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WHO reports record-low number of polio cases in Pakistan
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Cases of wild poliovirus hit a record-low in Pakistan last year, according to WHO.
As of Dec. 21, WHO reported 19 confirmed cases of wild poliovirus type 1 (WPV1) in Pakistan in 2016 — down from 51 in 2015 and the fewest ever recorded in the country.
Cases were reported in just 13 districts in Pakistan, according to WHO spokeswoman Sona Bari — also a record low. Last year, there were cases in 23 districts.
“It is heartening that Pakistan has reached the fewest cases and the smallest geographic reach of polio in its history,” Bari told Infectious Disease News. “This is due first and foremost to the tireless work of the country’s frontline health workers who go door-to-door in order to protect the most vulnerable children from this virus.”
WHO announced the milestone last week. At the same time, it said two apparently related isolates of circulating vaccine-derived poliovirus type 2 were detected in environmental samples in Quetta, a southwestern city not far from the Afghanistan border.
Bari confirmed that the isolates were found in sewage samples and said a series of vaccination campaigns with the monovalent oral poliovirus type 2 vaccine targeting Quetta and neighboring districts began on Jan. 2.
Type 2 poliovirus was eradicated in the wild in 1999 and was removed from the oral polio vaccine last year, but can still circulate in vaccine-derived form. There have been no human cases associated with the isolated strains discovered in Pakistan, WHO said.
Wild poliovirus (WPV) is endemic in only three countries, with most cases occurring in Pakistan and Afghanistan. Nigeria experienced a resurgence of the disease in August after going without a case since July 2014, nullifying Africa’s chances to be declared polio-free by 2017.
Militants have acted violently to halt vaccinations in all three countries, impeding progress toward the decades-long goal of eradication. According to Reuters, local officials in Pakistan said they had recruited Muslim clerics to help promote the immunization of 400,000 children after the recent discovery of the type 2 virus in sewage.
“We cannot underestimate the challenges that Pakistan is facing, from the law-and-order perspective to the weaknesses of its health system,” Bari said. “Stronger government ownership has made this progress possible. This ownership needs to be more consistent across all levels of government so there is accountability for reaching every last child. Community trust must be maintained and strengthened even in communities which are traditionally marginalized.”
In 2016, there were 35 cases of WPV1 in Pakistan, Afghanistan and Nigeria — half the amount as 2015 and a decline of nearly 100% from 350,000 cases in 1988 when the World Health Assembly launched a program it hoped would eradicate the disease by the year 2000.
Cases in Pakistan have plummeted from a recent peak of 306 in 2014.
“In a nutshell,” Bari said, “Pakistan’s program has been able to reach more children on a consistent basis over the last 18 months, hence leading to the decrease in the number of polio cases and geographic range.” – by Gerard Gallagher
Disclosure: Bari is a spokeswoman for WHO.