Polio Disease and Eradication Program

Polio, also known as Poliomyelitis is widespread in developing countries and is a highly infectious disease caused by a viral infection (poliovirus) that affect the whole body including muscles and nerves. In its severe form, it may cause everlasting paralysis or even death. It attacks the nervous system and patent is totally paralyzed with in hours. There is as such no age bar. It can hit at any age, but mostly commonly children below three (over 50% of all cases) are under grip of polio. In polio, the virus penetrates the body through the mouth and multiplies in the intestine. Patient shows symptoms like fever, fatigue, headache, vomiting, and stiffness in the neck and pain in the limbs. Statistical data demonstrates that one in 200 cases leads to permanent paralysis (usually in the legs). Poliovirus can extend extensively before cases of paralysis are observed. In general, most people who are infected with poliovirus do no show signs of illness, they are never conscious they have been infected. When person is infected with polio virus, the virus is shed sporadically in faeces (excrement) for several weeks. At that time, polio can spread speedily through the people. Immune and or partly immune adults and children can still be infected with poliovirus and carry the virus for long enough to transmit the virus from one country to another. They may infect close contacts and pollute sanitation systems. These people rapidly transmit especially in developing countries where hygiene systems are poor quality.

Poliovirus is generally transmitted through person-to-person contact. In many cases, it has been observed that when they are infected with polio virus, they do not have polio paralysis or show other symptoms of polio infection. But one in 200 people exhibit symptoms and have paralytic attack. The poliovirus can also infect persons who have been vaccinated and can be carried by them. Such individuals will not develop polio, but they can carry the virus in their intestines and can transmit it to others where hygiene is not maintained. According to World Health organization, a single confirmed case of polio paralysis can be a confirmation of an outbreak of polio. Even though medical science is advanced but doctors can not cure polio patients. Polio can only be prevented through immunization. Polio vaccines are given several times to baby. These doses protect a child for life. If person is immunized, there are chances of reducing a risk of developing paralytic polio. There are some cases reported where person can still have polio because they fail to respond to the vaccine.

When polio virus is penetrated in the intestines, it can enter the blood stream and attack the central nervous system and spread along nerve fibers. When it multiplies, nerve cells (motor neurons) are destroys which trigger muscles. These nerve cells cannot be stimulated and the affected muscles that can not function again. Generally leg muscles are affected as compared to the arm muscles. The limb becomes soft and unresponsive. This condition is termed as acute flaccid paralysis. In severe cases paralysis is widespread in the trunk and muscles of the thorax and abdomen can result in quadriplegia. Bulbar polio is the worst case. In this case, poliovirus attacks the motor neurons of the brain stem which reduces breathing capacity and cause trouble in swallowing and speaking. If respiratory support is not provided, it can result in death. Children whose legs are affected with polio virus and paralyzed still require crutches, special braces or wheelchairs in order to move around. In medical science, there is no drug for polio which can treat the disease. Treatment is totally symptomatic. Patient is given moist heat along with physical therapy to motivate the muscles and antispasmodic drugs are given to produce muscular relaxation. These treatment strategies can improve mobility but cannot overturn permanent polio paralysis.

Earlier, polio virus attacked huge number of children every year in industrialized countries but effective vaccines introduced in the late 1950s (IPV) and early 1960s (OPV). These vaccines controlled the polio disease and practically eradicated as a public major health problem in these countries. Public has recognized polio as a dangerous health problem very late in developing countries. Surveys reports of 1970s indicated that the disease was also common in developing countries, attacking number of children every year. As soon as children were vaccinated with OPV as part of national immunization program, the disease was brought under control in many developing countries. At present cases of polio are not found in most of the world but few countries are still suffering from polio disease.

Some facts have been identified regarding polio disease. Children who suffer from polio are at greater risk post-polio syndrome. India is conducting pulse polio immunization (PPI) program at mass level and oral polio vaccine is being comprehensively used to prevent the polio disease. But oral polio vaccine is also unstable. It has been observed that the capacity to give adequate prophylactic protection against polio disease reduces gradually over the period of time. If the vaccine is exposed in higher temperature, it reduces the effectiveness. India is self sufficient in the production of oral polio vaccine, post manufacturing conditions of cold temperature during packing, transport (short distance and long distance) and actual utilization of vaccine. There are some precautions to keep this vaccine so that it maintains its effectiveness. Oral polio vaccine must be packed with dry ice during transportation and must be delivered within three days. The life period of OPV is one year after manufacture. Another precaution must be taken when using vaccine. The vaccine containers are generally rubbed between hands in order to warm up the contents a little at the time of administration. It is to inform all health worker and public that when vaccine is removed from cold storage, it must be applied within 30 days. If the temperature of vaccine kept in storage surpasses +80 C even for a short period, it looses its strength considerably.

People must have knowledge about vaccine that is used to prevent polio. The vaccine contains phenol red as pH indicator and normally it is in pink color. If the vaccine worsens, it changes its color. People who are responsible for maintaining effectiveness of this vaccine must know that vaccine should be stored in a particular refrigerator. The vaccine containers, taken out for use, should be kept in an insulated box so that the temperature is maintained below +80 C while waiting for use. Many times, it has been observed that these precautions are not strictly followed when executing a pulse polio program on a mass scale. It reduces the potency of vaccine and there are chances of out break of polio. It mainly due to ignorance, negligence, irresponsible or careless attitude, overload of work, tired and exhausted staff, and lack of adequate supervisory control. If health workers do not take responsibility and accountability, government can not achieve the desired goal of effective immunization of every child. According to World Health Organization, three doses of oral polio vaccine must be given followed by one dose of inactivated injection vaccine in India. Many reports demonstrated that inactivated injection of polio vaccine program is quite difficult in a heavily populated country like India. Indian Institute and Technology, Hyderabad, has developed temperature sensitive sticker labels for use on the containers of thermolabile products such as vaccines. When the vaccine is exposed to a temperature higher than allowable, the label changes its color permanently that indicate that it is expired. Though polio has been eliminated in many countries but India continues to be in the list of countries in which polio disease exist. In Mumbai, large migrant population continues to seriously cause danger to the continued anti-polio efforts. Experts estimate that India will be free from a viral disease if no infected individual is found for three successive years. In India, along with immunization program, health professionals must have to focus on other major problems like malnutrition, personal and social hygiene, sanitation and waste disposal. These basic measures will assist to bring natural immunity in children and all people. Due to efforts of polio program, cases of polio have reduced and India will eradicate this disease in near future.

Recent achievement of the national polio eradication program supported by DFID since 1996demonstrate that India is on right track to stop further transmission of the virus by early 2006 and wipe out polio completely by 2009. DFID is supporting UNICEF to lead a large-scale Social Mobilization Network (SMNet) program in Uttar Pradesh (UP), supporting behavioral change to boost polio immunization coverage in children below five years in different states where the virus continues to be transmitted by polio patient. DFID is the largest two-sided donor to the Government of India's national polio eradication program and continue to support India In execution of polio since 1996.
DFID's support (2000-2005) has been executed through the Government of India to support training, procurement, logistics and monitoring of the national Polio Eradication Initiative, technical backing to the PEI through the World Health Organization-supported Polio Surveillance Systems and UNICEF's Social Mobilization Network. In order to prevent polio in India, UNICEF carries out the communication and IEC program. Rotary helps in support operations and provides most funds for the program. Recent data shows that India has made incredible progress in polio eradication. These efforts reduced the frequency of polio in India. It is very important to create awareness program continuously through media or other way to guide people and when they observe any such conditions in their surrounding, they must immediately report to near by hospitals or health care unit so that it can be prevented.

Note: This information is just for knowledge of disease. If such type of medical condition develops, consult your doctor.

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