Oct 22, 2010

Polio nears eradication: WHO


Mumbai, Oct 22 : India is well on its way to eradicate the polio virus, as per the latest World Health Organisation (WHO)data, which cites a sharp drop in the number of cases this year as compared to last year as an indication.

Largely because of effective surveillance of migrant population and vaccination drive, so far this year only 39 cases have been reported against 395 at the same time (Sept) last year. For the first time, UP has not reported even a single case of type1 polio so far. 

The only hurdle so far is the inability to break transmission of type-1 polio in the country despite reducing it to very low level.

Since January, two national immunization rounds have been held, and high-risk areas in the country have received two additional vaccination rounds.

The Indian Academy of Paediatrics (IAP), the premier association of Pediatricians in India, has lauded eradication efforts by the govt and recommended a judicious use of Oral Polio Vaccine (OPV) and Injectable Polio Vaccine (IPV) in the pre-eradication phase before singly introducing IPV in the post eradication era. 

As of now, IPV has never been used during current polio-eradication program in the country although GoI and India Expert Advisory Group (IEAG) has recommended studies on feasibility of using IPV during the pre-eradication phase on several occasions.

According to Dr Deepak Ugra, President, IAP, "In the current phase of pre-eradication, IPV can be a valuable tool if used in campaign mode in the endemic states to hasten the interruption of wild polio virus transmission. States that are polio-free and not contiguous with Uttar Pradesh or Bihar like the southern states need to introduce IPV in the Expanded Programme on Immunisation (EPI) schedule and restrict OPV only for three annual pulse campaigns instead of 2 as practiced now.

"Once UP and Bihar also qualify for introduction of IPV, the whole nation can use IPV in EPI and OPV by pulses, until clear evidence emerges of the total absence of wild polio virus. Thereafter OPV may no longer be needed."

Oral polio vaccine (OPV) has been the choice for routine immunization in India since 1995. However this hasn't helped the country to control the disease as many children have contracted the disease despite taking multiple doses of the vaccine.

According to T Jacob John, Member, Global Advisory Polio Eradication Committee, WHO and former Head of Clinical Virology at the Christian Medical College in Vellore, "A strategy shift from OPV to IPV will avoid inevitable problems associated with OPV such as vaccine associated polio, risk of polio in immunocompromised children and risk of vaccine derived polio outbreaks that have occurred in few countries even after successful eradication of wild polio."

OPV is a live but weakened virus given as drops to children. This is the most common mode of polio vaccination in India. However, most developed countries have already switched to IPV which contains killed or inactivated virus. Today, over 50 polio-free countries are already using IPV and/or combination vaccines with IPV.

According to the WHO, a nation cannot be declared polio-free unless there are no fresh cases reported for 3 consecutive years. The polio eradication deadline has already been extended thrice by over 8 years.

Polio is one of the leading causes of disability leading to permanent paralysis. Out of 197 countries in the world, in only 4 countries polio is still endemic. Nigeria, Pakistan and Afghanistan are the other three countries in the list.

According to Ugra, the last pockets of the virus remain the toughest to eradicate due to very high force of transmission of wild poliovirus mainly type-1 and 3, sub-optimal efficacy of trivalent OPV, extremely poor state of routine immunization, high incidences of diarrhea and malnutrition amongst young children and interference by non-polio enteroviruses in the gut.

Energizante, vertiginosa, ostentosa y cosmopolita, son algunos de los calificativos que recibe Mumbai, la ciudad más grande de la India y capital del estado de Maharashtra, y que se encuentra situada en una estrecha franja de terreno que surge de la costa pantanosa de Maharashtra y se adentra en el Mar Arábigo. 

Originalmente fue un conglomerado de islas que pertenecieron en el siglo XVI a los portugueses y que en el siglo XVII pasaron a control británico. Con el paso del tiempo estas islas se fueron uniendo para dar origen a la isla-ciudad de Bombay.

La ciudad cuenta con 17 millones de habitantes, lo que la convierte en una de las ciudades más grandes del mundo. Igualmente está considerada como la ciudad más congestionada de la India, pues los barrios bajos continúan creciendo y los asentamientos han invadido tierras públicas y privadas, venciendo todos los intentos por proporcionar de servicios a estas zonas.  http://www.viajes-exoticos.info/mumbai-india.php

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