Sunday, January 27, 2013

WHO Says Pakistan On Track to Be Polio Free in 2013

In spite of setbacks from the US CIA's fake vaccination scheme in 2011 and the killing of polio workers by the Taliban in 2012, the WHO says Pakistan is on track to be declared polio free in April this year.

“We believe that Pakistan is on the right track to become free of poliovirus a  type P3, as the last P3 case was reported in the Bara Tehsil in Khyber Agency in the second week of April 2012, whereas all recent sewage samples show no active transmission of the P3 strain across the country,” Dr Elias Durry, the head of the Polio Eradication Initiative at WHO Pakistan told Dawn newspaper.  Type 1 and type 2 strain of the poliovirus have already been eradicated in Pakistan.

Until 1988, the disease was endemic to 125 countries, paralyzing or killing 350,000 people each year--mostly children, according to Time magazine.  Now it remain in only three countries: Afghanistan, Nigeria and Pakistan. There were 57 polio cases in  Pakistan in 2012, significantly down from 198 in 2011. The last reported case of polio in Pakistan was in April, 2012. Pakistan will be declared free of polio by the WHO if there are no cases reported by April, 2013.
Here's an excerpt of a recent story in Time magazine explaining the polio vaccination campaign in Pakistan:

Pakistan is putting institutional power behind the sentimental appeals. After the December shootings, the government temporarily suspended the inoculation program, but Prime Minister Raja Pervez Ashraf quickly issued a statement confirming the country's commitment to the campaign. He called for an inquiry into the attacks, promised the safety of polio workers and pledged to proceed with plans to deploy 250,000 health workers to vaccinate 34 million children in 2013. Polio teams will continue to work at toll plazas, boarding buses and looking for children who don't have blue ink staining a finger--a mark applied by field workers after a vaccine has been administered. When they find an unmarked child, they vaccinate on the spot.  Appeals to religion and reason are being deployed as well. Health workers in tribal areas cite Koran verses that encourage the care of children and reach out to local religious leaders for support.

WHO's  Pakistan representative Dr. Durry said last year Balochistan cut the number of polio cases by 95 per cent, Sindh by 88 per cent, Punjab by 78 per cent and the Federally Administered Tribal Areas (FATA) by 66 per cent. “The most promising sign for Pakistan during the last year was a massive decrease in the number of polio cases during the high transmission season,” he said. Dr. Durry explained that all sewage samples collected from cities of Punjab in recent weeks were found negative. “Most samples collected from Peshawar, Gadap Town in Karachi and Hyderabad produced positive results in the past, but they showed negative results now,” he added.

Frontline health workers in Pakistan are in the midst of pulling off a major success under very adverse circumstances. They are taking great risks for a worthy cause and deserve the nation's gratitude for their exemplary commitment.

Related Links:

Haq's Musings

Polio Workers Under Attack in Pakistan

Pakistan's Lady Health Workers Best in the World 

American CIA Sponsored Fake Vaccination Campaign

Violence Against Social  Change in Pakistan

Silent Social Revolution in Pakistan

The Eclipse of Feudalism in Pakistan

Social and Structural Transformations in Pakistan

Malala Moment: Profiles in Courage-Not!

Urbanization in Pakistan Highest in South Asia

Rising Economic Mobility in Pakistan

Upwardly Mobile Pakistan


Indian said...

The article mentions just type 3 of the Polio virus. What about the type 1 virus?

From India's experience, the type 1 virus was the last one eradicated.

We are very close to success and I wish Pakistan all the best in eradicating this scourge.

Riaz Haq said...

Indian: "What about the type 1 virus?"

Read the post carefully...particularly the following para:

“We believe that Pakistan is on the right track to become free of poliovirus a type P3, as the last P3 case was reported in the Bara Tehsil in Khyber Agency in the second week of April 2012, whereas all recent sewage samples show no active transmission of the P3 strain across the country,” Dr Elias Durry, the head of the Polio Eradication Initiative at WHO Pakistan told Dawn newspaper. Type 1 and type 2 strain of the poliovirus have already been eradicated in Pakistan.

Khalid said...

The polio vaccine has virtually eliminated the wild polio virus in large portions of the world, but at the same time that world health officials are declaring a victory on polio in India (and now Pakistan), they are calling a global meeting in Switzerland on the growing problem of vaccine-caused polio, which causes acute flaccid paralysis.
The oral polio vaccine, which is still used in many third-world countries (including Pakistan and Saudi Arabia), is made from a live polio virus, which carries a risk of causing polio. The virus in the vaccine can also mutate into a deadlier version, igniting new outbreaks. The US began using an inactivated polio vaccine in 1999, after parents of vaccine-damaged children were successful in lobbing for a change in strategy.
According to a 2010 article in the New England Journal of Medicine, outbreaks of vaccine-derived polioviruses (VDPVs) have been occurring at a rate of once or twice per year, since the year 2000.

Vaccine-Caused Polio on the Rise

Another fact that may surprise you is that the vaccine itself is the source of newer cases of this disease. At the same time that world health officials are declaring a victory on polio in India (and now Pakistan), they are calling a global meeting in Switzerland on the problem of vaccine-caused polio.

The problem is that while the oral vaccine has reined in wild polio, the wild virus is being replaced by vaccine-derived polio virus (VDPV), which causes acute flaccid paralysis. (Health officials don't call it polio because it isn't "wild.") The international meeting, organized by the World Health Organization (WHO) in collaboration with the US Centers for Disease Control and Prevention (CDC) and the Japanese Ministry of Health, is scheduled for May 30-June 1, 2012, in Geneva, Switzerland.

According to polioeradication.orgii:

"The meeting will review the available scientific information on VDPVs; discuss the scientific, policy and programmatic implications of continued VDPV emergence and transmission; and, help inform the 'roadmap for VDPV elimination' for the post-oral polio vaccine (OPV) era."

Let us not be fooled by WHO propaganda.

See more:

Anonymous said...

Thanks for the post Haq Bhai ...truly enlightening to see such posts of encouragement from a patriot such as urself !

Riaz Haq said...

Here's a News report on presence of P1 in Pakistan:


The World Health Organisation (WHO) has confirmed the presence of poliovirus P1 in the sewage of three Pakistani cities - Karachi, Hyderabad and Peshawar.

“Laboratory analysis has confirmed that P1 poliovirus was present in the sewage of Gadap Town in Karachi, Hyderabad and University Town in Peshawar,” a WHO official said on Monday.

The official said the samples were collected earlier this month.He added that the laboratory tests helped identify the areas where the virus was rampant, allowing the authorities to plan extensive polio vaccination campaigns there.

Free of P3

The WHO plans to declare Pakistan free of poliovirus P3.

The WHO official said the last case of a P3 poliovirus infection was reported in Pakistan on April 14 last year and if no new case was reported by April this year, the country would be declared free of the virus.He said the virus was also not found in the sewage samples collected from 31 cities of the country.

Year’s first drive

Following the murder of women vaccinators during last year’s polio vaccination campaign, this year’s first centralised polio vaccination campaign in 97 union councils of 14 towns of Karachi will commence on February 4.

Unlike the previous vaccination drives, the provincial health authorities have decided not to publicise the campaign for the security of vaccinators, many of whom have been reluctant to take part in administering polio drops to children.

During the campaign, around 1,067,744 children up to five years old will be administered polio vaccine drops, for which over 300 teams of vaccinators and volunteers will be constituted.

Officials of the Sindh Expanded Programme on Immunisation (EPI) are planning to mobilise over 6,000 vaccinators and volunteers to inoculate children against polio.

They said that majority of the female vaccinators, especially the lady health workers, have been reluctant to take part in the campaign.

Sindh EPI Manager Dr Mazhar Khamisani confirmed that a comprehensive polio vaccination campaign was being planned to start early next month, but due to security concerns, the campaign was not being publicised like in the past.

He said vaccination would be carried out in some parts of Karachi amid tight security, for which the city administration would be consulted and taken into confidence to ensure that all the targeted children are covered during the campaign.

He maintained that tight security would be provided to vaccinators and volunteers, especially female volunteers.

He said lady health workers were not reluctant to take part in the campaign, adding that only a few vaccinators were asking for heightened security in certain sensitive areas of the city.

Drive across Sindh

Khamisani said a polio vaccination campaign across Sindh had started on Monday, during which over 3.2 million children in 620 union councils of 22 districts of the province would be administered polio vaccine drops.

He maintained that over 25,000 volunteers and vaccinators were taking part in the form of 12,000 teams to vaccinate the children, adding that 764 fixed and 712 transit stations had also been established to vaccinate the maximum number of children.

Riaz Haq said...

Here's a Nation newspaper story on polio free Pakistan in 2013:

Though, the recently held first nationwide polio vaccination drive of the year missed some 1.83 million children, still the polio eradication partners after the sharp decline in the cases are quite optimistic and hoping that if the pace is continued the country may be declared polio free in December 2013.
Sharing the details of anti-polio vaccination campaign that ran from April 15 to 17, the representatives of polio eradication programme informed that there has been 71 per cent decrease in the cases and 70 per cent decline in environmental circulation of the virus as compared to previous years. "Besides, Pakistan has been declared P-3 poliovirus free country on April 18 and if the upcoming polio campaigns are conducted successfully and the missed areas are also covered, polio will soon be a thing of the past in the country," said Dr Elias Durry, Head of Polio Eradication, World Health Organisation (WHO).
He maintained that security concerns in Pakistan are putting in danger a remarkable record of success toward wiping out polio, as well as progress against the diseases. He said that some areas of Peshawar, including Larama and Shaheen towns, still reported active transmission of polio virus that was a the biggest threat against the efforts. He said that central Khyber Pakhtunkhawa, Fata, high-risk areas of Karachi and Quetta were core endemic areas. However, he said that the reported decline in the number of cases was a significant achievement.
Drawing a comparison with previous years, he said that in 2011 total number of infected districts were 60 and 196 children were infected with P-1, 2 and 3 virus. He said that in 2012 the number of infected districts came down to 28 and the number of children infected with P-1 and P-3 virus reduced to 55 and 2. But in 2013 so far 6 cases had been surfaced from Sindh, Punjab, and KPK.
During the campaign some 1,834, 625 children missed polio drops across the country owing to various reasons, including security threats. About 763,714 children were missed only in Khyber Pakhtunkhawa, 621,724 in Federally Administered Tribal Areas (Fata), including 260,000 from North and South Waziristan and 396, 925 children in Balochistan.
About 69,926 children could not be administered polio drops due to parental refusal during the campaign. As many as 33,693 children were missed only in KPK, 24,569 in Sindh and 9,442 in Balochistan.
Out of 34,452, 502 targeted children, 32,617,876 children, almost 95 per cent, were successfully immunised against polio by the 196,057 health workers in the country excluding North and South Waziristan.....

Riaz Haq said...

There are some who single out Pakistan's poor and barely literate Taliban and other Islamic radicals for deservedly harsh criticism for stopping vaccinations. However, there's a strong anti-vaccination movement in the United States as well. Doctors and celebrities are part of it. Earlier this year, researchers confirmed that a 2010 whooping cough outbreak in California, the nation's worst in over 50 years, was spread by children whose parents applied for non-medical exemptions to school vaccination requirements, many for religious reasons. The study showed that more cases of whooping cough occurred in the clusters of unvaccinated children than not, resulting in 9,120 instances of the disease and 10 deaths. In San Diego county alone, there were 5,100 exemptions and 980 whooping cough cases. In August, the Texas megachurch Eagle Mountain International Church made headlines after 21 members of its congregation contracted measles. Coincidently, the outbreak occurred during National Immunization Awareness Month.

Riaz Haq said...

Here's an AFP story on anti-polio campaign in Pakistan's North West:

Peshawar: Pakistani health teams will on Sunday launch a drive to vaccinate some 750,000 children in the troubled north-west, with thousands of police guarding against attacks by militants who claim the polio campaign is a front for spying.
The campaign in Peshawar district, which covers Peshawar city and dozens of towns and villages, is the ninth phase of a push to eradicate polio in Pakistan, which along with Nigeria and Afghanistan are the only countries where the disease remains endemic.
The World Health Organisation has warned that Peshawar is the world’s “largest reservoir” of polio.
“At least 750,000 children will be administered the vaccine in Peshawar district where 335,000 houses have been identified for the purpose,” campaign organiser Yunus Zaheer told AFP on Saturday.

The campaign, which started early February, will continue until the end of April.
Vaccinators go door-to-door every Sunday across Peshawar district to administer drops to children for various diseases including polio, tuberculosis, tetanus, pneumonia, whooping cough, measles and hepatitis.
Zaheer said more than 6,200 teams comprising 12,500 workers have been set up to administer the vaccines, adding 6,700 police officials would be deployed on security duty during the campaign.
He said the campaign is likely to be extended to other districts of Khyber Pakhtunkhwa province later.
A senior local administration official, Zaheer-ul-Islam, also confirmed the details of the campaign.
According to the WHO, Pakistan recorded 91 cases of polio last year, up from 58 in 2012.
Pakistan’s failure to defeat polio stands in stark contrast to its neighbour and great rival India, which recently celebrated the eradication of the disease three years after its last case.
Some 56 people including health workers and police officials providing security have been killed in militant attacks on polio vaccination teams in Pakistan since December 2012.
Militant groups such as the Pakistani Taliban oppose the immunisation drive, saying it is a cover for US spying.
Violence, and the threat of it, have badly hampered the campaign to stamp out polio in Pakistan.

Riaz Haq said...

PESHAWAR, Pakistan — Determined to curb Pakistan’s polio crisis, police officials in the northwestern province of Khyber-Pakhtunkhwa said Friday that they had issued hundreds of arrest warrants for parents for refusing to vaccinate their children.

“We had 13,000 to 16,000 refusal cases,” the deputy police commissioner for Peshawar, Riaz Khan Mahsud, said in an interview. “There is total determination on our part. We shall convince parents of the good of vaccinating their children, but if they refuse, we shall detain them. There is no leniency.”

The police in other districts of the province also reported issuing warrants, though no official total was released.

“The number keeps fluctuating,” said a senior government official, speaking on the condition of anonymity because he was not authorized to brief the news media. “We are applying different laws. You have to resort to coercive measures when persuasion fails.”

The official added: “The application of laws is working. Some parents readily agree to vaccinate children to avoid detention. Others take a few days behind the bars to see reason. We take an affidavit from them and let them go if they bring kids for vaccination.”

Last year, 306 new polio cases were reported in Pakistan, breaking the country’s previous record high of 199 new cases in 2000.

“This was due to complacency and a very bad security situation,” said Dr. Imtiaz Ali Shah, head of the government’s polio monitoring group in Khyber-Pakhtunkhwa.

Dr. Shah said the outbreak was particularly bad in two northwestern tribal regions, North and South Waziristan, remote areas that have been havens for militants from Al Qaeda and the Taliban and their allies, making them mostly inaccessible to vaccination teams. Then, in June, the military began an offensive in North Waziristan to root out the militants, sending hundreds of thousands of refugees into the rest of Pakistan and across the border into Afghanistan.

The refugees “took the virus with them everywhere they went — in K.P., Baluchistan and Sindh,” Dr. Shah added. “There was a Ping-Pong, cases popping up here, cases popping up there.”

Despite this, Dr. Shah said the military operation had given officials the best chance in years for polio teams to make progress in the tribal areas.

So far there have been 13 new cases in all of Pakistan this year, 11 of them from Khyber-Pakhtunkhwa or the tribal regions. “We have better access and better monitoring now,” Dr. Shah said. “The quality of the campaign has improved. I am confident the cases would come down to less than 100 this year.”

Riaz Haq said...

By tracing cellphones, #Pakistan makes inroads in war against #polio

The 85 percent decline in new cases this year is boosting confidence that Pakistani officials are on pace to stop the spread of the virus here, perhaps as early as next year. If Pakistan can achieve that goal, the world will take a major step toward becoming polio-free.

In late September, the World Health Organization declared that polio was no longer “endemic” in Nigeria, leaving only Pakistan and Afghanistan on the list of countries where the crippling virus continues to spread.

The revelation that the CIA had used a fake vaccination campaign to gain intelligence on the whereabouts of Osama bin Laden in 2011 had been a huge blow to Pakistan’s efforts against the disease, especially in areas where Islamist militant groups were strong.

But as the militants have loosened their grip on Pakistan’s northwestern tribal belt, health officials are now vaccinating hundreds of thousands of children for the first time.


That coordination began late last year as Pakistan’s army pressed into North Waziristan, which had been controlled by Taliban militants and was largely off-limits to vaccination teams.

When more than 100,000 families were evacuated from the area, they were stopped at roadside checkpoints and forced to take a drop of the polio vaccine.

Later, when the displaced residents were registered at refugee camps, they were given a surprising offer: free SIM cards for their phones.


Unbeknownst to North Waziristan residents, health officials used the SIM cards to track them as they resettled in other parts of the country. Their locations were mapped in new polio-eradication command centers. When clusters of residents from North Waziristan were identified on the map, teams of vaccinators were sent to those communities to, once again, administer the vaccine.

“We were able to trace them, map them and follow up with them,” said Safdar Rana, head of Pakistan’s Program on Immunization.

The controversial strategy was combined with outreach to religious leaders, the creation of community health centers and a renewed push to put women — not men — on the front lines of the country’s campaign to eradicate polio. But as with many other aspects of life here, the battle against polio is inextricably linked to efforts to overcome the threat posed by Islamist militancy.

Attacks on polio vaccination teams, provoked by the CIA ruse in 2011, resulted in the deaths of 74 people from 2012 to 2014, including 41 last year. So far this year, however, the number of deaths has dropped to 10, according to government figures.

Riaz Haq said...

Bill Gates predicts #polio eradication in #Pakistan by 2017 - Pakistan - Dunya News …

Bill Gates said Wednesday that "with any luck" polio will be eradicated by 2017 in the last two countries where it remains active, Pakistan and Afghanistan.

The Microsoft founder, who has donated billions to fight global diseases, was speaking in Doha at the official announcement of a $50 million donation from Qatar to "The Lives and Livelihood Fund".

This is a partnership fund between the Bill and Melinda Gates Foundation and the Islamic Development Bank (IDB), who together have been working to try to eradicate diseases, including polio, since 2012.

"There’s very few cases left, just two countries at this point, Pakistan and Afghanistan, and with any luck either this year or next year we will have the last cases of those," Gates said.

Pakistan has already made it an official target to rid the country of polio -- an infectious viral disease resulting in muscle damage -- in 2016 though there have already been eight recorded cases so far this year.

Although these are the two countries where the disease remains endemic, the Global Polio Eradication Initiative calculates eight countries are "vulnerable" to the virus, including Cameroon, South Sudan and Syria.

The billionaire, who is the world’s richest-man according to Forbes, is also well-known for his work in trying to combat malaria.

Earlier this year he announced the launch of a $4 billion fund to help eradicate malaria, which he called the "world’s biggest killer".

The donation he received in Doha will go towards a fund seeking to provide affordable financing for the 30 least-wealthy countries among IDB members.

It aims to ease the burden for some of the world’s poorest people through grants and Sharia-compliant loans.

Gates said the injection of cash from Qatar will enable the fund to begin its work.

"This is a great milestone for helping the poorest," he said. "Qatar has always been very generous as a donor."
In total, the fund is trying to raise $2.5 billion.

The money has been donated by Doha through the Qatar Development Fund (QDF), a public body which distributes foreign aid.

The head of the QDF, Khalifa bin Jassim Al-Kuwari, said Qatar was "very interested in poverty reduction".

"We aim at launching several projects in the health sector, which will improve the quality of life for millions of people across the Muslim world," he said.

IDB president Ahmad Mohamed Ali Al Madani said help would go to those in war-torn regions, where possible.

"We try as much as we can to help the countries that suffers from conflicts depending on conditions," he said.

"If the conditions allow us to work, the Bank works."

Riaz Haq said...

BBC News - #Pakistan could beat #polio in months, says WHO

Polio could be eradicated in Pakistan within months, health officials say, as a mass vaccination drive is launched.
A World Health Organisation spokesman told the BBC only a handful of cases have been reported this year in Pakistan and neighbouring Afghanistan.
The two countries are the last places where polio remains endemic.
It is hoped millions of children will be vaccinated over three days. Police escorts will guard against Islamist militants who oppose immunisations.
"The challenges we have are both logistics and security," the WHO's representative for Pakistan, Dr Michel Thieren, told the BBC.
He said about 70,000 medical staff aimed to immunise almost 10 million children in the drive, which is taking place in Khyber Pakhtunkhwa and semi-autonomous tribal areas in the north-west, as well as in south-west Balochistan province.
"They have with them 12 million doses for the coming three days," he said.

"We are very close. A handful of cases [were] noticed this year - about 11 in Pakistan and I think about five in Afghanistan.
"This is the lowest toll of cases in history. We expect to be within months of polio elimination in Pakistan."
The BBC's M Ilyas Khan in Islamabad says the WHO's expression of optimism comes after the Pakistani authorities launched repeated anti-polio drives in high-risk areas.
Health teams gained access to formerly hostile regions in the north-west after the Pakistani military launched a 2014 offensive against the Taliban in North Waziristan.
Attacks on health workers have dropped since then, although they still remain a threat.
Islamist militants oppose vaccination, saying it is a Western conspiracy to sterilise Pakistani children.
In April seven policemen, three guarding polio workers, were killed in Karachi. A January bomb attack on a vaccination centre in Quetta killed 15 people.
Pakistan recorded more than 300 polio cases in 2014, its highest number since 1999. The number of cases fell to 52 last year.

Riaz Haq said...

#Trump's #Afghanistan policy set to hinder #war on #polio in #Pakistan. #CIA #drones

In Pakistan and Afghanistan, the big obstacle, experts say, is not lack of money to fight it, but mistrust of the western governments who bankroll the vaccines.

Now Donald Trump could be about to deepen that mistrust. If the president makes good on his bellicose threats to take a harder line on Pakistan, he will undoubtedly incite anti-US sentiments, which in the past have led to attacks on polio workers and prompted tribal leaders to ban vaccination campaigns.

It would not be the first time the US got in the way of the war on polio.

The fight against polio suffered its biggest blow in 2011 when the CIA concocted a fake hepatitis vaccination campaign as part of its efforts to find Osama bin Laden. The ruse, exposed in the Guardian, only confirmed Taliban claims that inoculation campaigns were smokescreens for espionage. The Taliban issued fatwas and murdered dozens of health workers. In 2014, Pakistan recorded more than 300 polio cases.

But even before the vaccination ploy, polio was gaining ground, coinciding with an intensified US drone campaign. As attacks spiked in 2008, so did polio cases. When drone strikes hit a high of 128 in 2010, the number of polio cases reached 198 the following year.

Drone strikes in Pakistan have now become rare and since 2014, the fight against polio has bounced back. In 2016, only 37 cases were recorded worldwide, 20 of them in Pakistan.

Meanwhile, in his recently announced South Asia strategy, Trump signalled a tougher line on Pakistan:

“We have been paying Pakistan billions and billions of dollars at the same time they are housing the very terrorists that we are fighting. But that will have to change, and that will change immediately,” he said.

Trump has shown a penchant for airpower. In Afghanistan, the US is dropping more bombs than at any point since 2012.

It is hard to predict how local communities will respond to health workers if bombings pick up, said Monica Martinez-Bravo, a researcher at CEMFI and co-author of a new paper on mistrust of vaccines in Pakistan.

But she has documented a clear correlation between support for Islamist groups, at times a result of air campaigns, and decline in immunisation rates.

“Everything the US does that reduces trust will damage the vaccination campaigns,” Martinez-Bravo said.

Bombings complicate access for immunisers, and insurgents have used polio to demand a halt to air strikes in return for allowing vaccinations.

This year, in Kunduz in northern Afghanistan, the Taliban banned inoculators for 15 months, relenting only when a 14-month girl contracted polio.

Polio primarily affects children under five, and is incurable. The virus causes paralysis, sometimes within hours of infection. It often hits the legs and spine, but can also kill victims by immobilising breathing muscles.

Since the Global Polio Eradication Initiative was launched in 1988, an estimated 16 million people have been saved from paralysis, and 1.5 million children from death.

Yet, without sustained efforts, polio could flourish and spread quickly. For every known case, about 200 people carry the disease without symptoms.

Riaz Haq said...

‘What the hell is going on?’ Polio cases are vanishing in Pakistan, yet the virus won't go away
By Leslie RobertsJan. 11, 2018 , 1:00 PM

Just a year ago, poliovirus seemed on its last legs in Pakistan, one of its final strongholds. Polio cases were steadily falling, from 306 in 2014 to 54 in 2015, 20 in 2016, and, by last count, eight in 2017. Blood tests showed that, overall, immunity to the virus had never been higher, even among children aged 6 to 11 months, thanks to years of tireless vaccination campaigns. Surely, there were not enough susceptible kids to sustain transmission, and the virus would burn itself out within a year.

Unsettling new findings, however, show it is far from gone. In the most extensive effort in any country to scour the environment for traces of the virus, polio workers are finding it widely across Pakistan, in places they thought it had disappeared. They are wondering “just what the hell is going on” and how worried they should be, says epidemiologist Chris Maher of the World Health Organization (WHO) in Geneva, Switzerland, who runs polio operations in the eastern Mediterranean region. Does this mean the virus is more entrenched than anyone realized and is poised to resurge? Or is this how a virus behaves in its final days—persisting in the environment but not causing disease until it fades out?

“We have never had this level of environmental sampling anywhere else. We have nothing to compare it to,” Maher says. “We don’t understand the dynamic,” agrees Michel Zaffran, who leads the Global Polio Eradication Initiative at WHO. “But we take it very seriously.” In response to the sampling data, he and his colleagues are already changing their tactics—and their definition of success.


One possible explanation for the disconnect is that AFP surveillance is missing cases. Maher doubts that the number is significant, but others suspect that too many children among the mobile populations, including the marginalized Pashtun minority, still aren’t being vaccinated despite ramped up efforts to reach them. “I don’t think polio is entrenched across Pakistan, but this last reservoir of ‘people on the move’ is sustaining the virus,” says Steve Cochi, a polio expert at the U.S. Centers for Disease Control and Prevention in Atlanta.

Maher has another view. “My own suspicion is this is part of what we see at the end,” he says. “The lack of cases means immunity is high, but because of the very difficult circumstance in Pakistan,” the virus still has a tenuous hold. Ultimately, he says, “The virus will die out because it is not getting enough purchase.”

The program is not taking any chances. The response to each positive environmental test is now as aggressive as to a case of paralysis. And the program is hammering the virus with repeated vaccination campaigns throughout the “low season,” between December and May, when cold weather makes it tougher for the virus to survive. Whether the strategy works will become clear later this year when the weather turns warm. But one thing is certain: The absence of cases is no longer enough to declare victory over polio. Going forward, a country will not be considered polio-free until 12 months have passed without a case—or a positive environmental sample.

Riaz Haq said...

#Pakistan's 'final push' against #polio. The number of cases declined from 306 in 2014 to 54 in 2015, 20 in 2016, 8 in 2017 and just 3 this year.

Poliomyelitis or polio is a highly infectious disease caused by a virus which invades the nervous system, ‎and can cause total paralysis in a matter of hours.
By Robin Gomes

The Pakistani government on Monday launched a week-long anti-polio campaign regarded as the nation’s “final push” to eradicate the crippling disease, says a Pakistani health official.

Dr. Rana Safdar, the campaign's national coordinator, said the campaign was launched on Monday amid tight security in 89 districts and towns with a total of 110,000 health workers who will fan out to vaccinate 19.2 million children under 5 years of age.

Crippling disease

Poliomyelitis or polio is a highly infectious disease caused by a virus which invades the nervous system, ‎and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person spread ‎mainly through the faecal-oral route or, less frequently, by a common vehicle such as contaminated ‎water or food and multiplies in the intestine.
One in 200 infections leads to irreversible paralysis (usually ‎in the legs). Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.‎ There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life.

Polio is still endemic in Pakistan, Afghanistan and Nigeria.

Pakistan’s battle

Pakistan regularly carries out anti-polio drives despite threats from the Taliban who claim the campaign is a Western conspiracy to sterilize children.

The country has been battling polio for the past several years and is close to completely eradicating the disease. The number of cases declined from 306 in 2014 to 54 in 2015, 20 in 2016 and eight in 2017.

But with just three cases reported this year, all from Balochistan, Pakistan is close to completely eradicating the disease.

Targeted regions

In Punjab, the campaign will be carried out in Lahore, Rawalpindi, Dera Ghazi Khan, Muzaffargarh, Rajanpur, Faisalabad, Multan, Rahim Yar Khan and Bahawalpur districts.

In Khyber Pakhtunkhwa, about 4.5 million children up to 5 years of age will be administered anti-polio drops, during the campaign.

Similarly in Balochistan, anti-polio drops will be administered to more than 1.7 million children.

Safdar says the campaign will last for four days in some areas.

99% fall in world polio

A country must have no cases for three consecutive years in order to be considered to have eradicated polio by the World Health Organisation (WHO).

According to the WHO, the number of polio cases worldwide has fallen by more than 99 per cent since 1988, from an estimated 350,000 cases then to 22 reported cases in 2017.

Despite the progress achieved since 1988, as long as a single child remains infected with poliovirus, children in all countries are at risk of contracting the disease. The poliovirus can easily be imported into a polio-free country and can spread rapidly amongst unimmunized populations.

Failure to eradicate polio could result in as many as 200 000 new cases every year, within 10 years, all over the world.