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Polio declines in Pakistan; complete immunization remains a challenge
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While immunization gaps exist, the number of people with polio in Pakistan declined 84% during a 9-month period this year compared with 2014, according to recent data.
“The number and geographic spread of wild poliovirus type 1 cases have decreased,” Noha H. Farag, MD, PhD, of the CDC’s Global Immunizations Division, and colleagues wrote. “However gaps in campaign performance and surveillance, evidenced by the persistence of continually missed children and the detection of wild viruses in environmental samples, are indicative of ongoing program challenges.”
The researchers said there were 38 reported polio cases from January to September vs. 243 cases for the same period in 2014.
“This might reflect expected low incidence following the high incidence seen in 2014,” the researchers wrote. “But, the decline also followed the launch and rigorous implementation of a plan to intensify polio eradication activities during January to April 2015, the low transmission season.”
Estimates by WHO and UNICEF reported polio vaccination coverage of infants in Pakistan remained at 72% for 2014 compared with 2013. The researchers said some children did not receive vaccinations because of poor supervision, inadequate microplanning and failure to train and motivate vaccinators.
“Focused efforts to close remaining immunity gaps by locating, tracking, and vaccinating continually missed children and improving coverage with the oral polio vaccine through the routine vaccination program are needed to stop wild poliovirus transmission in Pakistan,” Farag and colleagues wrote.
In addition, the researchers said polio was detected in 20% of environmental samples from January to September, suggesting surveillance gaps. In Sindh, researchers found two vaccine derived polioviruses that were either isolated from people with no known immunodeficiency or isolated from sewage with no known source. Field reviews of acute flaccid paralysis conducted in 67 districts from January to August detected gaps in surveillance quality at the sub district level.
“To achieve the goal of ending poliovirus transmission in Pakistan in 2016, continued government leadership of the polio eradication program and further improvements in campaign quality are needed to reach and vaccinate all children,” Farag and colleagues wrote. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
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