Polio Eradication and Acute Flaccid Paralysis

India along with ten countries of World Health Organization (WHO) South-East Asia Region has been certified Polio free by the Regional Polio Certification Commission on the 27th March 2014.  No laxity has been reported in the polio eradication program after the country was declared “Polio free country”.

India has maintained polio-free status through the following measures:-

·      Two rounds of high quality national immunization day (Pulse Polio) being conducted each year. 

·      Sub national immunization (SNID) rounds being implemented in high risk states such as Uttar Pradesh, Bihar, Delhi and high risk population pockets in the states of Haryana, Punjab, Gujarat, Maharashtra, Rajasthan, Jharkhand, Uttarakhand  and West Bengal. 

·      More than 100 vaccination posts are functioning along the international borders of India with Nepal, Pakistan, Bangladesh, Myanmar and Bhutan to administer oral polio vaccine drops throughout the year to all children below five years entering India.

·      India has also made polio vaccination a mandatory requirement for travellers irrespective of age coming from and going to polio infected countries.

·      Certification standard surveillance for cases with acute flaccid paralysis is in place to detect importation or emergence of polio case. More than 50,000 AFP cases are being investigated annually across India.

·      Environmental surveillance through testing of sewage samples for polio is functioning strategically at Mumbai, Delhi, Bihar, West Bengal and Punjab.

·      State and District level task forces are in place and actively overseeing the implementation of polio immunization and surveillance activity.

The Government has taken cognizance of the recent reports of suspected polio cases across the country. All such reported cases were investigated and discarded as non-polio acute flaccid paralysis (AFP) cases as the stool sample tested were negative for polio. The details of recent reports of suspected polio cases reported in media State/UT wise are given below:-

State/UT wise details of AFP cases reported in 2015 to media as suspected polio

Date of Report	Media	State/UT	No of suspect polio cases reported by media	Outcome following investigation
24 January, 2015	Local media	Pataudi, Haryana	1	Non polio cases stool samples were negative
23 February, 2015	Local media later picked up by national media	Darbhanga, Bihar	2	Non polio cases stool samples were negative
19 May, 2015	The Telegraph, Ranchi edition	West Singhbhum, Jharkhand	1	Rejected as not a  case of acute flaccid paralysis or suspected polio
20 June, 2015	Times of India	Bareilly , Uttar Pradesh	208	Non polio cases all stool samples were negative

The details of measureS taken on the negative reporting in media are as under:

·      The Ministry of Health and Family Welfare issued a press release on 20th June through Press Information Bureau to leading newspapers and news agencies. The press release informed the media that the 208 cases reported from Bareilly (Uttar Pradesh) were of acute flaccid paralysis (AFP) and the cases received from the laboratories in 2015 are negative for poliovirus. That stringent environmental surveillance is routinely undertaken to detect any polio cases.

·      In Uttar Pradesh, prompt action was taken by the Health Department in organizing a media briefing by the Chief Medical Officer and the District Immunization Officer. The media briefing was also attended by WHO-National Polio Surveillance Project (NPSP) and UNICEF Social Mobilization Net (SMNet).

·      Large scale media workshops in 38 districts reaching over 600 journalists have been undertaken in Bihar by UNICEF to sensitize journalists about the surveillance process, adverse events following immunization (AEFI) and educate them about the difference between polio and AFP cases. As a result of these workshops over 350 positive articles have been published from March – July 2015. The tonality of 92% stories on polio in Bihar is positive.

The reported suspected polio cases across the country are subsequently discarded as Non-Polio Acute Flaccid Paralysis (NPAFP) cases based on symptoms and stool results.

The State/UT wise NPAFP cases reported in the last three years and the current year is given below:-

Classification of Non-polio AFP   (NPAFP) Acute Flaccid Paralysis (AFP)

Cases: 2012-2015*

Sl. No	State/UTs	2012	2013	2014*	2015*
1	Andaman & Nicobar	1	2	1	0
2	Andhra Pradesh	1302	1098	519	180
3	Arunachal Pradesh	36	27	21	3
4	Assam	585	519	470	146
5	Bihar	15841	14125	14536	5034
6	Chandigarh	58	61	68	30
7	Chhattisgarh	616	565	409	114
8	Dadra and Nagar Haveli	9	1	4	2
9	Daman and Diu	2	6	6	4
10	Delhi	768	866	826	326
11	Goa	18	25	24	6
12	Gujarat	936	945	888	339
13	Haryana	1378	1250	1132	332
14	Himachal Pradesh	178	159	139	63
15	Jammu & Kashmir	271	184	167	76
16	Jharkhand	1484	1414	1504	425
17	Karnataka	995	943	1037	385
18	Kerala	327	379	390	144
19	Lakshadweep	1	0	0	1
20	Madhya Pradesh	2918	2679	2791	749
21	Maharashtra	3053	2862	2647	865
22	Manipur	33	17	47	10
23	Meghalaya	42	56	44	10
24	Mizoram	16	12	20	1
25	Nagaland	29	10	8	5
26	Odisha	1980	1964	1927	607
27	Pondicherry	15	18	23	7
28	Punjab	727	637	522	207
29	Rajasthan	2044	2214	1970	668
30	Sikkim	7	1	5	2
31	Tamil Nadu	654	625	694	264
32	Telangana	--	--	307	102
33	Tripura	90	60	71	22
34	Uttar Pradesh	20913	17761	17235	5918
35	Uttarakhand	422	372	367	120
36	West Bengal	3141	2737	2884	974
Total		60890	54594	53703	18141

* Data as on 18 July, 2015

Apart from the measure taken as detailed in para (b) above, the NPAFP cases are also advised for follow up for further treatment in Hospital.

The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today(24-07-2015).

Courtesy:pib.nic.in