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Polio no longer endemic in India
The country was once recognized as the world’s epicenter of polio.
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As of Jan. 13, India will have completed a full year without any reported polio cases, according to WHO.
If all pending laboratory investigations return negative in coming weeks, India will be officially recognized as having stopped indigenous transmission of wild poliovirus. The last case there was in a 2-year-old girl in the state of West Bengal on Jan. 13, 2011.
Upon this anticipated designation for India, the number of countries with endemic polio will be reduced to a historic low of three: Afghanistan, Nigeria and Pakistan.
Although this is a major accomplishment for a country that has spent nearly $2 billion on polio eradication efforts, WHO warns that India must maintain sensitive surveillance and high childhood immunity against wild poliovirus until eradication is achieved globally. In 2011, Afghanistan and Pakistan reported significant increases in polio cases, and poliovirus from Pakistan reinfected China, which had been polio-free since 1999. In Africa, active polio transmission continues in Chad, the Democratic Republic of the Congo and Nigeria, with outbreaks in West and Central Africa in the past 12 months. Therefore, the global polio eradication efforts will now focus on improving the implementation of emergency operations plans in Chad, Nigeria and Pakistan, according to a WHO press release.
The Global Polio Eradication Initiative is spearheaded by national governments, WHO, Rotary International, the CDC and UNICEF.
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In 1988, when the polio eradication effort began, there were an estimated 350,000 people paralyzed by polio, and 125 countries were considered endemic (ie, had never interrupted indigenous transmission). Since that time, there has been a 99% reduction in cases, and only three countries remain endemic (Afghanistan, Nigeria and Pakistan). Until recently, India often reported the greatest number of cases in recent years. And India was a major exporter of polioviruses to other countries. For example, in 2010, virus originating in India was exported to Tajikistan, where an outbreak of 460 paralytic cases was reported.
The most recent case of polio detected in India had onset on Jan. 13, 2011. Thus, Friday, Jan. 13, 2012, marks a full year without detection of a polio case, the first time this has ever been noted in India. India will come off the list of endemic countries.
This is a major breakthrough in the global polio eradication initiative and gives impetus to finishing the job, so that never again will children anywhere in the world be at risk for polio.
Walter A. Orenstein, MD
Infectious
Diseases in Children Editorial Board
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