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Tremendous progress has been made in the global fight
against polio since 1988, when the World Health Assembly resolved to
eradicate the disease.
In WHO’s South-East Asia Region (SEAR), seven
out of eleven Member States have been able to successfully interrupt
transmission of wild poliovirus for at least four years, with India being the
only endemic country, and Indonesia, Nepal
and Bangladesh, suffering recent importations of wild poliovirus. Overall, the number of cases of polio in
the Region has declined by more than 94%, from a reported 25 253 cases (Types
1, 2 and 3) in 1988 to 134 laboratory confirmed cases (Types 1 and 3) in only
one country, India, in 2004.
As of March 200 6 , India detected
only 66 polio cases in 2005 compared to 134
in 2004 and, is still in a favourable
position to halt polio transmission this year, especially if it maintains the
current levels of quality in the implementation of its eradication strategies
and the highly sensitive surveillance. A number of initiatives have been
implemented in India this year to intensify efforts to interrupt transmission
of wild poliovirus; advocacy efforts have been strengthened, monovalent oral polio vaccine (mOPV1) has been introduced
and used in campaigns in high-risk areas, new strategies are being employed
to reach underserved populations, and finally there has been a greater focus
on transit sites (including railways, bus stations, ferries, markets,
religious fairs) during campaigns.
The regional eradication programme
faced a set back in April 2005, when for the first time in 10 years, the
surveillance network in Indonesia detected and reported a wild poliovirus
type 1 case in Giri Jaya
village, Sukabumi District, West Java. The WHO Global Specialised
Polio Laboratory in Mumbai has since confirmed that the virus strain was very
closely related to the viruses responsible for the polio outbreaks in Yemen and Sudan
and also to the viruses found in Saudi Arabia in late 2004. Since the detection of this index case, the
number of affected children has rapidly increased to 287 (October 2005), with cases also being detected in
Central Java, East Java, Banten, Jakarta, Lumpung, South
Sumatra, Riau, North Sumatra and Aceh, the province affected by last year’s tsunami
disaster.
As a response the Government of Indonesia has conducted an
Outbreak Response Immunization (ORI), followed by two rounds of mopping-up
immunization for all children aged less than five years in West Java, Banten and Jakarta
Provinces. Following the completion of the second
mop-up round, the government conducted two rounds of National Immunization
Days (NIDs) in August and September, 2005. The third NID will be launched on the 30
November, 2005. The rapid spread and extent of the new wild poliovirus
circulation has necessitated WHO/SEARO/IVD to dramatically expand the scope
of its technical support to the Government of Indonesia.
An imported case of wild poliovirus from India was reported in Nepal in
September 2005. As a response, Nepal is conducting three rounds of mop-ups in
the five districts around the case and two rounds in other districts along
the India
border. Nepal has also responded by
strengthening AFP surveillance activities.
On March 8, 2006, Bangladesh
reported its first polio case since year 2000 from Chandur
district in Chittagong. An immediate ORI was conducted in the
surrounding area and the government is currently devising its response plan
with support from partners, including WHO.
The other countries in the Region, ie
Bhutan, the Democratic People’s Republic of Korea, Maldives, Myanmar, Sri
Lanka, Thailand and Timor Leste have all been
polio-free for more than four years.
In addition to assisting Member States with polio
immunization activities, WHO continues to provide the 11 countries in SEAR,
especially India, Nepal, Bangladesh,
Indonesia and Myanmar, with
acute flaccid paralysis (AFP) surveillance support.
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