Re: Pakistan: 2011 Polio cases
Source:
http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=68605&Cat=6
Islamabad
Two more polio cases take explosive outbreak to 89
Shahina Maqbool
Tuesday, September 20, 2011
With confirmation of another two polio cases from Balochistan here on Monday, the explosive outbreak of the crippling disease is continuing in the Quetta block, which constitutes a major threat to other areas within the province as well as the country at large.
The Prime Minister s Monitoring and Coordination Cell for Polio Control has advised the health secretary of Balochistan to immediately conduct mop-up activities in and around areas where the new cases have been reported so that other children in the vicinity are protected and further spread of the infection can be brought under control.
The latest cases, which are from Pishin and Loralai districts, have taken the total number of polio cases countrywide in 2011 so far to 89 (88 type-1 cases and 1 type-3 case). Loralai is a newly-infected district.
According to details, Yasin, an 18-month-old male child residing in Union Council (UC) Karbala of tehsil Pishin, had onset of paralysis on August 29, 2011. As per recall of the parents, the child has not received any dose of oral polio vaccine (OPV) due to refusal on part of the parents.
This is the ninth polio case from district Pishin this year and the third from UC Karbala. In fact, all the 12 polio cases in district Pishin during the last three years were reported from tehsil Pishin. It is reported that the three cases in UC Karbala belong to an area which has a significant number of families refusing to polio vaccination during the Supplementary Immunisation Activities (SIAs).
Moreover, the quality of vaccination campaigns in district Pishin has been a major concern. Pishin could not achieve 95% finger marking coverage in 5 of the 7 SIAs conducted in 2011. UC Karbala could not achieve 95% finger marking coverage in 2 campaigns. According to experts, high proportion of UCs below 90% finger marking coverage during most of the campaigns indicates performance gaps at the sub-district level.
Acute Flaccid Paralysis (AFP) surveillance data for 2011 shows that none of the 13 non-polio AFP cases aged 6-23 months received three routine OPV doses (based on parents recall), indicating gaps in the routine immunisation.
The latest case from Loralai is Shahzad Khan, a 12-month-old male child who had onset of paralysis on September 5, 2011. The child resides in Killi Ghasiabad, UC Dukki Saddar, in tehsil Dukki. As per recall of the parents, the child had not received any OPV dose due to parental refusal. This is the first polio case reported from district Loralai after about three years; the last reported polio case had onset of paralysis in July 2008.
The district could not achieve the target of 95% finger-marking coverage in any of the 5 SIAs conducted in 2011.
Since Loralai is situated outside the persistent transmission zones, an aggressive case response vaccination should be done followed by another round as per SIAD strategy and recommendations of the TAG for Polio Eradication in Pakistan and Afghanistan, the national coordinator of the PM s Cell Dr. Altaf Bosan recommended. He also stressed the need for greater focus on high-risk populations including migrant populations during the vaccination activities (both routine and SIAs).
With respect to the case from Pishin, Dr. Bosan recommended close follow-up for adequate implementation of micro-plans developed for high-risk UCs of Quetta block in order to ensure maximum vaccination coverage during the upcoming vaccination campaigns. The recent pledge by the parliamentarians of Pishin (and Killa Abdullah) to provide utmost support to SIAs must be followed-up closely to ensure its translation into action at the UC level, Dr. Bosan proposed. He also underscored the need for SIADS campaigns in the Quetta block (Quetta, Pishin Killa Abdullah) after the ongoing September vaccination round to rapidly build immunity in the region.
An analysis of data on confirmed polio cases from 2001 to 2011 shows Pakistan at its best in the year 2005, when the number of cases was restricted to 28 only. The year 2004 was also enviable for the fact that the number of cases declined from 103 in 2003 to 53 in 2004. Polio remained significantly under control during 2006 and 2007 as well, with 40 and 32 cases, respectively being confirmed during these two years. The situation got out of hand in 2008, when the number of cases jumped from 32 in 2007 to 117 in 2008, followed by 89 cases in 2009 and 144 cases in 2010. The country has thus far reported 89 cases in 2011, and the number is persistently increasing with every passing day now. Pakistan now runs the risk of becoming the last remaining reservoir of poliovirus transmission in the world, and thereby poses a threat to children worldwide.
