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Polio Outbreak on Wane: Next Rounds Must Focus on Youngest Children

With this year’s polio outbreak on the wane and excellent coverage during recent pulse polio campaigns, the Independent Expert Advisory Group today advised// the government that the next few pulse polio rounds must effectively reach the youngest and most vulnerable children, who are not being sufficiently immunized early enough. The group is composed of independent Indian and international experts who advised the government on strategies on polio eradication.

The group reviewed the epidemiological data, which indicates that over 80% of children affected this year were less than three years of age. Based on this and other evidence, the group concluded that in the unique context of UP and Bihar, an immunity gap in young children is sufficient to sustain transmission.

The IEAG also cautioned that the coming months would be the country’s best chance to stop the virus with a series of accelerated vaccination campaigns focused on the youngest children in high-risk districts of UP and Bihar. “The two recent high-quality campaigns, combined with the ‘low’ season of poliovirus transmission, make the next few months India’s best chance to eradicate polio,” said IEAG chairperson Dr. Jacob John.

“The government of India will deliver on the important strategies necessary to make this final push succeed,” said Naresh Dayal, Union Secretary of Health and Family Welfare. “We will continue involving the communities to make sure that every child is vaccinated and lead India into a polio-free future.” Religious figures and senior community members have played a critical leadership role, holding public meetings and issuing statements to ensure that parents are aware that vaccination is the only protection against polio.

The outbreak this year, which has paralyzed 583 children (as of 9 December,), has peaked at its origin in western UP. Experience indicates that Bihar and the states that were re-infected this year will soon start to repo rt fewer cases. The outbreak was partly due to children being missed in critical districts in the latter part of 2005 and early 2006. Data has shown that Uttar Pradesh and Bihar are among the hardest places in the world in which to interrupt poliovirus transmission, due to a unique combination of demographic, health and sanitation factors. In September and November 2006, the polio rounds in western UP had the lowest proportion of missed houses in over a year, the improvement in coverage means that immunity is very high now.

India came very close to eradicating polio in 2005: even during this current outbreak over 80% of India’s districts remain polio-free, evidence that the basic strategy of repeated mass vaccination campaigns is effective in protecting children. The outbreak itself has been much smaller than those in earlier years – 1600 children were paralyzed in 2002 – demonstrating the effect of pulse polio rounds and improved routine immunization. At this final stage, accelerated and very focused efforts are critical to reach each child in the youngest age group in the last strongholds of polio in India.

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