Pulse Polio

Pulse Polio is an immunization campaign established by the government of India in 1994 to eradicate poliomyelitis (polio) in India by vaccinating annually all children under age five against poliovirus. Every child receives a dose of Oral Polio Vaccine (OPV), a live, attenuated virus which colonies the gastrointestinal tract. This virus competitively inhibits the wild, disease-causing poliovirus. Not only does this prevent pernicious infection in the host, it precludes transmission of the wild poliovirus to other hosts. Since poliovirus cannot survive outside a host for more than two weeks, theoretically it would be eradicated, resulting in the eradication of poliomyelitis. The campaign proved to be successful, and the incidence of poliomyelitis in India has decreased dramatically: India recorded 4,791 cases of polio in 1994; 2,489 in 1997; 1,600 in 2002; 225 in 2003; and 135 in 2004. Nevertheless, critics charge that the campaign has seriously encroached on other essential public health services at times when health care resources were minimal.
The global initiative to eradicate poliomyelitis by the end of the year 2000 is the largest international disease control effort ever. Remarkable progress has been made since the initiative began in 1988. The number of global polio cases declined from an estimated 350,000 cases to just over 7000 in 1999. The polio virus transmission is interrupted from Europe (including Russia), Western Hemisphere, Western Pacific region (including China) and most of the Middle East and large part of Southern & Northern Africa. As a result, poliovirus transmission is now limited to few foci in 10 countries located in South Asia and Central/ Western Africa.

In India, vaccination against polio was initiated in 1978 under Expanded Programme on Immunization (EPI) and the coverage achieved by 1984 was around 40% of all infants with 3 doses of Oral Polio Vaccine (OPV). In 1985 the Universal Immunization Programme (UIP) was launched and implemented in phased manner to cover all districts in the country by 1989-90. During 1986 the UIP was accorded the status of a Technology Mission under the banner of the Technology Mission on Immunization. This resulted in significant increase in coverage to over 95% during 1990-91 and is being sustained over 90% since then. The number of reported cases of polio declined from 28757 during 1987 to 3265 in 1995.
At this stage, in pursuance to the World Health Assembly Resolution of 1988, in addition to administration of routine OPV through the Universal Immunization Program, the Pulse Polio Immunization (PPI) Programme was launched in 1995-96 to cover all children below the age of 3 years. In order to accelerate the pace of polio eradication, the target age group was increased from 1996-97 to all children under the age of 5 years. This resulted in further decline in number of polio cases to 1005 reported during 1996.Till 1998-99, the PPI Programme consisted of vaccination of children at fixed booths on two National Immunization Days(NID), separated by six weeks, during the winter season. Although, the coverage under the Pulse Polio Immunization since 1995-96 has been impressive, polio transmission was still active in most of the States during 98-99.In order to reach the global goal of reaching zero incidence of polio by 2000 AD, a strategy to intensify PPI was adopted in 1999-2000, after consulting national and international experts. The strategy consisted of four nation-wide PPI rounds in the months of October, November, December 2000 and January 2001; followed by two sub-national rounds in 8 States of Assam, Bihar, Gujarat, Madhya Pradesh, Orissa, Rajasthan, Uttar Pradesh and West Bengal and routine immunization, especially in the poor performing States.In earlier years, despite very good coverage, 5-6% of children was being missed even in the PPI Programme. During 1999-2000 therefore, in addition to booth immunization, a house to house search of missed children and vaccinating them on the next 2-3 days following each NID/ Sub-NID was undertaken. This house to house programme resulted in identification and vaccination 2.3 crore children who had never been vaccinated before.

The Current Position
In 2000, in spite of improved surveillance, only 186 cases have been detected throughout the country till 28th October 2000. It may be seen that six out of the eight States which had undertaken Sub-National Immunization Days in 1999-2000, have reported only a few cases, while the entire north-east including Assam and Orissa have not reported even a single case. In fact, most parts of the country have become polio free and widespread transmission is restricted only to the States of Bihar and Uttar Pradesh, which together, have contributed to 163(UP – 121 Bihar – 42) of the 186 cases detected so far. India is still the largest polio endemic country in the world accounting for 20% of the cases reported globally during 2000 (till July 2000) mainly on account of the situation in Uttar Pradesh and Bihar.

July 25, 2008 Post Under - Read More

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