INDIA POLIO FACT SHEET

Cases in 2011: 1 (last case 13 January 2011)

Cases in 2010: 42

Cases in 2009: 741

Cases in 1991: 6,028

Cases in 1985: 150,000

Last wild poliovirus type 1 (WPV1) case: 13 January 2011, Howrah, West Bengal

Last wild poliovirus type 2 (WPV2) case: October 1999, Aligarh, Uttar Pradesh

Last wild poliovirus type 3 (WPV3) case: 22 October 2010, Pakur, Jharkhand

Last positive case from monthly environmental sewage sampling (conducted in Delhi, Mumbai and Patna): November 2010, Mumbai

Number of Supplementary Immunization Activities in 2011:

-       2 National Immunization Days (NIDs) immunizing 172 million children <5 years in five days

-       7 Sub-National Immunization Days (sNIDs) immunizing 50-70 million children each

-       1 Mop-up Emergency Activity immunizing 2.6 million children

Number of Oral Polio Vaccine (OPV) doses administered in 2011: 900 million

SITUATION IN 2012

·         India has made unprecedented progress against polio in the last two years, reporting only one case of polio in 2011, on 13 January, compared with 42 polio cases in 2010 and 741 cases in 2009. The lone polio case in 2011 was reported in a two-year-old girl in Howrah, close to Kolkata, West Bengal.

·         On 13 January, 2012, India will reach a major milestone in the history of polio eradication – a 12-month period without any case of polio being recorded. This date marks the unprecedented progress in India and is an endorsement of the effectiveness of the polio eradication strategies and their implementation in India.

·         Since the launch of the Global Polio Eradication Initiative in 1988, the incidence of wild poliovirus has reduced by 99 per cent – from 350,000 children paralyzed or killed annually in 125 endemic countries in 1988 to 620 cases reported in 16 countries in 2011 (as of 3 January, 2012). In 2006, the number of polio-endemic countries (countries that have never stopped indigenous wild poliovirus transmission) was reduced to four – India, Nigeria, Pakistan and Afghanistan.

·         If all testing for WPV in India through January – including laboratory analysis of acute flaccid paralysis cases with onset up to mid-January and environmental sewage sampling – returns negative, India will officially be deemed to have stopped indigenous WPV and will be removed from the list of WHO polio-endemic countries (by mid-February), reducing that group to a historical low of three.

·         One of the three types of wild poliovirus – wild poliovirus type 2 (WPV2) has been eradicated globally. The last case of WPV2 was in Aligarh, India, in October, 1999.

·         When the Pulse Polio Immunisation Programme was launched in India in 1995 an estimated 150,000 polio cases were reported across the country each year.

·         The two polio-endemic states of Uttar Pradesh and Bihar have not reported any case of polio since April 2010 and September 2010, respectively.

·         The transmission of the most dangerous WPV1, which caused 95 per cent of polio in India until 2006, dropped to record low levels in 2010. Uttar Pradesh, the epicenter of most polio outbreaks in the country, has not reported any WPV1 cases since November 2009.

·         This progress follows intensive immunization campaigns focusing on areas at highest risk of transmitting polio and the most vulnerable populations, such as newborns (>500,000 children are born in UP and Bihar each month) and migrants; use of the more efficacious monovalent oral polio vaccines and, since 2010, the bivalent oral polio vaccine (bOPV) which protects against both P1 and P3 concurrently.

·         In India, the polio partnership is led by the Government of India, with continued support from WHO’s National Polio Surveillance Project (NPSP), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, as well as significant contributions by the Bill and Melinda Gates Foundation.

THE POLIO PROGRAMME

During each NID, nearly 2.3 million vaccinators under the direction of 155,000 supervisors visit 209 million houses to administer OPV to around 172 million children under 5 years of age across the country. To reach people on the move, mobile vaccination teams immunize children at railway stations, inside running trains, at bus stands, market places, construction sites, etc. Around 5 million children are immunized by transit and mobile teams during every round in UP, Bihar and Mumbai alone.

Between 50-70 million children are vaccinated with OPV during SNIDs which cover the endemic states of UP and Bihar, re-infected states such as West Bengal and Jharkhand, polio high-risk areas of Delhi and Mumbai (and their surrounding areas). Migrant and mobile populations in Punjab, Haryana, Chandigarh, Rajasthan and Gujarat are also covered in the SNIDs.

Progress in India follows:

·         The strong commitment of the Government of India and the endemic and high-risk states, ensuring that the entire government machinery is geared for the polio eradication programme down to the block and village level.

·         Intense and focused measures with tailored tools and strategies to reach and deliver the maximum possible protection to children in the highest-risk areas and among the highest-risk populations.

·         The concerted and tireless efforts of the millions of frontline workers – vaccinators and community mobilizers - braving all odds and challenges to ensure that children <5 years are protected with OPV in each immunization round.

·         An intense surveillance network for polio, ensuring rapid detection of polioviruses for a timely response.

·         A huge network of nearly 8,500 community mobilisers in polio-endemic and high-risk states of Uttar Pradesh,  Bihar and West Bengal, which is continuously counseling families in the highest-risk areas and tracking and reaching out to the most vulnerable migrant and mobile populations to ensure their children are protected against polio in every polio round, and for routine immunization. The community mobilisers are now also spreading awareness about polio-associated risk factors: the need to protect children with life-saving vaccines being offered free of cost under Routine Immunization; hygiene and sanitation; hand-washing; exclusive breast feeding up to six months; and diarrhea management with ORS and zinc.

·         Robust communication strategies, including a new communication campaign targeting the need for repeated immunization up to the age of 5 years; the fact polio has no cure but can be prevented, and targeting the highest-risk migrant, mobile and nomadic populations with messages that read: Wherever you stay, wherever you go, ensure your child gets protection against polio. 

CHALLENGES & PROGRAMME PRIORITIES

·     The key challenge now is to ensure any residual or imported poliovirus in the country is rapidly detected and eliminated. This requires very high levels of vigilance and emergency preparedness to respond to any importation of wild poliovirus. The importation of wild poliovirus into China in 2011 highlights the risk that India faces of polio returning to the country.

·         The Government of India and all states are putting together Emergency Preparedness and Response Plans to ensure a rapid and appropriate response to any case of polio in the country.

·         The challenge is to ensure all children up to 5 years of age continue to take OPV at every available opportunity (polio campaigns and routine immunization) both in and outside the polio-endemic states until global eradication is achieved.

·         Ensuring populations on the move – migrants, nomads and cross-border movements – both inside and outside polio-endemic, high-risk and re-infected states and entering India from neighboring Pakistan and Nepal, are protected with OPV in each round.

·         Tackling the risk of complacency among the community and within the polio programme in view of zero cases.

Keeping polio eradication as a key health priority in India until global eradication.