Polio- an Endemic Disease in Pakistan

Polio- an Endemic Disease in Pakistan

Nearly three effortful decades of Polio eradication campaigns but Polio is still an endemic disease in Pakistan.

Polio is a viral infection disease and left as an endemic disease in two countries only, Pakistan and Afghanistan. 

Poliovirus is a viral infection that causes several severe health-related issues. Such as immobility, breathing difficulty, limb deformation, and rarely death. 

Polio Eradication Campaigns

The government of Pakistan started official campaigns for polio eradication in 1994, which showed a noticeable fall in polio outbreaks in the coming years. Almost three decades ago, the wild poliovirus affected 30,000 kids across Pakistan. In 2018, the number decreased to 8 cases only, which showed tremendous progress in the eradication.

Unfortunately, the year 2019 did not bring luck in this scenario and the country saw another hit again. This time, we had 146 documented cases that rang the alarm bell once more. KPK remained on the top of the list among all provinces with the highest number of cases (93 documented cases).

As of 2020, the first campaign started on 17th February, aiming to vaccinate 3.9 million children under the age of five years across the country. Nearly 265,000 polio workers were assigned this tough but noble cause, to protect every Pakistani child against the crippling virus.

Woefully, the campaigns had to be stopped due to the coronavirus outbreak as saving the kids lives was in a pandemic was more important. 

Seeing the decline in COVID-19, Pakistan resumed the Polio campaigns from 20 July 2020. The country has recorded 60 new cases this year, making it again a warning as potential widespread transmission. 

National Strategies

Although Pakistan along with international health aid, trying hard to eradicate this endemic disease by struggling to vaccinate every single child before the virus reaches them. 

To achieve this goal the government has designed the National Emergency Action Plan (NEAP), an online document that defines the outlines of eradication strategies. To combat with Poliovirus, the government has also come up with a door to door Polio campaign. In which thousands of frontline polio workers go door to door to vaccinate the children under the age of five, after every four weeks.

The officials have also launched a program naming Sehat Tahaffuz Helpline 1166 with local languages to make seeking advice about Poliomyelitis more convenient to common men.

Safety Guidelines for Polio Front liners During COVID-19

The health officials have resumed the Polio campaigns again from July 2020 with a safety guideline list for polio workers. Some key points from the list are; 

  • No polio worker will knock the door or press the doorbell with their hands. They will ring the bell with their elbows, or knock the doors with pens or any other tool. 
  • Wearing a mask and sanitizing hands is compulsory for every polio worker. 
  • Polio workers will make sure to maintain a safe social distance with the kids while vaccinating them.
  • The workers will not touch any child’s face or hand, they will orally vaccinate them, holding the dropper away from the kids’ mouth. The officials have instructed to discard the vaccine right away if it becomes in contact with the child’s mouth.
  • Similarly, the polio front liners will mark the kids’ fingers with a marker without touching their hands.

The front liners are going house to house with complete safety measures to vaccinate the children and to protect them from COVID-19 at the same time.

 

Hurdles and Challenges

Pakistan is an already under-resourced country with a deteriorating public health care system. Along with the poor healthcare system, the Polio eradication campaign faces several religious, political, and socioeconomic factors. 

The main challenge is to reach every child for vaccination in far and immobilized rural areas. Poor sanitation, low immunization, illiteracy, poverty, and myths and rumors associated with polio vaccines are the co-factors that make polio eradication difficult in Pakistan.

Parents refuse vaccination due to divergent misinformation such as:

  • The vaccine is sub-standard.
  • It’s not Halal, it contains ingredients forbidden in Islam.
  • It causes infertility.

 

Background to the Disease 

Poliomyelitis is a viral infection caused by poliovirus, however, the wild poliovirus (WPV) has three different types, type one, type two, and type three.  We need to protect kids against all three types by proper vaccination. 

Among all three types, PV1 is the most common type. Also, the one that is the most closely related to paralysis. Currently, Pakistan is fighting against circulating vaccine-derived poliovirus type 2 (cVDPV2) and the wild poliovirus (WPV).

Symptoms and Transmission

The general and early symptoms may include sore throat, fever, vomiting, stiffness, and pain in the back, neck, arm, or leg muscles, fatigue, and muscle tenderness.

Poliomyelitis can spread from person to person. The infected people have poliovirus in their feces, and they can carry the deadly virus along with them for weeks. One in direct contact with the infected person is at higher risk of catching the virus. People who carry the virus but do not have any symptoms can also infect others. Contaminated food and water can be the less common transmissions modes.

Anyone who has not been vaccinated before is at risk of encountering the poliovirus, however, kids under the age of five are at a greater risk.

To save the future of Pakistan, and to list it among Polio-free countries, We need to fight with this endemic disease as a unified nation.

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