MUMBAI: Dr. T Jacob John, the expert who pushed the pulse polio campaign more than 25 years ago, now wants to tweak his strategy to kill the crippling virus. It begins with “making” a medical statement that polio is spread by the orofaecal route, and also increases the dose of polio vaccine given in the national polio vaccination program.
In a letter published in a leading medical journal, Lancet, on Wednesday, he and Mumbai-based pediatrician Dr Dhanya Dharmapalan emphasized that the wild polio virus is “transmitted by inhalation,” or by air. “In the late 80s and 90s, wild (natural) viral polio was not common. countries to which all the extermination specialists went. Low-income countries have polio as well as poor sanitation/hygiene, consequent diarrheal diseases, and experts surmise that wild polio is also spread by the fecal-oral route. But that’s just conjecture,” said Dr John, a pediatrician and virologist from CMC Vellore. As a result, the oral polio vaccine (OPV) target the gut. But the strategy doesn’t work completely; The Global Polio Elimination Initiative (GPEI) had to set a new target of 2026 from the original 2000.
Dr Dharmapalan said that polio infection has been reported in infants during exclusive breastfeeding, with a mean age of infection of 15 months. The wild polio virus’s base reproduction number is 40-45, while the R0 for measles is 30. “Therefore, polio is more contagious than measles,” she added.
The Lancet letter states that GPEI’s second mistake was to continue to use vaccine viruses (which sometimes cause polio) beyond their epidemiological needs. For example, although wild poliovirus type 2 was eliminated in October 1999, OPV type 2 vaccine continued until April 2016.
This will lead to an unknown number of vaccine-associated polio cases and multiple outbreaks.
The best course of action for the global program would be to promote IPV (three doses per child) and withdraw OPV from countries that have reached 85% coverage in children under 5, they added. In India, the national immunization program provides each child with two shots of the injectable polio vaccine, said the health official who runs the BMC. Dr. Mangala Gomare. In Mumbai, she added, “We haven’t had a case in Mumbai since the last one in March 2008.”
However, government programs only provide a fraction of the globally recommended dosage. Even in the private sector in India, Dr. Nitin Shah The injectable vaccine is given as part of a six-in-one shot at weeks six, ten and 14. Dr. Shah added: “After that, children receive it,” says the Indian Academy of Pediatrics. get two boosters – at 15 to 18 months and at 5 years old.