In western UP, vaccine no guard against polio

[Guest guest]

In western UP, vaccine no guard against polio

 

Yoga Rangatia | New Delhi

 

A majority of children contacting polio have already been vaccinated

several times in western Uttar Pradesh. This has led experts to debate

whether the oral polio vaccine is less effective in preventing polio

in the region than in other parts of the country.

 

" There is wide variation in the oral vaccine's efficacy across

geographical regions. It cannot be ruled out that children in western

Uttar Pradesh are not responding to the vaccine as those in other

parts of the country, " says Dr Jacob John, member, expert committee of

the WHO-National Polio Surveillance Programme.

 

Health Ministry says the vaccine is not part of the problem, the State

Government's apathy is. " The virus was routed in other parts of the

country with the same vaccine. In UP, each time we miss some children,

about 10-15 per cent. When an outbreak occurs, like this year,

children whose immunity is low are the first to get affected. The

force of transmission was higher this year. The problem is with

uniform coverage of vaccine, not the vaccine itself, " an official

explained.

 

It is nobody's case that the vaccine is ineffective, since it has

achieved its target in say southern India with lesser number of doses

than currently used in UP. But western UP is throwing uncomfortable

questions on the immunological response of children to the oral

vaccine.

 

" What compounds the problem is high density of poorly immunised child

population, higher birth rate, faster spread of polio virus and poor

hygiene, " Dr John argues.

 

The victims of polio are also growing younger. A vast majority of

those afflicted by the disease are children below the age of two

years. " Small children are more susceptible to the disease, because of

the poor number of doses they would have received. Unlike routine

immunisation, which they receive before three months of age, pulse

polio reaches them much later, if at all, " Dr John explains.

 

This only reinforces the need for robust routine immunisation backed

by campaign-mode polio eradication programme.

 

Waking up to the reality, the Centre has decided to administer

injectible polio vaccine to children below two years alongside oral

polio. As compared with 'blunt axe' oral vaccine, injectible is a sure

shot to ward off the virus. Once immunity receives a boost through

injectible vaccine, experts hope that oral polio will help prevent

circulation of the virus in the area.

 

Dr John advocates an India-specific polio campaign, one that takes

into account the variations in oral polio efficacy. Writing in an

editorial for Indian Journal of Medical Research, he said,

" elimination of wild virus transmission is clearly impossible in 2006.

Time over-run beyond the target year of 2000 has caused cost over-run.

Globally over 4 billion dollars have been spent, while the original

budget was only half as much. India had been spending more than what

the country can afford, while other health programmes are being

adversely affected. "

 

If India does not succeed by 2007, when wild poliovirus (along with

new subtypes of influenza, SARS and smallpox) will become notifiable

under the new 'International Health Regulations 2005,' the consequence

could be embarrassing. The delay has its local repercussions as well.

 

According to rumour, health workers are losing faith in OPV as are

many families with polio occurring in children despite taking 10 or

more doses. Consequently the quality of immunisation campaigns may

deteriorate. If this state of affairs continues, improved intervention

may not be implemented well. The longer the delay, the greater is the

risk of losing much of the gains achieved so far, the expert felt.

 

 

Polio cases among children vaccinated in Uttar Pradesh

 

Doses

Year total >=7 4-6 0-3

------------

2006 255 149 80 26

2004 082 047 27 07

2003 088 024 38 26

2000 179 058 52 70

 

 

http://dailypioneer.com/indexn12.asp?main_variable=front%5Fpage & file_name=story4\

%2Etxt & counter_img=4

[Guest guest]

Greetings

 

In the pioneer report that I mailed 4 days back, statistics was

provided which indicated that more than half the polio affected kids

have been vaccinated as many as seven times. Here I quote the

statistics given in the Pioneer report again.

 

>> Polio cases among children vaccinated in Uttar Pradesh

>> Doses

>> Year total >=7 4-6 0-3

>> ------------

>> 2006 255 149 80 26

>> 2004 082 047 27 07

>> 2003 088 024 38 26

>> 2000 179 058 52 70

 

 

Now the health minister is saying that " infection is spreading "

because some kids have not been vaccinated! His reasoning -- " Lab

reports have shown that bad vaccines is not the reason " .

 

Unfortunately the Pioneer report does not give out exactly how many

kids with ZERO doses have been infected. Going by the statistics the

number should be 26/4 or 7 (though I am sure it would be less). 7 out

of 255 is 2.7%, which is much less than 7-15% which Ramadoss says have

not been vaccinated.

 

It is quite clear there is no such thing as " good polio vaccine " .

 

Regards

Puneet

 

----

http://www.indianexpress.com/story/13181.html

 

Govt confirms: 7-15% UP kids gave polio drive a miss, virus spreading

 

Express news service

 

Posted online: Friday, September 22, 2006 at 0000 hrs IST

 

NEW DELHI, SEPTEMBER 21

Days after the World Health Organization (WHO) sounded the alarm that

the Uttar Pradesh polio virus strain had spread to new areas, even

Nepal, Bangladesh and two African countries, Union Health Minister

Anbumani Ramadoss today admitted that nearly 7-15 per cent of children

in western UP, the epicentre of this year's outbreak, had been left

out of the polio vaccination drive.

 

Ramadoss, who held an emergency meeting with states on the spurt in

polio cases, announced that there would be three rounds of polio

vaccination across the country, starting this November. The reason:

Children were left out in the 2005 vaccination exercise and the virus

began manifesting itself from May last year.

 

India has reported 297 cases this year, over four times the 66 in 2005

— UP itself is responsible for 269 cases this year. There have even

been 23 deaths.

 

" Lab reports have shown that bad vaccines is not the reason. It is

clear that children have been missed in the immunization drive, " said

Ramadoss.

 

Now the concern is beyond UP. Officials fear it's spreading to not

just states outside UP but also other countries. " We cannot take any

chances now, every child should be vaccinated,'' said Jay Wenger, head

of National Polio Surveillance Programme, explaining the reason behind

the national drive.

 

Following the outbreak, the WHO has redefined the high risk zones. It

includes Maharashtra, Haryana, Uttaranchal and Chandigarh. The first

phase of the immunization drive will concentrate on these new

high-risk zones where 37 million children under the age of five would

be vaccinated.

 

For now, cases in other states have been few but enough to raise an

alarm because some of these had no cases in 2005. The break-up: UP

leads the pack with 269, Bihar (17), Haryana (5), Madhya Pradesh (1),

Jharkhand (1), West Bengal (1), Uttaranchal (1) and Maharashtra (1).

 

" The high risk zones have been identified not because there are high

number of cases now but also because of high migrant population,''

said Wenger. For example, the virus has been found in sewage water

samples collected from slums in Dharavi, Wadala and Shivajinagar in

Mumbai. It has the same genetic sequence as the UP strain.

 

Another problem that the government has to deal with is that UP's

large Muslim minority are reluctant to get their children immunized

because of rumours that polio drops are part of a Western conspiracy

to make their children sterile. Nearly 70% of the cases are from

minority communities.

 

The Government today said that there would be special efforts to

involve the minorities, even talking to their religious heads to

dispel rumours. " We will also be announcing some incentives for those

involved in the vaccination drive, " said Ramadoss.

 

In the November pulse polio round, some 75,000 Ashas, or health

volunteers who form the core of the National Rural Health Mission,

would be pressed into service. Around 40,000 of these women have

already been trained.

 

Present in today's meeting were health officials of eight affected

states as well as WHO and UNICEF representatives. In 1998, the WHO

launched a global programme to eliminate polio by 2005 but missed the

deadline.