Pulse Polio Immunization Programme

Poliomyelitis has been a major cause of disability among children in India. Before the introduction of National Immunization Days (NIDs) in 1995, an estimated 35000 children were paralyzed by polio in India each year. Thereafter tremendous progress has been made since polio eradication activities were first introduced in 1995.

Epidemiology of Polio

The Polio viruses are three related entero-viruses: Type 1, 2,3. All three types cause Paralysis. Most frequently Polio is caused by Type 1 poliovirus. Polio is highly communicable having incubation period of 7-10 days. Transmission is primarily person- to-person via faecal-oral route; i.e. the poliovirus multiplies in the intestine and is spread through the faeces. The virus is intermittently excreted for one month or more after infection. Communicability of infected children is highest just prior to the onset of paralysis and during the first two weeks after the paralysis occurs. Protective immunity against poliovirus infection develops by immunization of natural infection.

The Strategies for Polio Eradication

Polio has been eradicated from most of the world using several key strategies. Each of the following strategies is important components in the National Polio eradication programme
  • Routine Immunization: Sustaining high levels of coverage with 4 doses of oral polio vaccine in the 0-1 year age group.
  • Supplementary Immunization Activities (SIAs): Simultaneous administration of oral polio vaccine to all children in the age group of 0-5 years, 4-6 weeks apart to interrupt wild poliovirus transmission and to increase immunity amongst children.
  • Formulation of EPRP (Emergency Preparedness & Response Plan) & RRT (Rapid Response Team)

    SIAs include
    • National Immunization Days(NIDs) when the entire country is covered
    • Sub National Immunization Days (SNIDs) when some states or parts of states are covered.
    • Mop-ups are conducted, as soon as possible after identification of the virus as an end game strategy to interrupt transmission.
  • Surveillance and investigation of cases of Acute Flaccid Paralysis (AFP)

Surveillance data is used to identify areas of wild poliovirus transmission and to guide immunization activities.

Current Situation of Gujarat State

India has been removed from the list of polio endemic countries in the month of February 2012 (Polio endemic countries are Pakistan, Nigeria and Afghanistan). India will no longer be considered "endemic "meaning that it will have successfully interrupted polio transmission. This has been a great achievement in the public health programme after smallpox eradication. Gujarat State has been able to prevent polio cases. The State had reported 25 cases in the year 2002 and last wild polio case had been reported in March 2007 in Amreli district. The effective Polio vaccination coverage through routine immunization and Pulse Polio rounds has helped in moving towards Polio eradication. Although, our state has not reported a case of wild poliovirus thereafter, sustaining high levels of coverage with 4 doses of polio in the 0-1 age group in routine immunization& SIAs (Supplementary Immunization Activities in the form of NIDs/SNIDs/Mop-Ups) is a key strategy to be followed. No complacency as a large number of migrants from the affected states of UP, Bihar and other States constantly visit and work in our state.

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