yemen, Indonesia, Bangladesh, Ethiopia, Namibia, Niger, Nepal, and Democratic Republic of Congo ? have reported polio cases because of ?importations? this year, and four say they have got it from India, more precisely western Uttar Pradesh. The cases in Congo and Namibia have been genetically inked to a virus strain originating from Angola, which in turn had got it from western Uttar Pradesh in 2005.
India is among the four countries in the world identified by WHO as polio-endemic. The others are Pakistan, Afghanistan, and Nigeria. And Moradabad and adjoining regions stand out for the high incidence of cases, which took up by 29 from last year?s figure the number of cases reported from Uttar Pradesh.
The reasons for western Uttar Pradesh reporting a high incidence of polio are several, though the most immediate ones are a slack government health machinery, which simply missed covering many children, as well as localized pressures from Muslim clergy spreading the canard among the most poor and illiterate that the polio drop aims to reduce the community?s fertility. Also, lack of sanitation, and contamination of piped water with water from leaking sewers. Polio virus is released from faeces of infected persons.
When contacted, Director General of Health B Nath agreed to all the reasons cited by WHO and UNICEF for the outbreak in Moradabad and neighbouring districts. ?If the number of missed houses is more, if the nutritional status of children is poor, if the sanitary conditions are poor, this was expected to happen,? she said. However, she denied any slackness in the vaccination campaign. ?There would not be more than one per cent slackness,? she said.
Dr Nimal Hettiaratchy, the UNICEF State Representative in UP, says during his visits to the region he found a general tendency of health department staff was to miss children in certain localities.
?This was either on the assumption that the immunisation efforts may be resisted or sheer fudging of figures to show more than the number of children covered,? he says.
A joint team of the WHO and UNICEF found during an evaluation study in April this year that the coverage deteriorated between late 2005 and early 2006, resulting in large number of children not receiving polio vaccine.
In Moradabad, the houses with missed children increased from eight per cent in January 2005 to nearly 12 per cent during rounds conducted in August, September, November, 2005 and January 2006.
Sources in WHO said it was further revealed during a sample check of 3,300 houses in Moradabad district in June 2006 that an additional 6.5 per cent children did not actually receive polio vaccine, though records said the children in the house had been vaccinated.
Random stool checks of children, too, showed 12 per cent testing positive for the vaccine in the first quarter of 2005, but this fell to four per cent for the corresponding period in 2006. This was clearly because fewer children had been vaccinated from late 2005 to early 2006.
Dr Hettiaratchy denies that Muslims as a community resisted polio immunisation and that it was a chief reason for the programme failing in western Uttar Pradesh ? he said the resistance was localised, in a few places.
The real reasons, he said, were pathetic sanitary conditions, contamination of piped water supply from leaking sewers, and so forth.
?Since the polio virus releases from the faeces of the infected person, open defecation and poor sanitation make the spread easier,? he says. Besides, he said lack of nutrition contributes to lowering immunity. Add to this the slackness of government vaccinators, ignorance of the people and misleading local leaders and the picture is complete.
DARSHAN DESAI
Posted online: Thursday, September 14, 2006 at 0000 hrs IST
LUCKNOW, SEPTEMBER 13
The news is not just that Uttar Pradesh accounts for as many as 255 polio cases out of the 283 reported across the country this year. The news is that Moradabad and five neighbouring districts in western UP, which account for 70 per cent of India?s cases, have emerged as the exporter of the polio virus, according to the World Health Organisation (WHO).
?In 2006, western UP is the only area in the world with a geographically expanding polio epidemic that is actively exporting polio to previously polio-free countries, like Namibia, Democratic Republic of Congo, Bangladesh and Nepal. The virus originating from here has also been detected in polio-free area like Madhya Pradesh in India,? states the WHO website relating to polio eradication.
What WHO indicates is that the virus strain found in those countries and in Madhya Pradesh has a lineage linked to that found in western Uttar Pradesh. Nine countries? Somalia, Yemen, Indonesia, Bangladesh, Ethiopia, Namibia, Niger, Nepal, and Democratic Republic of Congo ? have reported polio cases because of ?importations? this year, and four say they have got it from India, more precisely western Uttar Pradesh. The cases in Congo and Namibia have been genetically inked to a virus strain originating from Angola, which in turn had got it from western Uttar Pradesh in 2005.
India is among the four countries in the world identified by WHO as polio-endemic. The others are Pakistan, Afghanistan, and Nigeria. And Moradabad and adjoining regions stand out for the high incidence of cases, which took up by 29 from last year?s figure the number of cases reported from Uttar Pradesh.
The reasons for western Uttar Pradesh reporting a high incidence of polio are several, though the most immediate ones are a slack government health machinery, which simply missed covering many children, as well as localized pressures from Muslim clergy spreading the canard among the most poor and illiterate that the polio drop aims to reduce the community?s fertility. Also, lack of sanitation, and contamination of piped water with water from leaking sewers. Polio virus is released from faeces of infected persons.
When contacted, Director General of Health B Nath agreed to all the reasons cited by WHO and UNICEF for the outbreak in Moradabad and neighbouring districts. ?If the number of missed houses is more, if the nutritional status of children is poor, if the sanitary conditions are poor, this was expected to happen,? she said. However, she denied any slackness in the vaccination campaign. ?There would not be more than one per cent slackness,? she said.
Dr Nimal Hettiaratchy, the UNICEF State Representative in UP, says during his visits to the region he found a general tendency of health department staff was to miss children in certain localities.
?This was either on the assumption that the immunisation efforts may be resisted or sheer fudging of figures to show more than the number of children covered,? he says.
A joint team of the WHO and UNICEF found during an evaluation study in April this year that the coverage deteriorated between late 2005 and early 2006, resulting in large number of children not receiving polio vaccine.
In Moradabad, the houses with missed children increased from eight per cent in January 2005 to nearly 12 per cent during rounds conducted in August, September, November, 2005 and January 2006.
Sources in WHO said it was further revealed during a sample check of 3,300 houses in Moradabad district in June 2006 that an additional 6.5 per cent children did not actually receive polio vaccine, though records said the children in the house had been vaccinated.
Random stool checks of children, too, showed 12 per cent testing positive for the vaccine in the first quarter of 2005, but this fell to four per cent for the corresponding period in 2006. This was clearly because fewer children had been vaccinated from late 2005 to early 2006.
Dr Hettiaratchy denies that Muslims as a community resisted polio immunisation and that it was a chief reason for the programme failing in western Uttar Pradesh ? he said the resistance was localised, in a few places.
The real reasons, he said, were pathetic sanitary conditions, contamination of piped water supply from leaking sewers, and so forth.
?Since the polio virus releases from the faeces of the infected person, open defecation and poor sanitation make the spread easier,? he says. Besides, he said lack of nutrition contributes to lowering immunity. Add to this the slackness of government vaccinators, ignorance of the people and misleading local leaders and the picture is complete.
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