INTRODUCTORY NOTE ON PULSE POLIO PROGRAMME- 2014-15

WITH PROPOSED NEWER INITIATIVES-AN APPRAISAL

PULSE POLIO DAYS
21
st
September 2014 and 16
th
November 2014
POLIO RAVIVAR

What is Polio Eradication & its Strategy

Humans are the only reservoir / Carrier of Polio Virus called Wild Polio Virus. It has three types 1, 2, 3. It is
type 2, which is the first one to get eliminated, followed by type 3 & then type 1 Polio Virus from the
human environment. Elimination of type 2 virus generally indicates a good / Satisfactory Routine
Immunization System / Coverage in an area. The country had eliminated Type-2 Virus Fourteen years ago.

The Strategy for elimination / Eradication are by having an equally strong system of 4 components. These
are: Strong Routine Immunization, well Conducted Pulse Polio Rounds, Selective /Focal Mop-up rounds &
a Sensitive & Responsive AFP System.

1. Delhi initiated Pulse Polio Programme in the year 1994 and set the ball rolling for the Eradication of
Polio from our country. In 1994 and 1995, children up to 3 yrs of age were covered. From 1996-97
onwards all children up to 5 years of age are being covered under this program. Since the year 2000-01,
house to house component has been added on a full scale in the State as a part of intensification of
Pulse Polio Programme with the aim of reaching each and every child in addition to booth strategy
of Polio vaccination alone which existed in earlier year. The state of Delhi is able to immunize around
23-25 lac children in each phase of the Pulse Polio I mmunization Programme. Six ( 6 ) rounds of
Intensified Pulse Polio I mmunization during the year 2013 and Three (3) rounds in the year 2014 so
far, had been conducted in the State with more then 8200 booths created for conducting Booth Activity
and about 9400 teams ( Each team comprising of 2 members) deployed for carrying out House to House
Activity, during each round for vaccinating all children under five years of age. More then 46 lac
household on an average are visited during each round to cover all eligible children which clearly
reflects the mammoth ness of the entire exercise undertaken during each phase.

2. Achievements of Pulse Polio Programme;

National level :

India has been declared polio free along with countries of South East Asian
Region of WHO on 27
th
March 2014.

Polio free for >3 Years,
35000 in 1994 to 1 in 2011 (Last Polio Case 13
th
J an 2011)
India removed fromList of Endemic Countries on 25
th
Feb, 2012

Delhi :

Polio free for >5 Years
500 Cases in 1994-95 to No Case since 2010 (Last case in June 2009)


2


3. Risks/Challenges to Polio Eradication Strategy:

a) International Importation of wild polio virus. Neighboring countries like Afghanistan, Pakistan
and Nigeria has had a major outbreak of Wild Polio Virus in the recent past who pose a major
threat to Polio Eradication.
b) Complacency both for public & system.
c) Gaps in AFP Surveillance or delays in detection of wild polio virus
d) Delayed and or inadequate response to importation.
e) Areas with low population immunity.
f) Gaps in Routine Immunization & SIA especially in High Risk Areas.
g) Various resident societies in Delhi are not allowing vaccinators to enter their premises and
immunize children in these societies.

4. Current Program Priorities in Delhi

a) Intensify AFP Surveillance including environmental surveillance
b) Maintain Intensified program in High Risk Areas
c) Fully and consistently cover Migrant and Mobile populations
d) Strengthening Routine Immunization especially in North East district
e) Prepare for Emergency: rapid and effective response to any wild polio virus




5. Initiatives and Preparedness of State

Emergency Preparedness and Response Group has been constituted under chairmanship of
Principal Secretary (Health and Family Welfare), Govt. of Delhi to respond rapidly to wild polio
virus importations.

In Delhi, environmental sewage sampling has been initiated in May, 2010 to isolate wild polio
virus. Initially 5 sewage sites were identified and these sites were catering to the sewage
predominantly from migratory communities. Sewage samples had shown both types of wild P1 & P3
polio virus till August 2010. After August 2010, sewage samples have not shown any wild polio
virus in the Delhi environment. Now the number of sites for taking sewage samples has been
increased from 5 to 7.
3
Sewage sample collection sites: Delhi
Sewage collection site
SOUTH
WEST
SOUTH-WEST
NORTH-WEST
NORTH
EAST
NORTH-EAST
CENTRAL
NEW DELHI
High ri sk districts
Medium risk districts
Low risk di st rict s


Acute Flaccid Paralysis (AFP) Surveillance is a key strategy or monitoring the progress of
polio eradication and is a sensitive instrument for detecting potential polio virus infection. AFP
Surveillance has become more sensitive and the number of AFP reporting sites has increased
from 184 in the year 2010 to 593 in the year 2014. All major Govt. & Private hospitals are part
of surveillance network.
Risk Analysis of the State has been completed from Polio Programprospective and all high risk areas
and migrant sites and a highly focused strategy is in place to cover all these children
Population in transit covered in the State in each phase at Railway Stations, Moving Trains, ISBTs,
border areas, Mc Donalds, Dominos Pizza outlets, IGI Airport, Milleniumpark, Japanese park and at
Metro Stations, Religious congregations like Nirankari Sant Samagam, Urs Mela, Haj Pilgrimage
etc. and places of Tourist Interest. Additional transit booths have beencreated at AkshardhamTemple,
Birla Mandir, Kalkaji Temple, J handewalan Temple.
In view of massive construction activity as part of infrastructure development activities in the
State, all construction sites tracked and listed to ensure these highly vulnerable children of
these workers are covered in each & every polio phase.
Each vaccine is also having a Vaccine Vial Monitor (VVM) which helps in identifying the loss of
efficacy of vaccine due to heat.






4

INTENSIFIED PULSE POLIO IMMUNIZATION PROGRAMME

Frequently asked questi ons (FAQs) :

Q) How the wild Poliovi rus i s commonly t ransmitt ed f rom one child to another?
A) Wild Poliovirus is commonly transmitted from the infected child to the non vaccinated child.
Faecal-oral transmission is most common especially where sanitation is poor.

Q) Is the Polio vaccine saf e when gi ven in repeat ed doses?
A) Yes, the vaccine can be safely given in repeated doses.

Q) Can Polio vaccine be gi ven with other vacci nes?
A) Polio vaccine may be given simultaneously with any other childhood immunization and
there is no limit to the number of doses, which may be safely given.

Q) Is it possible for me to check the qualit y of vacci ne being gi ven to my child?
A) The potency of vaccine can be gauged by looking at and interpreting the Vaccine Vial
Monitor (VVM) that is affixed on all OPV vials. (see VVM). The label of the vaccine vial
darkens if the potency of vaccine is not up to mark.

Q) Should a child having high grade f ever and loose motions f or the l ast 3 days be
given Polio drops on PPI days?
A) Yes, all children below 5 years of age even if sick or hospitalized should be given Polio
drops on Pulse Polio days.

Q) Can a newborn child be gi ven Pul se Polio vaccine?
A) Yes, a newborn child can be given Pulse Polio vaccine very safely.

Q) A child has received booster dose of DPT/OPV 2 days before the National Immunization
day. Should the child be taken to Polio Kendra for Pulse Polio drops after 2 days?
A) Yes, the child should be taken to the Polio Kendra and given Polio drops. It is safe for the
child and is necessary for Polio eradication.

Q) Can routi ne Immuni zation with DPT, OPV, and Measl es etc. be continued after giving
the child Pul se Polio drops?
A) Yes, routine immunization should be continued even after the child has received Pulse
Polio drops. Routine Immunization increases the childs defence against diseases like
Tuberculosis, Diphtheria, Tetanus, Pertussis, Measles and Poliomyelitis. Both are
complimentary to each other but not a substitute to one another.

Q) Is thi s the l ast year of Pulse Polio Immunization?
A) No, this is not the last year of Pulse Polio Immunization. The rounds will continue in India,
for the next few years and will be discontinued after the global eradication of wild polio
virus.



5
Number of Polio Cases :
Year India Delhi
1998 1934 47
1999 1126 73
2000 265 3
2001 268 3
2002 1600 24
2003 225 3
2004 134 2
2005 66 1
2006 676 7
2007 874 2
2008 559 5
2009 741 4
2010 42 0
2011 01 0
2012 0 0
2013 0 0
2014 till 27-08-2014 0 0

Q) How can I help in Polio eradication?
A) You can be part of this program by participating in National/Sub- National Immunization
Day activities and House-to-House Search and Immunization Program. You can motivate
parents of young children to bring their children to the Polio Kendras for vaccination. You
can be a local guide or helper for the teams of workers who go from House to House to
look for children who missed the Pulse Polio dose on the National Immunization days.

RWA bei ng the coordinator of all acti vities t hat are held in the residenti al localit y
can play an i mport ant rol e i n ensuring t he proper impl ement ation of Pulse Polio
Immunization Programme by:

1. Motivating t he parents of young children to bring them to the nearest Polio
Kendra f or vaccinati on.
2. Educati ng the RWA members regarding the import ance of immuni zing t heir
children with Pul se Polio drops on Pulse Poli o Days.
3. Acti vely publi cizi ng the pul se polio programme by di splayi ng banners, post ers,
sti ckers, in your locality.
4. Removi ng the doubt s, misbeli eve, t aboos of t he members of the associ ation by
actively sharing the information provided t o you regardi ng pulse polio
programme.
5. Opening of Polio Kendra in your localit y i f the exi sting pulse polio Kendra i s at
relati vely i naccessibl e pl ace.
6. You can be a guide to t he house-to-house t eams visiting your locali ty by ensuring
that they are abl e to cover the whol e locality and immunize all the left out
children.



The volunt ary effort made by our ci tizens may be a vit al f actor in ensuring the success of
the program. If we commit oursel ves t o reach every child, Polio will soon be hi st ory.
6

Why see a crippled chil d affli cted with wild poliovirus when we can root out
the disease by simply gi vi ng the poli o drops to al l children under 5 years of
age.



MESSAGE TO PUBLIC


Parents are requested to get their children less than five years of age protected with oral polio
vaccine drops on the given dates from any polio booth near your house.

21st September & 16th November 2014


Even sick and newborn children are to be given Poli o drops.
These drops are in addition to routine immunization doses.
These drops are completely safe and are of highest quality.
Repeated doses provide additional protection.
Routine polio vaccination at birth, 6weeks, 10 weeks and 14 weeks of age is also essential.
Polio Eradication efforts will continue till polio is globally eradicated.



Soci ally spirit ed indi viduals & organizati ons are i nvi t ed to activel y parti cipate in thi s
programme.


For any clarification / query, please contact Dr. D.K. Dewan- Di rector Famil y Wel f are cum
Officer on Special Dut y, Pul se Polio Cell, Direct orate of Family Welf are, Govt. of Delhi, 7
t h

Floor, B & C-Wing, Vi kas Bhawan-2, Near Met calf House, Upper Bel a Road, Civil Lines,
Delhi 110054. Tel : 23813210