THIS is with reference to the report ‘Polio case in Jacobabad takes year’s tally to 64’ (Dec 19) and various other reports in recent months regarding polio prevalence and its eradication in the country.

Many points pertaining to insecurity of health workers, community resistance, cold chain issues, population density, and unchecked mobility of the people generally get highlighted in such reports. With the present level of commitment of the federal and provincial governments, there is hope that we will succeed in eliminating this menace by 2025.

As a retired public health practitioner, I venture here to recapitulate some points for the consideration and information of everyone. In March 1995, a gentleman from Switzerland wrote in your columns that by the use of oral polio vaccine (OPV) there would be an epidemic of polio in Pakistan.

At the time, myself and a senior paediatrician supported the use of OPV because of its superiority in antibody production as well as administrative convenience for immunisation of large communities.

This also happened to be the govern-ment policy. Subsequently, when the occurrence of paralytic cases among vaccinated children was reported (Dec 20, 2010), two letters appeared in these columns (Dec 26, 2011, and Feb 25, 2012), conveying the message that the children who had been already immunised against polio did not need to be subjected to excessive overdosage of OPV.

Doctors often differed. Some thought that irrespective of the earlier immun-isation status, a child may be subjected to repeated vaccination. This is how vaccine-related paralysis occurred.

Regrettably, it was not the government policy to publicly accept either the occurrence of such cases or to put in place rehabilitation mechanisms for the victims.

The other point in those letters was about the improvement of environmental sanitation since the virus is passed out in faeces and can find its way either in food or water to inflict another victim. The level of environmental sanitation in many of our cities still needs much to be desired.

As far as the occurrence of 13 cases in Sindh is concerned, all of them did not occur at one place or at one point of time. The report is incomplete about many of the epidemiological aspects of disease causation.

Sindh being the most hospitable of the provinces, people travel from all over the country, especially Khyber Pakhtunkhwa (KP), Balochistan and south Punjab. Some of these cases might have originated outside Sindh.

I have seen some young medical officers in the urban and semi-urban areas of Karachi working with enthusiasm and responsibility to make the immunisation programme successful. I look forward to seeing the end of this malady in the country. I do not agree that the battle to eliminate polio from Pakistan is lost.

Prof Khalid Hassan Mahmood
Karachi

Published in Dawn, December 23rd, 2024