• A two-year-old boy in a remote village in Meghalaya’s West Garo Hills district has been found with symptoms of poliomyelitis or polio, prompting health authorities to start an investigation, officials said.

• Health authorities in the northeastern state have already started an investigation.

• A team of doctors from WHO have also arrived in the village in Tikrikilla to collect samples.

Poliomyelitis (Polio)

• Poliomyelitis, commonly called polio, is a highly infectious disease caused by the poliomyelitis virus.

• Polio (poliomyelitis) mainly affects children under 5 years of age.

• One in 200 infections leads to irreversible paralysis. Among those paralysed, 5–10% die when their breathing muscles become immobilised.

• Cases due to wild poliovirus have decreased by over 99 per cent since 1988, from an estimated 350 000 cases in more than 125 endemic countries, to just two endemic countries (as of October 2023).

• As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in a global resurgence of the disease.

• In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems.

• There are two vaccines available: oral polio vaccine and inactivated polio vaccine. 

• Both are effective and safe, and both are used in different combinations worldwide, depending on local epidemiological and programmatic circumstances, to ensure the best possible protection to populations can be provided.

Symptoms and risk

• Polio is a highly infectious disease caused by a virus. 

• It invades the nervous system and can cause total paralysis in a matter of hours. 

• The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine. 

• Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. 

• There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life. 

Eradication of polio in India

• India was certified polio-free by the Regional Polio Certification Commission in 2014. 

• Last case of wild poliovirus in the country was reported in 2011 from Howrah, West Bengal and no wild poliovirus cases have been reported thereafter from any state/UT.

National Immunisation Days

• Population immunity against polio is being maintained by observing polio campaigns every year. 

• National Immunisation Days (NIDs) are held across India twice a year, with the government of India setting out to give two drops of oral polio vaccine (OPV) to every child in the country under the age of five. 

• The scale is extraordinary, with more than 17.2 crore children immunised by 2.3 million vaccinators who visit every house in every city, town and village across the country. 

• Several Sub-National Immunisation Days (SNIDs) are also held annually in the highest-risk states. 

• Inactivated Polio Vaccine (IPV) has been introduced across the country to further boost the population immunity as additional protection against polio.

• Vaccination to international travellers to and from polio endemic countries and continuous vaccination at the international borders of India are being carried out throughout the year to mitigate risk of importation.

• Sensitivity of polio surveillance is maintained through Acute Flaccid Paralysis (AFP) surveillance in human and environment surveillance to detect any polio threat as early as possible and respond quickly to mitigate the risk of circulation.

To maintain the polio-free status, country is implementing the following strategies:

• Maintaining community immunity through high quality of national and sub-national polio rounds each year, apart from routine immunisation. 

• Polio vaccination is provided to all eligible children round the clock through special booths set up at international borders (both Rail and Road routes) — Pakistan, Bangladesh, Bhutan, Nepal and Myanmar. 

• Travel advisory has been issued for polio vaccination for those travelling between India and eight other countries — Pakistan, Afghanistan, Nigeria, Kenya, Ethiopia, Somalia, Syria and Cameroon. 

• An Emergency Preparedness and Response Plan (EPRP) have been put in place under which Rapid Response Teams (RRT) are set up in every states/UTs for timely action in case of any occurrence of a polio case in the country.

• As a part of Polio Endgame Strategy, India has introduced Inactivated Polio Vaccine (IPV) across the country to provide double protection against polio.

• Acute Flaccid Surveillance (AFP) and Environmental Surveillance across the country (which act as surrogate indicator for polio virus transmission) are being strengthened at Mumbai, Delhi, Patna, Kolkata, Punjab, Hyderabad, Lucknow, West Bengal and Gujarat.

(The author is a trainer for Civil Services aspirants.)