More polio cases despite efforts to contain it

Confirmation that a two-year-old has polio in Diamer District of Gilgit-Baltistan region, northern Pakistan, has raised fears that the disease could have spread to areas previously believed to be free of it, despite a national polio emergency plan launched by the government in January.

The World Health Organization (WHO) recently confirmed the case: “This is the first polio case reported from Gilgit Baltistan after over 12 years. The last case was also reported from the same district, Diamer, in 1998,” WHO spokesperson Gul Afridi told IRIN.

Since Diamer District is outside the zones previously thought to be affected by the virus, WHO has immediately initiated a number of aggressive vaccination measures to help “stop the polio virus circulation in the area, limiting further spread to neighbouring areas”.

The affected child, Afridi said, was a female from a family originally from Mohmand Agency in the Federally Administered Tribal Areas along the Pakistan-Afghan border, but who settled in Gilgit Baltistan four years ago. "The child reportedly missed the OPV [Oral Polio Vaccine] dose due to the refusal of the family,” he added.

In March, the Speaker of Gilgit Baltistan Assembly, Wazir Baig, said: “The region was polio free for the past 13 years and, God willing, we will keep the region free of this disease in the future too.” Baig was inaugurating a three-day anti-polio drive targeting more than 200,000 children.

“Refusals” by parents to have their children vaccinated have been a frequently reported problem, notably in Khyber Pakhtoonkhwa Province (KP), with campaigns by militants opposed to vaccination further complicating the situation.

Pakistan, one of four remaining polio endemic countries in the world, reported 32 cases in 2007, but that number rose to 144 in 2010, according to the Global Polio Eradication Initiative (GPEI) - the highest in any country in the world.

Cases over wide area

This year, 51 cases have already been reported. To add to the difficulties, according to GPEI, “five new positive environmental samples were reported from across the country, including from Karachi, further confirming widespread geographic transmission of wild poliovirus.”

While the disease had mainly been restricted to three groups of districts - Karachi city, a group of districts in Balochistan Province, and districts in the Federally Administered Tribal Areas (FATA) and KP - new evidence points to a spread across a wider area.

“Oral Polio Vaccine will be given to all the targeted children in Gilgit-Baltistan during the measles-Maternal Neonatal Tetanus campaign running 4-9 July. The target children of Gilgit Baltistan will have their fifth dose of OPV during the next National Immunization Days campaign on 18-20 July,” WHO’s Afridi said.

Medical experts say “irresponsible” media reports, such as one stating that a 16-day-old infant died in Punjab Province this month after receiving expired polio drops, have added to fears among parents and encouraged “refusals”.

“It does not seem likely the vaccine caused the death, but rumours about such incidents spread fast,” Hassan Ali, a general practioner in Lahore, said.

Chaudhry Muhammad Aslam, director-general for health in Punjab, said in a statement: “The death of a baby due to the polio vaccination is out of [the] question. The polio vaccination is an oral treatment in the form of liquid which remains in the bowels while the other medicine is administered through the veins or stomach to be mixed in blood."

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