Second polio virus case surfaces in Karachi

Refusals, lack of awareness being attributed to rising incidence

KARACHI: A six month-old child tested positive for the polio virus on Thursday, raising the total number of reported cases in Karachi this year to two. This is the third case of the province and the 17th of the country in the current year.

The latest victim, identified as Abdul Nasir, son of Abdul Qahar, is a resident of Abul Hassan Isphahani Road in Gulshan-e-Iqbal. According to the Emergency Operations Centre - a federal-level unit working on polio eradication and immunisation - the victim's parents had never allowed the child to be administered the polio vaccine since his birth. The parents, said one official, were vaccine-deniers and had refused the inoculation for their child. They had concealed the child's presence each time the vaccinators came to their home.

According to the victim's father, the child had developed a low-grade fever on April 28 and had been taken to the Mamji Hospital in Gulberg. The fever was followed by weakness in both limbs, after which samples were sent to the laboratory for testing. The samples came back positive for the polio virus.

NIH finds presence of polio virus in Hyderabad's sewage

A precarious situation

This is the second case to have surfaced in the city and the third in the province. Earlier in March, a child was diagnosed with the polio virus in Lyari. That was followed by a case in Larkana, where a three-year-old girl tested positive for the polio virus earlier this month. What is alarming is that the girl had previously travelled to Karachi's Bin Qasim area in district Malir, considered to be a hotbed of poliovirus in Karachi.

The situation is alarming, given that the number of polio cases had been on the decline in Pakistan after several aid agencies had joined hands with the health authorities on the federal and provincial levels to eliminate the virus. Millions of children were inoculated multiple times to ensure the efficacy of the vaccine. Until last year, the efforts seemed to be working, with the number of polio cases decreased from their highest at 306 in 2014 to 54 in 2015, 20 in 2016, dipping to the lowest ever at eight in 2017, before rising to 12 in 2018.

The current year has, however, been particularly unnerving as the number of cases across the country has jumped to 17 in the first five months alone.

The problems

The EOC as well as the Expanded Programme for Immunsation, which have carried out various immunisation campaigns across the country, blame the rising incidence on the high number of refusal cases. Authorities have tried various methods, ranging from legal action to awareness campaigns, to counter the refusal cases, but the efforts don't seem to have been working.

According to National Institute of Child Health's Director Prof Jamal Raza, the latest victim had not received a single drop of the polio vaccine. "Refusal cases have increased in Pakistan, largely because of the propaganda emanating from South Waziristan," he lamented.

The viral disease has remained endemic in the country after the Taliban banned vaccinations, targeted vaccinators and raised suspicions about the inoculations. For example, in the last immunisation campaign carried out in Hyderabad and Mirpurkhas in March, earlier this year, as many as 5,670 and 1,535 cases of refusals surfaced from the two districts respectively.

Polio virus found in sewage systems of 11 districts

The refusal cases, combined with the growing presence of the poliovirus strain in the environment presents a worrying picture for all the stakeholders who have been trying to eradicate the virus in the last few years.

According to the Global Polio Eradication Initiative - a joint venture of the World Health Organisation, Rotary International and the United Nations Children's Fund, among others, as of April 2019, a total of 107 environmental samples collected from across the country have tested positive so far. Compared to the 140 positive samples in 2018, the statistics paint a bleak picture especially as the number of affected persons is on the rise too. Samples taken from sewerage in almost all major urban centres in Sindh have tested positive for the presence of the polio virus in recent months.

The danger

Pakistan is one of only three countries, along with Afghanistan and Nigeria, which have been unable to completely eradicate the polio virus so far, leading to fears that the virus strain could spread to other regions if a carrier travels abroad. 

Published in The Express Tribune, May 17^th, 2019.