A comprehensive update on Polio

A detailed update on Polio and its eradication in the world

 A comprehensive update on Polio

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• The story: While the world has nearly eradicated polio, Afghanistan and Pakistan are the countries with endemic polio incidence. Poliomyelitis (Polio) is a crippling and possibly deadly viral infectious disease that affects the nervous system. The disease is preventable with the polio vaccine; however, multiple doses are required for it to be effective.
• Technical details: There are three distinct wild poliovirus strains: Wild Poliovirus type 1 (WPV1), Poliovirus type 2 (WPV2), and Wild Poliovirus type 3 (WPV3). All three are identical, and cause irreversible paralysis or even death. But their differene merit different treatments.

1. The virus is transmitted by person-to-person mainly through the faecal-oral route or, by a common vehicle (for example, through contaminated water or food).
2. It mostly affects children under 5 years of age. The virus multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
3. Most people with polio do not feel sick. Some have only minor symptoms, such as fever, tiredness, nausea, headache, pain in the arms and legs, etc.
4. In rare cases, polio infection causes permanent loss of muscle function (paralysis). It can be fatal if the muscles used for breathing are paralysed or if there is an infection of the brain.

• Cure: There is no formal cure, but it can be prevented through immunisation.

1. The Oral Polio Vaccine (OPV) is given orally as a birth dose for institutional deliveries, then primary three doses at 6, 10 and 14 weeks and one booster dose at 16-24 months of age.
2. The Injectable Polio Vaccine (IPV) is introduced as an additional dose along with the 3rd dose of DPT (Diphtheria, Pertussis and Tetanus) under the Universal Immunisation Programme (UIP).

• Eradicating polio: The "Global Polio Eradication Initiative" was launched in 1988 by the Global Polio Eradication Initiative (GPEI), by national governments and WHO. Presently, 80% of the world’s population is now living in certified polio-free regions. Systemic administration of vitamin A during polio immunization activities has saved countless lives.

1. World Polio Day - It is observed every year on 24th October in order to call on countries to stay vigilant in their fight against the disease.
2. Pulse Polio Programme - It was started in India with an objective of achieving hundred percent coverage under Oral Polio Vaccine.
3. Intensified Mission Indradhanush 2.0 - It was a nationwide immunisation drive to mark the 25 years of Pulse polio programme (2019-20).
4. Universal Immunization Programme (UIP) - It was launched in 1985 with the modification to ‘Expanded Programme of Immunization (EPI). The objectives included rapidly increasing immunization coverage, improving the quality of services, establishing a reliable cold chain system to the health facility level, etc.

• Global troubles: In 2019, polio outbreaks were recorded in the Philippines, Malaysia, Ghana, Myanmar, China, Cameroon, Indonesia and Iran, which were mostly vaccine-derived in which a rare strain of the virus genetically mutated from the strain in the vaccine. If the oral vaccine-virus is excreted and allowed to circulate in an unimmunised or under-immunised population for at least 12 months, it can mutate to cause infections. India received polio-free certification by the WHO in 2014, after three years of zero cases. The successful Pulse Polio Campaign in which all children were administered polio drops is responsible for the same. India's last wild poliovirus was detected on 13th January 2011.
• EXAM QUESTIONS: (1) What are the challenges in eradication diseases like Polio from the world, in a coordinated fashion? Explain analytically. (2) What were the reasons for the remarkable success of polio eradication programme in India? What public policy lessons can be drawn from it? List and explain.
  

#Health #Polio #DiseaseEradication #WHO

 

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