When 18-month-old Rukhsar Khatoon was detected with polio around this time last year, it came as a rude shock to the government. But what hit like a boulder was the fact that she had never been immunised!
Worse, the case was reported from Howrah district which is far away from the normal suspect Murshidabad and happened during low transmission period, indicating that that polio was not being handled with utmost seriousness.
A first
No polio cases were reported in West Bengal in 2009 though India reported 741 cases elsewhere, but 8 cases were reported from the State in 2010 of which 7 were from Murshidabad and one from Birbhum. Thus, West Bengal became the only State where poliovirus transmission continued for 12 months in spite of multiple polio campaigns. “One of the areas of concern is that 8 to 15 per cent children remained unvaccinated in each of the polio campaigns conducted during 2010,” Union Health and Family Welfare Minister Ghulam Nabi Azad wrote to the then State Chief Minister Buddhadeb Bhattacharya subsequently asking him to personally review the situation so that a concerted effort involving the district administration, local bodies and Panchayat representative can be made to ensure proper immunisation as well as addressing the water and sanitation issues in an effective manner.
While all this was being done at the official level, mopping up operations on war footing had already started at ground zero. “We were worried because Howrah is a crowded area and the virus could spread really fast. We could not afford to waste time and got down to mopping up operations to check the spread which was finished in a record time of six days from the day the case was notified,” Anuradha Gupta, joint secretary in the Health Ministry, told The Hindu .
Response actions
The outbreak response actions were carried out jointly by the Centre, State, the World Health Organisation-National Polio Surveillance Project, UNICEF and Rotary along with some stakeholders who identified 36 high risk blocs/municipalities and 222 high risk Gram Panchayats/wards to focus activities on. This was followed by enhanced by coordination by the local administration at all levels and 25 experienced additional Surveillance Medical Officers were deployed at each district for intensive monitoring. The vaccinators and supervisors were imparted training to improve skills trainings to improve skills & performance of vaccinators and supervisors. Approximately 9,096,609 children were vaccinated in January of 2011 which was followed by special immunization rounds on February 6 (990,586), February 13 (1,422,549), February 27 (8,996,193) and the figure remained upwards of 4,100,100 in the subsequent months.
Step forward
“India has gone a step forward in procuring bivalent polio vaccine from domestic pharmaceutical companies and raised its own resources instead of waiting for the World Bank funding and procuring from the WHO-prequalified manufacturers who were short of supplies when the vaccine was most needed. It paid rich dividends,” Ms. Gupta said.