EradicationofPoliomyelitisGlobal & National Overview

Goal : Complete interruption of wild poliovirus transmission

Dr OR Goldie (State EPI Officer Punjab)

EradicationofPoliomyelitisGlobal & National Overview

Goal : Complete interruption of wild poliovirus transmission

Dr OR Goldie (State EPI Officer Punjab)

Acute Flaccid Paralysis (AFP)surveillance System

Hospitals

Clinics

Communit

y

Hospitals

Clinics

Communit

yAFP

casesAFP

cases

WPV(Polio) WPV

(Polio)

Non-Polio AFP

Non-Polio AFP

CaseInvestigati

on andLab

Analysis

CaseInvestigati

on andLab

Analysis

Wild Poliovirus*, 07 Jul 2009 – 13 Aug 2010

Case or outbreak following importation (0 - 6 months)Endemic countries

Case or outbreak following importation (6 - 12 months)

Wild virus type 1 Wild virus type 3

Wild virus type 1/3

Wild virus type 1 Wild virus type 3 Wild virus type 1/3

Total Cases Wild Polio Virus

2009 Jan 01-13 Aug2009*

Jan 01- 13 Aug 2010*

Globally 1606 817 608

Pakistan 80 31 36

Afghanistan 38 14 13

India 741 184 27

Nigeria 388 372 6

No of countries with virus.

23 19 15

State P1 P3 Total

Bihar 38 79 117

Uttar Pradesh** 34 569 602

Delhi 3 1 4

Punjab 2 2 4

Jharkhand 2 0 2

Rajasthan 1 2 3

Haryana 0 4 4

Uttarakhand 0 4 4

Himachal Pradesh 0 1 1

Total 80 662 741

WPVs

Location of poliovirus by type, 2009*

* data as on 9 April 2010

Ludhiana • Priority District For Polio Eradication • Repeated Virus Importations• Rapid Urbanization And Industrialization • Extensive Construction Activity • Labour Forces From Endemic States • Highest percentage of migrants in Punjab

Location of poliovirus by type, 2010*

Most recent virus22 July 2010

Pakur, Jharkhand

* data as on 9 Jul 2010

Maharashtra WPV : Genetically related to Khagaria strain isolated in June 2009

Jammu WPV :Genetically related to an imported strain in Punjab Sept 2009

W Bengal WPV: Genetically related to Saharsa strain isolated in June 2009

WPVs

State P1 P3 Total

West Bengal 4 2 6

Jammu & Kashmir 1 0 1

Jharkhand 2 1 3

Maharashtra 2 0 2

Uttar Pradesh 0 10 10

Bihar 0 6 6

Haryana 0 1 1

Total 9 20 29

Reduction in Genetic Diversity and Overall Burden of WPV1

20072006

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2009*

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9 clusters 7 clusters 3 clusters 1 cluster

Number of cases

2006

Monthly incidence of polio in PunjabJanuary 2006 – July 17 2010*

2007 2008 2009 2010J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J

Very High Risk Period

Current Status • India to date has 29 WPVs including 9 WPV type 1

and 20 WPV type 3 cases • NO P1 cases reported from UP & Bihar since Oct/Nov

2009• Majority of Punjab cases in past 3 years are related

to migrants. – Last case was in Oct 2009 in Ludhiana. – Low level circulation is believed to be continuing – Intensified efforts need to be sustained

Punjab is entering its Very High Risk Period for virus.

Polio Eradication efforts : Ludhiana

• State level mtg chaired by Hon’ble Health minister on 16 July 2010– DTF– Intensify monitoring– Microplanning– Improve reach in slums

• DTF Ludhiana 21 July 2010– District admn support assured– Increase District level monitoring– Seek partner support in microplanning

next round• Polio Activity 25-27 July

– Active monitoring in slums by CS , staff, state level observers, partners

– Review done by DFW (26 Jul)– Evening meetings held – Feedback: Quality of activity good, supervision

needs strengthening

Wild Virus /Compatible cases- 2009

Confirmed Polio -4

Compatible-3PBJLD09021 Block- JLD West- Kartarpur Donset 09/09/2009 Age 4 mths - P1W Doses- RI-2 SIA-1

UPLNO09200 Block- LDN City Donset 20/09/2009 Age 13 mths - P1W Doses- RI-0 SIA-5

UPBJN09275 Block- Mohali Donset 28/09/2009 Age 8 mths - P3W Doses- RI-0 SIA-6

PBLDN09043 Block- Jagraon Donset 13/10/2009 Age 15 mths - P3W Doses- RI-0 SIA-8

Wild Virus /Compatible cases- 2010

No Polio Case

% Adequate Stool Collection Rate – Punjab 2007-2010

< 60%

60% - 69%

> 80%

70% - 79%

GDP

HSPASR

FZP

FRK

MKSBTD

MNSSAN

LDNMGA

PTL

JLDKPT

NSRRPN

TNT

MHL

BNL

200782%

200879%

200978%

201082%

as on week 30 ending on 7th Aug 2010

GDP

HSPASR

FZP

FRK

MKSBTD

MNSSAN

LDNMGA

PTL

JLDKPT

NSRRPN

TNT

MHL

BNL

20083.94

20073.86

< 0.70< 0.70

0.70 - 0.990.70 - 0.99

1.00 – 1.991.00 – 1.99

>> 2.00 2.00

Non Polio AFP Rate 2007-2010Non Polio AFP Rate 2007-2010

20094.55 2010

3.28

as on week 30 ending on 7th Aug 2010

% Cases Investigated w/in 48 hrs- Punjab 2007-2010

< 60%

60% - 69%

70% – 79%

> 80%

200892%

200788%

200993%

201090%

as on week 30 ending on 7th Aug 2010

% Cases Notified w/in 10 Days - Punjab 2007-2010

GDP

HSPASR

FZP

FRK

MKSBTD

MNSSAN

LDNMGA

PTL

JLDKPT

NSRRPN

TNT

MHL

BNL

< 60%

60% - 69%

70% – 79%

> 80%

200784% 2008

81%

200981%

201083%

as on week 30 ending on 7th Aug 2010

Weekly Summary Of Timeliness of District Reports- 2010

1st Quarter 2nd Quarter

98%98%

94%

97%

84%

94%

98%

97%

91%

98%

No Report received from Patiala since last 3 weeks

The Impact of Polio Eradication

Since the Global Eradication of Polio Initiative began in 1988, over 50 Lac disabilities have been prevented worldwide.

THANK YOU