Reda Sadki
Qaisar Abbas
Dr Mufakker Mian
Shaukat Ali
Rabia SadatRashid Ghouri’s Updates
Pakistan and Polio eradication, a piece of my mind.
In Pakistan as polio virus eradication enters its final stages, with great efforts of all institutions and community a bigger challenge yet remains. House to house campaigns and delievery of bOPV has proven benificial with drop in number of human cases but requires much care, specially during summers with rising temperatures. Viability of vaccine has to be maintained which requires proper monitoring and timely corrective measures. The question arises what can to be done?
Routine Immunization seems a much confident answer along with mobilization of the community to the support centers. The challenge that we face as in now is how much have we succeeded in mobilising the community. In urban areas the situation may have improved but in rural areas with socioeconomical constrains and lack of education gaps still remain.
Hence strong RI remains the backbone of this entire program along with further encourging the community to bring their children to support centers.
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Thank you Christin Emeany. This is the best part about this platform where different schools of thought come together on one cause.
great discussion. It is useful to know the opinions of other people
Greetings to All,
Agreed to all the points mentioned above by all of you. According to recent SAGE report, IPV is good for individual immunity, but as we still be missing some population at some point, we may not use IPV solely for immunization against polio. As per SAGE two fractional, full or stand alone doses of IPV are superior than single full dose of IPV. Currently, world has enough IPV supply to introduce it in routine immunization globally, but not for the use in catch-up campaigns due to supply constrain. IPV would have great role in post certification strategy when OPV would be ceased. It is recommended that countries hosting (Poliovirus-essential facilities) PEFs and using single dose of IPV should adjust their IPV schedule, coverage targets & geographical scope before the OPV cessation.
Thank you for your inputs and it's definitely nice to read the views and brainstorm on this topic.
The recent polio case of Venezuela may just be a tip of the iceberg. After 1989 they now might have not 1 but 3 cases. Reading the material available and knowing their current political situation there has been shortage of vaccines for quite some time now, not only of polio but other VPD as well have hit the country, cases of measles have been reported in much higher numbers.
I hope we can relate to this example, my take on this is that the virus may survive in the environment but for how long? If immunity gaps are filled in then human cases can be restricted and the virus may burnout.
The recent 3 cases of Dukki also marks that the virus is some what cordoned in that area but has the capacity to grow exponentially if given the chance example being positive ES else where in the country due to movement of population as indicated by Dr.Mehroze as well.
Punjab has definitely maintained its position as a fort against this virus with strong commitment in good SIAs and RI, but, 8 cases in Afghanistan and frequent to and fro movement will keep the bordering area at highest risk therefore good RI, SIAs and Surveillance in those areas may be a key for polio free Pakistan.
I hope this may have answered some of your queries Dr.Sadaf.
Any thoughts on IPV.
Greetings
Very healthy and thoughtful discussion, I would add few points:
1. In Punjab context the presence of +ve ES and no human case, there are two school of thoughts, optimistically due to good RI WPV is not succeeded ro develope paralysis on human but positive ES shows internal circulation due to frequent HR&MP movement from core reservoir areas, or we are missing the cases as no compatible case yet.
2. Yes among the Polio eradication pilars RI serve as back bone without good RI we took so long but its never too late, Punjab improved in RI when we see the PHS and MICS but it needs to be improve more so that if a small gap left may enjoy the benefits of herd immunity.
3. The recent WPV1 cases (03) from District Dukki showed that EPI still a big challege there.
Thanks.
Couldn't agree more. I would add that to encourage RI and have successful SIAs, importance of political will can not be overemphasized.
Govt. needs to take the bull by its horns. No part of the community, civil society can sit on the fence during the current situation because that would amount to complacency. The goal of eradication is closer than ever and everyone needs to join in.
Containment efforts in response to trigger events (including positive environmental samples) need be proactive and depend on sensitivity of the surveillance system.
So, returning to the textbook, all three pillars of eradication (RI, SIAs and Surveillance) have to go hand in hand. But, what do we need to add to the strategy, if at all ? And what are your thoughts on evasive nature of environmental surveillance?
I'd like to know what you think.
Regards,
Agree with you Sir