Polio cases on the rise in Uttar Pradesh
Efforts to eradicate polio in India have received a setback. A poliomyelitis epidemic has hit Indias most populous state, Uttar Pradesh (UP) which is situated in northern India, seriously derailing efforts to control the disease. So far this year, 407 cases of polio have been recorded in India, 347 (85%) of which have been in UP.
Efforts to eradicate polio in India have received a setback. A poliomyelitis epidemic has hit India's most populous state, Uttar Pradesh (UP) which is situated in northern India, seriously derailing efforts to control the disease. So far this year, 407 cases of polio have been recorded in India, 347 (85%) of which have been in UP. Poor implementation of the polio immunization programme in UP is being blamed for an increase in the number of new cases.
During the 1999 World Health Assembly, delegates voted unanimously to accelerate efforts to meet the World Health Organization's target of eradicating wild poliovirus from the world by the end of 2000. This has now been put back to the end of 2005. Cases in India account for about 65% of the world's cases. In 2001, 239 cases occurred in India, with 265 cases recorded in 2000. For every case of wild polio, it is believed that 200-400 infections have occurred. There has been a spill over into Delhi as well, where four children were found to have contracted polio. Scientists engaged in mapping all polio cases say that these cases are genetically similar to the ones detected in UP. The other states with polio cases this year are Bihar (19), West Bengal (14), Gujarat (6), Uttranchal (7), Jharkhand (5), Maharashtra (3), Delhi (4) and Haryana (2).
There is undoubtedly an epidemic. The transmission season goes on till the end of October, and the cases could go as high as 800-1000. Immunization coverage in western Uttar Pradesh have not improved, and is responsible for the ongoing polio circulation in India. The ongoing polio in western UP is completely due to the failure to reach all children. This is confirmed in the monitoring data showing that more than 15% of the houses were not reached as recently as June 2002.
Attempts to improve immunization rates are hampered by unfounded rumours that circulate about the vaccine. In pockets where polio prevails, many people believe that polio vaccine is an anti-fertility vaccine and would lead to impotence in male children or infect them with HIV/AIDS. Almost 70% of polio cases have occurred in a particular community. The biggest challenge for UP is to improve its routine immunization coverage among newborns in the coming years.
BMJ September 2002, Vol. 325(7365)
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