Will Pakistan ever rid itself of the polio menace?

Almost 95% of patients infected by polio do not experience any initial onset symptoms which makes the disease very hard to detect in the earlier stages

When the patient does exhibit symptoms, it is usually in the form of fever, fatigue, headache, vomiting, and stiffness in the neck and pain in the limbs

Such signs can be easily mistaken as symptoms of the common cold or other rudimentary afflictions, making polio even harder to diagnose in a timely manner

Once polio cases are detected, treatment can only be given to patients to alleviate the symptoms, not cure them

Heat and physical therapy is used to stimulate the muscles and antispasmodic drugs are given to relax the muscles

While this can improve mobility, it cannot reverse permanent polio paralysis

The Government of Pakistan, with the support of the World Health Organisation (WHO), United Nation’s Children Fund (UNICEF) and other key partners of the Global Polio Eradication Initiative (GPEI), has made long strides towards the global goal of eradicating polio in the recent years

A robust vaccination campaign, strong monitoring and the unflinching resolve of the health workers tasked with this gargantuan task should ideally have rid us of this menace by now

Unfortunately, Pakistan remains one of three countries in the world along with Afghanistan and Nigeria with active polio transmission and only one of two countries with wild polio transmission

The official number of reported polio cases in 2017 and in 2018 were eight and 12 respectively

As a result, the prospects of eradicating polio in the country in the coming years were promising

However, in 2019, a total of 134 cases were reported from all across the country signifying that this problem was far from over

Pakistan is currently grappling with an increased number of cases of wild polio virus WPV Type 1 as well as a cVDPV2 outbreak as confirmed by WHO in 2019

WPV type 1 polio virus is a naturally occurring strain found in the environment while the second variant of the disease is vaccine-derived polio type 2 (cVDPV2)

It is caused by a mutated form of the excreted virus contained within the oral polio vaccine (OPV)

An OPV contains a weakened vaccine virus which allows antibodies to prepare for a stronger strain of the virus if push comes to shove

When a child is immunised, the weakened virus replicates in the intestine for a limited time

Then, it is excreted in faeces and eventually dies out

On rare occasions, if the population is not adequately immunised, the virus starts circulating amongst members of the community for an extended time when it gradually undergoes genetic changes

This mutated form of virus can cause paralysis

CVDPV2 is not related to, nor indicative of a re-emergence of wild polio virus, but still poses a significant challenge as Pakistan looks to eradicate polio

According to the Polio Global Eradication Initiative’s (PGEI) official statistics, the number of cases of WPV polio in 2019 is 134, with 91 of them coming from KP

Thankfully, the number of cases of cVDPV2 is only 12

The recent surge in cases of WPV Type 1 polio in 2019 can be attributed to misinformation and a sham video that was circulating on social media, claiming that polio drops had poisoned children which had resulted in their death

While this video eventually proved to be false, the damage had already been done

Certain parents went as far as marking the fingers of their children in an attempt to hoodwink polio workers and prevent their children from receiving the drops

The WHO, based on an analysis of multiple environmental samples taken from the country, has painted a gloomy picture for 2020

Polio will most likely remain a problem for Pakistan during the year, because of which the WHO has extended travel restrictions in Pakistan for three more months

As mentioned previously, the solution lies only in prevention through an oral polio vaccine

The vaccine eliminates the risk of developing polio in the general population and also, helps prevent cases of cVDPV2 caused by lingering mutant strains of polio virus in the environment

Improved sanitation and living conditions can eliminate the risk of cVDPV2 as well while frequent environmental sampling to detect this variant of the disease can help in early estimates of transmission and potential outbreaks

Moreover, strengthening polio surveillance systems and ensuring high vaccination coverage can help tackle both problems of emergence of WPV type 1 and control of cVDPV2

Finally, mass awareness campaigns which engage with the religious factions of society will certainly help dispel misinformation and can go a long way in changing the attitudes of communities towards vaccination

Admittedly, Pakistan faces an uphill battle in the fight against the polio, but the task at hand is by no means insurmountable

Date:11-Jan-2020 Reference:View Original Link