Sharp increase in polio cases

Cases of polio, a debilitating disease that mainly strikes children, increased by 30 percent in Pakistan in 2006, the World Health Organization (WHO) confirmed on Thursday.

“In 2005, we had 28 reported polio cases while in 2006 we ended with 39. But this increase is a localised one – mainly in western border areas of the country,” said Dr Nima Abid, head of the agency's polio eradication team in the country.

“Yes, we have more cases, but they are limited to a few districts, with more than 70 percent of cases in only eight districts,” the WHO official added.

His comments coincided with the conclusion of a three-day nationwide immunisation drive against the disease, the first this year, during which 32 million children younger than five were successfully given polio drops.

Of the cases reported in 2006, 15 were in Pakistan’s North West Frontier Province (NWFP), 10 in southwestern Balochistan, 12 in Sindh and two more from the eastern Punjab province.

The capital, Islamabad, Pakistani-administered Kashmir and the Federally Administered Northern Areas (FANA) have reportedly not recorded any polio cases for several years.

According to WHO, poliomyelitis is a highly infectious disease caused by a virus. It invades the nervous system and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. One in 200 infections leads to irreversible paralysis, usually in the legs.

Among those paralysed, 5 to 10 percent die when their breathing muscles become immobilised. It affects mainly children younger than five. Once contracted, polio cannot be cured, though vaccination can provide protection.

And while polio immunisation has become widespread, making cases of the disease rare, the current epidemiology suggests virus sharing between Pakistan and neighbouring Afghanistan. It is estimated that more than 1.7 million children below the age of five cross the border annually.

Given the scale of population movements, health authorities in both countries have agreed to boost the number of permanent cross-border vaccination posts along entry points in Balochistan and the NWFP from an existing three to seven this year.

For effective polio vaccination coverage in 2007, health authorities have planned four nationwide immunisation campaigns. But, “to concentrate more on ‘the reservoir of polio virus’, we’ve planned an additional five immunisation rounds in high-risk areas”, Abid said.

Health practitioners have long expressed concern over the quality of polio vaccine available and inadequate training of vaccinators. However, Abid maintains that the vaccine used in Pakistan is internationally produced and the quality is approved by the world health body.

“The fact [is] that polio cases in Pakistan have been reduced from an estimated annual 18,000 in 1994, when the polio eradication initiative was launched. Now, we are talking about 39 cases only. This shows that the vaccine is very effective,” he reiterated.

Nonetheless, access in some areas remains problematic. “We have some areas where accessibility to children is not 100 percent. Also this is a very conservative society and service delivery in a few districts is not up to the mark due to these reasons,” Abid said.

In addition to those cases reported in southern NWFP, there has also been an increase in cases in the southern Sindh province, as well as in Quetta, the capital of Balochistan, the UN Children's Fund (UNICEF) reports.

“The majority of cases are among young children under the age of two years,” Sabahat Turk, working with UNICEF’s Polio eradication programme confirmed.

In Pakistan, polio monitoring and research also reveals that a high number of children below the age of one have not received sufficient doses of polio vaccine and are the most vulnerable to the illness, Turk added.

Pakistan, Afghanistan, India and Nigeria are polio-endemic, while another 16 countries reported sporadic polio cases in 2006.

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