Abstract

PIP: Poliomyelitis, an acute infectious disease which chiefly affects the central nervous system, is included in the list of 20 communicable diseases which are to be reported monthly by all institutions to the State Bureau of Health Intelligence for onward transmission to India's Central Bureau of Health Intelligence (CBHI). The reported number of 17,441 cases of poliomyelitis (annual average) since 1974 fail to reflect the magnitude of the problem in India. Directorate General of Health Services (DHGS) in collaboration with the State health authorities organized sample lameness surveys of children 5-9 years in the community during 1981-82. Poliomyelitis was found to be the major cause of lameness in children 5-9 years (64.5%). Data on admission of poliomyelitis cases from selected hospital in metropolitan cities were collected. All the hospitals reported maximum number of polio cases (more than 78%) below the age of 2 years. This data reinforce the importance of improving vaccination coverage in the age group most affected. High incidence of poliomyelitis (45% of the cases) were observed during July, August, and September, corresponding to the well demarcated monsoon season. This suggests a need to intensify immunization coverage during the low polio incidence period, namely, November to April. Polio vaccine was introduced in the national immunization program in 1980. The schedule recommends 3 doses of oral polio vaccine (OPV), starting from the age of 3 months with intervals not less than 1 month. DPT and polio vaccine are administered to the child at the same time. 1 booster dose of OPV is recommended 12-18 months later. The live attenuated OPV, not produced in India is used in the national program. The requirement of the program is met by import of bulk concentrated vaccine separately for type 1, type 2, and type 3. Then, it is diluted, blended, and ampouled by Haffkine Biopharmaceutical Corporation, Ltd. The recent visit of Dr. Jonas Salk has raised the issue of introduction of killed polio vaccine (KPV) in the national program. It now is claimed that 2 doses of KPV are adequate for protection, and this can be blended with DPT to make it a quadruple vaccine. The many advantages of the live OPV used in the national program are listed, including: confers both humoral and intestinal immunity like natural infection; immunity induced may be lifelong; induces antibody very quickly in a large proportion of vaccines; and oral administration is acceptable and easier to achieve.