Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Polio "0" efforts in South Asia
- Arun N Patel (21 September 2002)
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Personal experiences in Polio immunisation
- Indranil Mallick (23 September 2002)
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The Beginning of End of Polio
- Dr Mohan R Babu (26 September 2002)
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2002 rise in poliomyelitis episodes in India
- Subhash C Arya, New Delhi- 110048, India (29 September 2002)
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Arun N Patel, Speailaist Registrar in Public Health Medicine NNOTTS Public Health Network,
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Ramifications of circulation of wild poliomyelitis virus in Uttar Pradesh, India go beyond its boundaries. Waters from Ganges flows down to Bangladesh, often within few days. Poor sanitation and contamination of drinking water is still a big problem in Bangladesh. Bangladesh has made good progress in reaching a high coverage of Polio 3 vaccine, but this can be undermined by wild polio coming into their drinking water from India. Polio “0” efforts should keep this under serious consideration. |
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Indranil Mallick, House Physician Medical College, Calcutta, 88 College St., Calcutta
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I was a part of a group of medical students who were sent to a village close to Calcutta during the Pulse Polio drive in early 2001. Nearly 50% of the population was made up of muslim weaver families, the remaining were hindus. We faced a lot of resistance from the Muslim families, primarily because they, as a community, had been led to believe that a) The vaccine would give their children polio (instead of prevent it) and b) their children would become sterile. This was compounded by media reports (mainly in the Bengali private TV channels) which each day focussed on families which had had polio inspite of vaccine use. The larger picture of the benefits, or of the scientific basis of the failures was not communicated by even a single one of these channels. In spite of of the best efforts of our fresh and idealistic group of students (helped immensely by the group of local health workers who were guiding us from house to house) we were unable to vaccinate a significant number of children. This social resistance is something that has to be dealt with patiently and intelligently. I'm sure people in the more developed nations will find it hard to understand this, but the ground realities sometimes overwhelm the best of efforts. I also personally believe that the media was irresponsible and partly to blame for this failure. |
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Dr Mohan R Babu, Junior resident (Non Academic) ,AIIMS Dept of Urology, All India Institute of Medical Sciences, New Delhi.110069
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Dear Sir, This is in response to the article on Polio outbreak in UP, India. But my perspective to this endgame of polio eradication in the state of UP in specific and in India in general is that it is this stage that we should be confident of, that we are going to win the battle against Polio. This is just like a battle where in the final stages, the enemy (Wild Polio Virus) is scattered and spread out and is taking refuge in the name of resistant community. But the winning team of is not weak by any proportions. It consists of millions of Indians who are working day and night to get this out of Indian soil. Thanks to NPSP (A joint collaboration of Govt of India and W.H.O) which is a General leading from the front. Thanks again to all the agencies that are playing key role in eradication. (UNICEF, and all the Donor agencies for polio eradiation) It wouldn’t take long for this process to be over. This is just the beginning of end of Polio in India. All the best to each and every Individual engaged in this drive to eradicate polio. |
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Subhash C Arya, Research Physician Centre for Logistical Research and Innovation, New Delhi- 110048, India
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2002 rise in poliomyelitis episodes in India Editor_ Religious resentment against live poliovaccine (OPV) has been incriminated for the recent rise in poliomyelitis episodes in Muradabad and adjoining areas in India1. That is nothing unusual as, decades earlier, the Ordox Reformed Population, a religious group in the Netherlands had rejected all types of vaccinations2. Recently, resentment against OPV was recorded in northern Nigeria with pockets of resistance in Niger, Jigawa and Kano States3. Nevertheless, it would be better if all episodes of acute flaccid paralysis (AFP) attributable to poliovirus or non-poliovirus infection were diagnosed promptly by imaging techniques and offered antiviral therapy. Magnetic resonance imaging of the cervical spine of a 27-year-old man who developed AFP three weeks after his 20 month-old infant was immunized with OPV revealed smooth hyperintense bands. Sagittal-spin proton-density T2-weoghted images revealed involvement of the regions corresponding to the anatomic location on the ventral horns4. Recently, therapeutic intervention with pleconaril in three patients with acute poliovirus infection, two vaccine-associated and wild type poliovirus, was associated with a definite clinical response. Neurological improvement was evident in two cases while in one case, there were better respiratory status and muscle strength. Furthermore, in one patient even the initial CSF positive viral culture and PCR were followed by negative results5. Future episodes of poliomyelitis in India or elsewhere should be addressed by seeking a diagnostic indication of poliovirus replication in motor neurons by imaging technology. MRI based involovement of target neurons by poliovirus should be accompanied by a pleconaril recipe. Certainly, they should alter any poliovirus-induced morbidity during the 2002 spurt of polio cases in India1. Subhash C Arya, MBBS, PhD Research Physician Centre for Logistical Research and Innovation M-122 Greater Kailash-Part 2 New Delhi- 110048, India Email subhashji@hotnmail.com References 1. Kumar S. Polio epidemic hits Uttar Pradesh. BMJ 2002; 325:617 2. Conyn-van Spaendonck MAE, de Melkar HE, Abbink F, et al. Immunity to poliomyelitis in the Netherlands. Am J Epidemiol 2001; 153:207-214 3. Mohammed I. Cases of polio in Nigeria are dropping. BMJ 2002; 325:493 4. Malzberg MS, Rogg JM, Tate CA, et al. Poliomyelitis: hyperintensity of the anterior horn cells on MRI images of the spinal cord. American Journal of Roentg 1993; 161:863-865 5. Robert HA, Webster AD. Treatment of potentially life-threatening enterovirus infection with pleconaril. Clin Inf Dis 2001; 32:228-235 | |||