Polio cases in India shot up to 641 in 2006, with 17 more cases in the last week of December pushed back India's polio eradication efforts by at least two years. Apart from a spurt of 1,600 cases in 2002, polio occurrence has steadily declined in India since 2002. In 2005, only 66 cases had been reported, making public health experts optimistic about India becoming polio-free by 2007.
* Polio cases declined from 1,600 cases in 2002 to 66 in 2005, but sot up to 641 in 2006.
*Polio cases reported from the Democratic Republic of Congo, Angola, Namibia, Bangladesh and Nepal are reported to have come from Uttar Pradesh and Bihar.
The epicenters of last year's outbreak are Western Uttar Pradesh and Bihar, which account for 519 and 57 cases respectively. Worried public health officials at the Union Health ministry and its partner agencies such as World Health Organisation and UNICEF have pulled back all stops to ensure that polio national immunisation round on January 7 covers all the 176 million children under 5 years across the country.
The January 7 round is expected to cost Rs 180 crore - Rs 110 crore vaccine cost and Rs 70 crore operation cost.
India's pulse polio campaign started in Delhi in 1994 and was stepped up to cover the rest of the country in 1995. Since then, an average of Rs 1,000 crore are spent each year to repeatedly vaccinate all children under 5 years old as many times as possible.
Wild polio virus type 1 was the dominant circulating virus in 2006, with type 3 causing just 18 infections last year. Polio cases from round the country have all been traced back to western Uttar Pradesh and Bihar, where the wild polio virus continues to thrive. "Himachal had been polio-free for eight years, Jammu and Kashmir for three years and states such as Punjab, Madhya Pradesh, Rajasthan and Uttarakhand for two years.
All the cases reported here are importations from Uttar Pradesh," says a public health consultant with UNICEF. Bihar has reported 57 cases, and from there virus spread to Jharkhand and West Bengal.
Union health ministry officials are more optimistic. "International agencies such as the WHO and UNICEF investigated and found that polio had re-emerged in Western Uttar Pradesh and Bihar because almost 12 per cent houses were missed by vaccinators during the polio immunisation campaigns in 2005 and early 2006.
Vaccination coverage has been very good over the past six months and surveillance data by the same agencies shows that the number of missed houses has gone down in the latter half of 2006. If we can maintain this quality of rounds on January 7 and follow it up with a repeat act in February, the virus will not find anyone to infect and die out, hopefully by the end of this year," says BP Sharma, joint secretary, Union Ministry of Health.
Apart from two national immunisation day rounds on January 7 and in February 2007, six sub-national immunisation days will be held (two in the first half of the year and four in the second half of the year) covering Uttar Pradesh and Bihar, and other districts, if required.