Mass public campaign a success but experts warn of need for continued vigilance

Not even superstition can render this Friday the 13th unlucky for India. Today, the nation will reach a major milestone in the history of polio eradication – a year without any case of wild polio being recorded. For a nation that notoriously had, only two years ago, the largest number of polio cases in the world (741), this is clearly an unprecedented achievement.

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Poliomyelitis (polio) is a highly infectious viral disease which mainly affects young children. The virus is transmitted through contaminated food and water, and multiplies in the intestine, from where it can invade the nervous system. Even those who do not show any symptoms can excrete the virus, thereby spreading the infection. Acute Flaccid Paralysis is a disabling condition where there is absence of muscle tone in one or both limbs, and tendon reflexes. While no ‘cure' exists for polio, the oral polio vaccine prevents the transmission of infection effectively.

As India reaches this ‘no wild case' mark, it will no longer be considered ‘endemic' to polio, a status it has harboured thus long, with three other nations — Pakistan, Afghanistan and Nigeria. If all tests for the wild polio virus in India — including laboratory analysis of acute flaccid paralysis cases with onset up to mid-January and environmental sewage sampling — return negative, India will officially be deemed to have stopped the transmission of the indigenous wild polio virus.

Following this, the World Health Organisation will remove India from the list of endemic nations, probably by mid-February. “India's success is arguably its greatest public health achievement and has provided a global opportunity to push for the end of polio,” said WHO Director-General Margaret Chan.

Responding to the achievement, Union Health Minister Ghulam Nabi Azad said: “This giant leap towards polio containment in a short span of two years is an endorsement of India's tireless and persistent efforts.” India had set an example with the highest level of political commitment to the programme — with resource allocation, continuous efforts to identify and reach out to vulnerable children with tailored strategies for maximum reach, optimum use of available vaccines under the guidance of top national and international experts, an extra-ordinary communication strategy and strong partnerships, he added.

According to the Global Polio Eradication Initiative (GPEI), the next step would be to look at a polio-free South East Asian Region in 2014: Over the next 24 months, the Regional Certification Commission of the WHO South East Asian Region (of which India is a part) will start examining the surveillance and programme performance for polio eradication across the region to determine whether it can be certified as having eradicated the indigenous wild poliovirus.