Karachi resolves new response against polio cases

KARACHI: The metropolitan city of Karachi, with official scientific reports confirming significant prevalence of polio virus in its environment, is all set to witness administration of fractional dose intradermal inactivated polio vaccine (fIPV) into its deserving children from August 15 to 25 to protect them from infectious crippling disease which has affected 13 children countrywide, including one in Karachi so far this year.

A source in the health department said that in view of month-wise data suggesting increase in detection of polio (poliomyelitis) virus in various sewage samples, the authorities have resolved to ensure new response activities, including administration of emergency fIPV injection in high-risk areas, besides improving routine immunisation scheme of the government for children, to boost the immunity in children of Karachi and Sindh against polio and other vaccine preventable diseases. 

As per official data, Sindh has 28 sites for environmental sample collection in its 15 districts, from where 111 samples tested positive for poliovirus so far in 2024. Positive samples were received from all districts of Karachi (72), Hyderabad (14), Sukkur (8), Jacobabad (5), Jamshoro (5), Mirpurkhas (3), Kambar (2), Badin (1) and Dadu (1).

Karachi districts collectively reported 72 positive environmental samples -- East (24), South (13), Keamari (13), Central (7), Korangi (7), Malir (6), and West (2).

In the realm of polio, a sewage water sample from an area is the basic parameter to determine if polio vaccination campaigns are being carried out successfully, say experts.

Sharing details of some recent positive sewage water sample tests with this scribe, a senior communication official at the Sindh Emergency Operation Centre (EOC) for polio said a sample was collected from Chakor Nala site in Karachi East on July 18, which was the 24th positive sample from the district this year. The isolated virus has been described “genetically linked to two viruses – one detected in an environmental sample in Pishin (April 22 this year) and another detected in an environmental sample in Hyderabad (June 3).

Lately, one positive sample was collected from Korangi Nala site on July 18, which was seventh case from the district. The isolated virus is genetically linked to the virus detected in an environmental sample in the same district on June 13, the EOC official said.

In the meantime, Commissioner Karachi Syed Hassan Naqvi chaired a review meeting on arrangements for launching the proposed campaign in Karachi at Sindh EOC headquarters. He was told that a special anti-polio campaign was being launched in Karachi’s high-risk areas in collaboration with Sindh EPI, WHO and Unicef and other partners, with a resolve to reach children and persuade parents to participate in it.

The meeting was updated that specially trained vaccination and mobilisation teams were being formed to go door-to-door and persuade parents of children between 4 months to 5 years of age to get fIPV vaccinated, alongside oral polio vaccine administration to their wards during the campaign.

The required IPV vaccines for the campaign have been provided by the Sindh EPI, said a source in EOC.

In all, 85 union councils in Karachi, witnessing increase of polio virus, have been listed for the fIPV campaign wherein about 4,700 teams comprising 4-5 members each, including social mobilisers and inoculators and supervisors, will work within a defined jurisdiction, with various outreach centres for 10 days.   

As per the campaign plan, there are 47 union councils (UCs) which will be covered fully to reach all the children of 4 months to 59 months of age for administration of fRIV, while the rest of the earmarked UCs will be covered partially.

Maximum of 18 UCs have been selected from district West to target 299,770 children for OPV and 273,695 children for fIPV. Of the total, 14 UCs will be fully covered in the district.

Campaign managers have planned to target 1,036,930 children for fIPV and 1,107,415 for OPV during the two-phase campaigns, it is learnt.   

A source privy to the polio eradication activities in Sindh said a child is supposed to get 3 OPV doses and two IPV doses, under the Expanded Programme on Immunisation (EPI), which are considered sufficient to ensure immunity against polio virus in children.

When contacted, Sindh EPI Project Director Dr Mohammad Naeem said that OPV administration rate among children was up to the mark, but the coverage rates of IPV (two doses with a gap), included in the routine preventive vaccination schedule, has been fluctuating for reasons, which are now being focused for redressal.

In 2023, the rate of IPV-1 coverage remained 89%, while the IPV-2 coverage rate came as 56.2%, he said, adding that the rate of the IPV second dose administration can be questioned as parents skipped that for their personal inconvenience.

Keeping in view hesitancy among parents or caregivers of children in the administration of multiple injections alongside IPV2 injection, authorities are considering replacement of pentavalent vaccine and IPV with hexavalent vaccine to save the children from the fear and pain of multi-inoculations at one time.

Moreover, the Sindh health minister and health secretary have already allocated budgets for provision of Panadol drops vials to the children who experience fever or pain due to administration of IPV-1 and IPV-2 jabs, he shared, adding the delivery of Panadol to deserving children will begin sometime in September this year. --MA

Courtesy: Social Track, weekly.