HYDERABAD: Sindh Health Minister Dr Azra Pechuho has warned people that poliovirus has been spreading vigorously across this province. “Vaccination is the only way to protect your children. Two drops of polio vaccine can save your children from lifetime disability,” she said, and urged all parents to get their under-five children vaccinated against this virus during the ongoing seven-day campaign.

Dr Pechuho, along with Health Secretary Rehan Baloch, inaugurated the ‘SNID (sub-national immunisation days) campaign at the Taluka Health Office in Korangi district of Karachi on Monday. This campaign would target 9.4m under-five children across 30 districts of Sindh.

With three out of 17 polio cases of 2024 in Sindh, this campaign needs to be taken very seriously by parents and care givers, she said.

For those who miss vaccination during the campaign, the Emergency Operations Centre’s Sehat Tahaffuz Helpline 1166 or WhatsApp Helpline 0346-7776546 is available to provide assistance and information on how to get a child vaccinated.

Launches seven-day immunisation drive, urges all parents to ensure vaccination of their under-five children

All district administrations are now making extra efforts to make their respective area polio-free. Not only environmental polio sample remains positive in some districts, but the poliovirus case of a 29-month-old girl was also reported last month.

The patient, Munira, daughter of Zubair, was diagnosed positive for polio on Aug 23 after having been tested for it a day earlier. She and her family are residents of Liaquat Colony, Hyderabad.

The seven-day SNID started on Monday across Sindh.

In 2019, two poliovirus cases (both girls) were reported in Hyderabad, after the previous one in January 2012. Environmental samples were collected through ‘grab’ and advanced method of ‘Bag Mediated Filtration System (BMFS)’ from designated sites. Sindh has 17 designated sites for collection of samples. Of them, 11 are located in Karachi.

According to officials in Hyderabad, some new points have been added to the existing methodology regarding anti-polio vaccination campaign after Hyderabad city itself became a host district for polio strain that has affected other districts, like Sujawal, Karachi East, Quetta and Mirpurkhas, as well, according to one government official.

Since November 2023, environmental sample of polio has consistently been emerging as positive in Hyderabad. The November 2023 polio virus sample was found positive after July 2021, i.e. after 29 months. Before July 2021, poliovirus sample had remained positive since 2020. In the April-October 2020 period, the sample was found to be negative.

“Every poliovirus creates its strain. The strain that has been found in 12 other districts now is the one that is resident/found in Hyderabad,” said Hyderabad Deputy Commissioner Zainul Abiden Memon. He said that 400,837 children were to be inoculated in this SNID.

In this campaign, some districts are focused entirely and some partially for polio eradication purposes given the number of inoculation.

Refusal cases

In the last campaign, around 6,800 refusal cases were reported but the number dropped to 1,311 after two additional days of catch-up drive.

Following recent positive environmental samples of polio, the district administrations across Sindh were advised by the chief secretary to take extra measures. Such advice is available with Hyderabad administration as well according to which ‘scorecard system’ is to be introduced for performance appraisal (of teams like those working under DCs, DHOs and members of the district emergency operation cell. Such scorecards were devised for the offices of DC, DEOC and DHO (district health officer). Town support teams (TSTs) and union committee support teams were to be formed for coverage of refusal cases.

The DC stressed that micro plans should be revised to cover high-risk migrant and mobile populations, especially those from core reservoir areas of Quetta, Peshawar and Karachi.

‘15,000 hidden children reached’

The DC said that the houses marked as ‘zero by zero’ should be revalidated.

Explaining the ‘zero by zero’ terminology, the DC explained: “There was apprehension that children are hidden in houses [to avoid vaccination]. Such houses are marked ‘zero by zero’. To address this issue, we started validating such houses through area in-charges and the monitoring tier”.

Over 15,000 children were found in such houses [who were supposed to be vaccinated] in the June and July campaigns, the DC said, adding that extra members should be deployed in the high-risk UCs, draining UCs and the UCs surrounding wild poliovirus1 (WPV1) case.

He said that standard operating procedure (SOP) was changed to approach such houses. “We started going into houses, checking into multiple entrances of such a house, interviewing mothers, etc. It was in this process, that over 15,000 children were found to have been hidden in the houses marked ‘zero by zero’, DC Memon said.

Published in Dawn, September 10th, 2024