A successful journey to Polio Free INDIA

Dr. Prakash Khalap MBBS, PGDGM, DIH

Dist. Polio Chair [RI Dist. 3140] In-charge of END POLIO activities for ROTARY Clubs in Mumbai Metropolis / Suburbs up to Palghar / Karjat / Kasara

Polio – What is it all about?

Polio disease spreads through human excreta contaminating water/food or saliva, affects mostly children below 5 yrs, but age no bar may affect adults

Caused by POLIO Virus [Type -- I / II / III]

Is a age old disease known since 17th century

Symptoms – 5% to 10% will have like common cold, mild fever ,soar throat , loose motions, sever body ache, headache, pain in lower and upper extremities and 90% to 95 % will have no symptoms will recover normal

Out of these less than 1% will develop AF Paralysis of either one/two of Lower/ Upper limb ,may rarely paralyze [Respiratory] diaphragm or Bulbar part / Cortex of Brain.

In sever cases will cause death. AFP - Acute Flaccid Paralysis - Skeletal Muscles of Leg/ Hand get loose, floppy, powerless due to Polio Virus infection in motor nerve ganglion of SPINAL CORD , which is life long disability.

Polio – How do you prevent it?

Good Nutrition

Good Personal and Public Hygiene [sanitation]

Immunization against Polio Disease - POLIO Vaccines - ORAL [OPV]. Live Vaccine given orally 2 drops ,easy to administer requires to maintain cold chain [2to 8 degree centigrade] available since 1958 and gives better HERD IMMUNITY, hence used in END POLIO campaign. Injectable Polio Vaccine[IPV] available since 1955. Injection usually given on thigh gives better IMMUNITY to Individuals hence will be used in Routine Immunization in Developed and POLIO Disease FREE COUNTRIES.

Important facts about Polio

POLIO disease is common in children under 5 yeas age and is a communicable, crippling disease, non curable but preventable though VACCINATIONS

Czechoslovakia was first polio free, followed by USA, Europe, Japan, USSR, by good IPV coverage[0.1% OF WORLD POPULATION].

In 1998 there were 3,50,000 POLIO cases in the WORLD that is when Rotary International pledge to make world polio free’.

Efforts by Rotary to make INDIA Polio Free

1979 Rotary makes 5 years pledge to immunize 6 million children against POLIO WITH 6 million US Dollars.

1985 Rotary launches POLIO –PLUS program to eradicate 5 Vaccine Preventable Diseases.

1986 US Dollars 2.6 million to Tamil Nadu State for POLIO Vaccine

1987 US Dollars 248 million raised to purchase POLIO Vaccine for 5 year term

1988 WHO assembly resolve to make POLIO FREE World by year 2000

1994 Pulse Polio Immunization in New Delhi , then across INDIA in 1995. Efforts were made to involve GOIndia, WHO. UNICEF, CDC, Local State Gov, Municipal councils, NGOs, Corporates, to work with 1,24,764 Rotary Volunteers and 21,398 Inner Wheel members.

National Immunization Days (NIDs)

Purpose of NID is to create herd immunity in the country by immunizing all children below 5 years simultaneously in one day [ 80% to 90% coverage] and OPV is the best choice [easy to administer by well trained volunteers]

Sub-NID done only in areas where more POLIO cases are found and Wild POLIO Virus is present in sewage samples and MOP-UP rounds in community settlement, within 24 hrs. of detection of POLIO case in that area.

Awareness and Motivational Activities - Street Plays, Polio Rallies/ Polio Volunteer Groups Chain rallies/ this year POLIO FLAME was carried from RC Madras through Shri Lanka, Pakistan, Afghanistan, Nigeria, East and West Africa, and ended at Sao Paulo Brazil at RI Convention in first week of June 2015.

Strategy & Action Plan

A] at Rotary – National PolioPlus Committee New Delhi headed by Chairman , meets in June end every year along with Union Health Minster and his/her team for national polio eradication plan ,WHO , and Rotary team in-charge of end- Polio activities in all Rotary Districts along with DG and many NGOs like Muslim Ulema Committee etc. these decisions are rectified in respective Rotary District teams in July and detail action plan is formulated in Dist coordination meet where Municipal Health staff ,WHO, Rotary Inner Wheel members, IMA and Rotary Volunteers to finalize action plan in the Rotary Districts and required training is given. Mumbai City and Maharashtra State has well trained staff and Volunteers to carry out END Polio activities even at remote places like Ghadchiroli and Talasary in Dhanu.

Strategy & Action Plan in Mumbai

1. Routine Immunization

2. NID/SNID

3. Surveillance –reporting all AFP case upto 15 years age individuals to MOH of the area

4. Mop-up OPV rounds after polio case detection.

All done under supervision Ex Health Officer and EPI located at F -south ward office Parel TT.. Two days prior to NID publicity in print media/TV/ Radio/ Cable preferably by VIP/ Celebrity actor done . OPV is stored with proper cold chain maintenance [2 TO 8 Degree C] for vaccine potency. One day prior to NID, vaccine is delivered to each MOH office from where on the day of NID/SNID volunteers carry OPV in cold vaccine box/ Thermos box to respective vaccine booths and with close supervision on vaccine indicator, which operates 8am to 6pm, at the end report is submitted to MOH. Next 5 days house to house OPV given to children who were leftover to make 100%OPV coverage. Rotary volunteers help them in transport /men force and other activities many of us manage POLIO Booths.

NUMBER of NIDs/ Sub NIDs:

Each year from 2000 decided by WHO and India Polio Plus Committee

Till 2008-2 NID and 6 Sub NIDs , 2009 and 2010 had 1 NID and 10 Sub NIDs,

from 2011 onwards 2 NIDs and 3 / 4 Sub NIDs

Rotarians in action

Photos : Rotary Club of Bombay Chembur West Volunteers working on the STREET of Chembur on 21/6 Sunday. .

Resistance for Polio Vaccinations

RESISTANCE for POLIO Vaccination for both ROUTINE and NIDs from UP/ BIHAR / Malegaon in MAHARASHTRA till 2007 was common ,when RI formed MU Ulema Committees were formed in these areas to convince the community (Pict PDG Ahok Mahajan)

Last wild Polio cases in India

POLIO FREE INDIA - Certification

In 2014 South East Asia Region [Bangladesh, Bhutan, Nepal, Myanmar, Indonesia, Sri Lanka, Thailand, Timor, Maldives, DPR Korea, INDIA] received WHO certificate. Polio Travel Advisory-in India a measure to prevent polio importation is given to all travelers , from 30 Jan 2014 to take OPV six weeks prior to travel in seven polio affected countries – Afghanistan, Pakistan, Nigeria, Ethiopia, Israel, Kenya, Somalia, and will carry certificates as proof.

We are Polio Free…lets keep it that way!

India’s hard earned status of POLIO FREE COUNTRY will be difficult to maintain unless we are able to stop the transmission

of wild polio virus by strengthening ROUTINE POLIO immunizations

Supporting remaining Polio endemic countries, AFP Surveillance, close watch on migrating population, with the help of WHO, Local Health staff in Municipal corporations and GOI health workers and

Local Politicians and NGOs, with firm commitments from Governments .

WE are proud to achieve OUR TARGET OF polio free India crossing all hurdles in long journey from 1988 to 2014, well done INDIA.