Poliovirus found in Multan Road drain

LAHORE
Environmental samples for poliovirus, collected in the month of June from Multan Road drainage in Lahore, have been found positive, which posed a threat of transmission and recurrence of the crippling disease in Punjab in an otherwise polio-free year so far.
The Punjab Health Department may have to reschedule anti-polio campaign and is likely to conduct an early campaign to prevent the threat of transmission. For the purpose, a case response is likely to be conducted in the first week of August.
As Punjab is scheduled to organise the campaign on September 14 this year under the national commitment, it may have to conduct a targeted polio campaign in selected high-risk union councils in Lahore from August 3 to 5. Official sources said that though no official intimation had been issued, yet preparations for logistics and vaccine supply were likely to be made this week.
Furthermore, it is also learnt that the Punjab Health Department has also facing the challenge of shortage of vaccines, as the federal government has also not given any commitment so far to provide a consignment of vaccines to conduct the urgent campaign. Oral polio vaccine is to be administered among children in high-risk union councils while the injectable inactivated polio vaccine may also be used as per need.
The officials said that Punjab had negative environmental samples for the past few months and though there were occasional issues with the quality of environmental samples in Faisalabad and Multan, it appeared generally that the province was eying a zero polio year. But, they stated that the sample collected for the month of June means that threat of a polio case was very much imminent unless measures were taken urgently.
They further said that the genetic trace of the virus was being linked to a circulation to Qila Abdullah in Balochistan. The genetic link gives an idea that the poliovirus is related to migration or movement of some population from Balochistan. It was also learnt that Qila Abdullah and Qila Saifullah from where the virus transmission in Punjab is linked, has a sizeable Pashtun population and the campaign may look to immunize children with a special focus on migrants from these areas.
The experts opined that the presence of the virus in the environment raised questions on the quality of routine immunization coverage in the provincial capital. Punjab has introduced measures like E-vaccs for the GPRS driven accountability of the performance of vaccinators. But, they observed that the result of environmental samples implies that there are certain pockets around the area carrying transmission that has not been reached out yet.
Punjab has maintained zero polio presence in 2015 out of registered 28 cases in Pakistan so far, which include four cases from Sindh, 11 from Khyber Pakhtunkhwa, eight from FATA and four cases from Balochistan. In 2014, Punjab had reported four cases out of overall 306 cases in Pakistan including 30 cases from Sindh, 68 from Khyber Pakhtunkhwa, 179 from FATA and 25 cases from Balochistan.
Meanwhile, National Emergency Action Plan (NEAP-2015), held in Lahore on Tuesday under the chairpersonship of PM’s focal person for polio eradication Senator Ayesha Raza Farooq and attended by health authorities of all the four provinces, chalked out a plan to effectively combat the crippling disease and make Pakistan polio-free along with successful countries of the world. The NEAP has stressed strengthening of Expanded Programme of Immunization (EPI). Unfortunately, Pakistan is among three countries along with Afghanistan and Nigeria, which are still combating with their indigenous polioviruses and have become a focus of the world for the risk of transmission of the virus to other countries that entails certain sanctions including travel restrictions.
When contacted, Director General Health, Punjab, Dr Zahid Pervaiz confirmed that environmental samples for polio had been found positive in Multan Road drainage, which might require an emergency vaccination campaign in certain union councils along the drainage. However, the campaign has yet not been planned so far, he added. When asked about the origin of the poliovirus from Balochistan, he clarified that the origin of the virus in Lahore, Faisalabad or Rawalpindi was linked to FATA and KPK, because the origin of the virus from Balochistan was usually found in Southern districts like Multan, Muzaffargarh, DG Khan, etc.
He said the National Emergency Action Plan had divided districts in four tiers with tier-1 comprising high risk districts and the remaining three tiers comprised districts with declining intensity of the virus. There is no district of Punjab in tier-1, two districts of Muzaffargarh and Rajanpur in tier-2, three districts of Lahore, Multan and Rawalpindi in tier-3, while the remaining 31 districts fall in tier-4. The vaccination campaign against polio will be conducted under EPI as per schedule on September 14, 2015.