There is some 'very disturbing' news for health planners in Bihar.
Of the 98 cases of poliomyelitis detected in Bihar till October 30 this year, 93 children had been administered seven doses of oral polio vaccine (OPV). One child had been given three doses and the vaccination status of the other four kids is unknown.
Not surprising therefore, those in the know of things are now passing the buck.
The data, collected under the National Polio Surveillance Programme (NPSP) of the World Health Organisation (WHO), has baffled experts, many of whom have started questioning the usefulness of the OPV.
"The latest statistics of polio cases in Bihar is perplexing. Either the affected children suffer from serious immunity deficiency or the OPV has failed to produce required immunity in them," said Dr Gopal Krishna, State immunisation officer.
Dr Hemant Shukla, in-charge of the NPSP and WHO representative in Bihar, evaded queries on the data saying: "I am not the authorised person to comment on the issue." Principal Health Secretary CK Mishra could not be contacted despite repeated efforts by HT.
The WHO provides technical support to the polio elimination programme while the United Nations International Children's Emergency Fund (UNICEF) takes care of the social mobilisation aspect of the exercise. The State government executes the work as per the directives issued by the Union Ministry of Health and Family Welfare.
"The agencies involved in the programme are groping in the dark," said a senior doctor on condition of anonymity. " Their hit and trial tactics to eradicate the debilitating disease has failed to deliver the goods, " he added.
In 2007, when they concentrated on eliminating P1 polio virus, the P3 virus went wild and affected 459 kids. In 2009, when they focused their attention on the P3, the P1 afflicted 34 children. The alarming rate of growth registered in polio cases also raises serious questions on the quality of teams deployed or whether, all teams shown as deployed are actually there or not.
Data now suggests that when anti-polio activity was said to have been intensified in north Bihar, the number of cases abnormally increased in central parts of the State. And when they came to central Bihar, the number of those afflicted rose significantly in north Bihar. In the current year, Saharsa district has reported maximum number of cases (22), followed by Khagaria (15) and Patna (13), the doctor said.
The agencies have also tried all types of vaccines: monovalent, trivalent etc. to contain the disease.
Dr SP Srivastava, former head of department (HoD) of paediatrics, Patna Medical College and Hospital (PMCH), believes that one of the major factors for recurrence of the cases is that the vaccine has failed to act on the changing genetic mutation of the virus.
Dr SA Krishna, former HoD of paediatrics, Nalanda Medical College and Hospital (NMCH), questions the maintenance of the cold chain, required to maintain the efficacy of the OPV. "How do you expect the OPV vials retain their potency, when volunteers carry them in their bare hands, exposing them to direct sun," he added.
Dr Sujit Kumar Sinha, president of the Indian Academy of Paediatrics (IAP), Patna chapter, believes that immunity status of the child should be examined before the administration of the OPV. Some other doctors blame poor sanitation and population density for the high incidence of polio. The issue is being taken up at the two-day meeting of the Indian Expert Advisory Group on polio, beginning in New Delhi on Thursday.