ISLAMABAD: The fifth polio case of the year was reported from Quetta on Saturday, 17 days after the victim’s death, underscoring a significant lapse in surveillance and escalating the risk of transmission at a crucial juncture in the polio eradication campaign.

The case with onset of paralysis on April 29 was confirmed on June 8, a six-week delay, underscoring a notable lapse in diagnosis. As the high transmission season approaches, the anti-polio programme leadership faces a major challenge in containing the spread of polio.

According to an official at the Regional Reference Laboratory of National Institute of Health (NIH), the latest victim was a two-year-old boy who passed away before the confirmation of the poliovirus, which took six weeks instead of the usual three weeks for diagnosis. The deceased was a resident of UC Tameer-i-Nau, Ganj Bypass, Quetta.

“According to the patient’s attendant, the child got diarrhoea and vomiting, for which, he was taken to a private hospital in Quetta for treatment. After 10 days, the patient started having bilateral lower limb weakness on April 29. Initially, the weakness was mild but became progressive later and involved upper limbs as well. The child was then taken to NICH, Karachi, where he was admitted, and notified as an acute flaccid paralysis (AFP). Unfor­tunately, the child passed away on May 22. The virus isolated from the samples belonging to the imported YB3A cluster of WPV1,” the official said.

“Samples from three contacts were collected as the case was inadequate. Two were collected from the siblings and one from a cousin who lives in the same house. WPV1 was detected in the stool samples of one brother and the cousin. No history of travel to any other district in the last 35 days prior to the onset of paralysis was observed,” he said.

In reply to a question, the official said the child had not received a single dose of polio vaccine during routine immunisation, and it was being investigated whether this was a case of vaccine refusal. However, records show that he had received five doses of vaccine during supplementary immunisation activities.

Dr Malik Mukhtar Bharath, the prime minister’s coordinator on national health services, said the case served as a poignant reminder that until Pakistan achieved polio eradication, no child anywhere would be completely safe from the crippling disease.

Muhammad Anwarul Haq, coordinator of the National Emergency Opera­tions Centre for Polio Eradication, said a case investigation was underway to trace the source of the virus that led to the infection and identify potential gaps in vaccination coverage, specifically targeting populations that may have missed out on polio immunisation.

Published in Dawn, June 9th, 2024