DERA GHAZI KHAN, May 12: Four more cases of acute flaccid paralysis (AFP) have been reported from Dera Ghazi Khan district, having the dreadful P1 strain.

Ironically, three of the victims live in the municipal limits of Dera Ghazi Khan.

Sources in the health department told Dawn that the four P1 polio-affected children had not been administered vaccine.

This belies the provincial health department’s claims of having achieved the immunization target against the dreadful disease. Occurrence of cases in the town area has further revealed the poor performance of department’s field staff.

During the last quarter of the year 2001, dozens of polio cases were reported from Dera Ghazi Khan, Rajanpur, Leiah and Muzaffargarh districts of the former Dera Ghazi Khan division. Health department authorities had then maintained that access to all the targeted children in hilly and riverine tracts of Dera Ghazi Khan division could not be possible.

Health department authorities had also directed all the paediatricians of Dera Ghazi Khan not to report polio cases in black and white.

Quoting surveys by donor agencies, sources revealed that the coverage of the Expanded Programme of Immunization (EPI) in Dera Ghazi Khan remained under 30 per cent.

The World Health Organization has launched an extensive campaign in Dera Ghazi Khan to ensure universal immunization of anti-polio vaccine.

A paediatrician reported the four polio cases to the WHO representative, Ms Veena, who has been posted at Dera Ghazi Khan to monitor for six months the mopping up campaign to combat the ‘polio challenge’.

The polio virus has three strains — P1, P2 and P3. The world wide experiences of polio elimination is that the P2 strain is first to be eradicated followed by P1 and P3. A victim of P1 himself or herself falls prey to the AFP while in P3 the child plays the role of disease-carrier while he or she does not have any paralysis.

Paediatricians say that P3 polio virus was difficult to be eliminated. Reported cases of the paralytic disease owing to P1 virus and its asymptomatic carriers could widely spread the disease than its other types. According to the World Health Organization (WHO) estimates, a case of P1 polio may represent 200 infected children while the P3 type may represent 1,000 infected children.

In P-1 type of infection, 90 per cent of the affected children have no signs of illness. Most of them are not even aware that they have been affected with polio virus.

But they are a potential threat for others as despite being asymptomatic the polio virus remains in their stools.

Paediatricians say that these asymptomatic polio-carriers may cause the disease to unprotected or not immunized children.