Resurgence: Polio vaccination to resume across Sindh

Sindh Chief Minister Syed Murad Ali Shah directed the health department on Saturday to resume the polio eradication drive, which was disrupted in the wake of the coronavirus outbreak, from July 20.

He issued the directive during a provincial taskforce meeting on polio eradication, where health authorities sounded alarm over the exponential rise in polio transmission expected from September onwards if vaccination drives remained suspended.

At the meeting, Emergency Operations Centre (EOC) coordinator Fayaz Abbasi told the CM that there were 58 active polio cases in the country, of which 20 were reported from Sindh - the highest count after Khyber-Pakhtunkhwa.

According to Abbasi, the latest polio case in the province was reported on Thursday.

The CM was told that the emergence of the coronavirus had brought polio eradication drives to a halt since March. He was informed that the decline in acute flaccid paralysis (AFP) surveillance was reflected by the decrease in the number of AFP cases being reported, while the coverage of essential immunisation being carried out under the Expanded Programme on Immunisation had declined by more than 50 per cent and the transit point vaccination programme had come to a standstill.

In light of these developments, health authorities stated that without any vaccination, polio transmission was expected to increase drastically from September onwards, particularly in Karachi and Northern, Central and Southern parts of Sindh, even when the government had the capacity to vaccinate around 700,000 children under the age of five every month.

They pointed out that a large part of the population was at risk of being infected with poliovirus type 2, and that conducting supplemental immunisation polio drives would not substantially increase the risk of pandemic escalation.

The CM was further informed that during 2019 and 2020, 16 vaccine-derived poliovirus type 2 (cVDPV2) strains were isolated from 10 environmental samples in Sindh. Of these samples, six were collected in 2019 and 10 in 2020. Moreover, 15 of these samples were collected from Karachi alone, the CM was told.

According to details shared during the meeting, in March, 100 samples of healthy children from Orangi Town were collected and one among them was found to be containing cVDPV2 strain. Following this, the number of cVDPV2 human cases in Karachi rose to two.

Health officials further told the CM that supplemental immunisation activity modalities, in relevance to polio eradication, were revised so that when carried out, they would not lead to introducing Covid-19 in communities that were not infected thus far.

As per the new modalities, polio workers are to be screened for Covid-19 symptoms, and they are to use masks and sanitisers and limit physical contact while vaccinating, particularly with adults. Deploying polio workers in an area inhabited largely by the community they belong is also to be given preference and polio workers are to avoid contact with people showing Covid-19 symptoms.

At this, the CM directed the health department to start a special vaccination campaign in 23 union councils of Central and West districts, covering 26,742 children.

Besides, he instructed the EOC to apprise vaccinators of immunisation guidelines during the pandemic and provide them personal protective equipment (PPE), directing Abbasi to ensure that the guidelines were properly followed and PPE was properly used. The CM asked him to monitor visits regularly for the purpose.

He further instructed the EOC to carry out monthly polio vaccination campaigns from July to December with the World Health Organisation's support and deploy five mobile vaccination vans in high-risk union councils of Karachi.

Published in The Express Tribune, July 12^th, 2020.