Karachi back to being a reservoir for polio, as WHO discovers virus in sewage in Gadap

Violence in the city takes its toll on the polio eradication campaign in the city.

Samia Malik August 05, 2012

KARACHI: As the World Health Organisation appears discouraged from taking further part in future polio eradication campaigns in the city, a new report released by the organisation on Sunday points out that researchers discovered high traces of the poliovirus in sewage samples of several towns in the city.

The discovery is considered to be correlated with inability of teams to visit certain areas due to the tumultuous law and order situation in the city.

The WHO report mentions that the virus reemerged in Sohrab Goth, Badin, Gadap Town, Hyderabad city and Sukkur, which raises questions about the outbreak of the disease beyond Karachi.

Meanwhile, Karachi seems to have regained its status of being one of three high-transmission polio zones in the country. Sewage samples from multiple localities in the city continued to present traces of the virus in lab tests till 2011. However, the efforts of polio teams appeared to have paid off when later samples appeared devoid of the virus, allowing the city be stripped off its high-transmission status for a short period of time.

The resurgence of the virus in the city’s sewerage system has been blamed on the failure of the latest nationwide polio campaign in July to reach thousands of children in Karachi and other trouble spots in the country.

Attacks on dedicated polio workers in the city on July 17 and 20, which left one person dead and two injured, meant that 22,000 children in areas like Gadap could not be vaccinated.

Perhaps unsurprisingly, WHO pointed out that the poliovirus was found in sewerage water samples collected from Gadap. The area has been dubbed as one of two reservoirs of the poliovirus in the country, and has been the focus of much anti-polio campaign activities in the past.

Meanwhile, the latest sewage samples collected from Baldia Town also showed the presence of the poliovirus for the first time this year, after 12 previous samples collected earlier in the year did not.

The bigger picture

Pakistan has reported a total of 27 polio cases so far this year, with 13 of them from the Federally Administered Tribal Areas, six from Khyber Pakhtunkhwa, three each from Sindh and Punjab, and two from Balochistan. These polio cases were reported from 15 distinct districts in the country. Apart from Sindh, sewerage water from Lahore, Rawalpindi and Peshawar also contained traces of the virus.

“While polio eradication has become a global emergency and it is time to reach more children, it looks like we are determined to miss out on more children than before,” lamented a WHO official who did not want to be named.

The causes for the presence of the poliovirus among the top high transmission areas in the country, are said to be varied. Gadap, Baldia and Gulshan-e-Iqbal are considered black spots in the city because parents in these areas reportedly often refuse to allow their children to be administered the oral polio vaccine. The deteriorating law and order situation, on top of the targeting of polio workers, only makes the matter worse.

Meanwhile, North and South Waziristan have become high transmission zones as polio campaigns have been banned there, depriving more than 200,000 children from being vaccinated. The Bara tehsil in Khyber Agency has been inaccessible for vaccination teams since September 2009. As a result, 10 of the 13 polio cases reported from Fata have actually come from Bara.

Prime Minister Raja Pervaiz Ashraf has called a meeting of the National Polio Task Force on August 7. The four chief ministers, health ministers and secretaries are supposed to attend the meeting.

Published in The Express Tribune, August 6th, 2012.