POLIOMYELITIS

To study the risk factors of polio in Southern Punjab.Material and methods: The data of Acute Fluid Paralysis (AFP) cases of year 2003 from the districts of South Punjabnotified to the National Surveillance Cell, Islamabad was collected and analyzed. Results: Group A consisted ofBahawalnagar, Khanewal, Lodhran, Multan, Muzaffargarh, Pakpattan, Sahiwal and Vehari districts with polio caseswhile group B consisted of Bahawalpur, Dera Ghazi Khan, Layyah, Rahimyar khan and Rajanpur districts which werepolio free. Total 397 AFP cases with age range of 1-180 months were recorded. Total 17 polio cases (12 confirmedand 5 compatible) were reported with age range of 4-42 months. Total 36 (9.07%) deaths were recorded. Casesrecorded with two stool specimens not collected within 14 days of onset of paralysis (24 hours apart) were 19(4.79%).Children who received routine polio doses < 3 or unknown were 193(48.61%) while 150(37.78%) children received <7 or unknown additional polio doses. Two stool specimens were collected in 380(95.72%) cases. The non-polioenterovirus was isolated from the stool specimens of 92(23.17%) cases while polio vaccine virus was isolated in15(3.78%) cases. There were significantly greater chances of late notification responsible in the non-collection of twostool specimens within 14 days of onset of paralysis (p <0.006) and under vaccination during routine immunization (p<0.0053) in polio cases. Significantly greater number of polio cases received additional polio doses <7 or unknown (p< 0.0001). The difference in deaths rate in polio and non-polio AFP cases was insignificant (p=0.6597). Conclusion:Children remain at risk for polio unless routine immunization is strengthened or additional supplementary immunizationis provided as well as timely collection of stool specimens.