LAHORE       -         The National Institute of Health in Islamabad has confirmed presence of polio virus in two female children from Punjab, one in Lahore and the other in Okara.

On seeing symptoms, stool samples of both the kids living under poor socio-economic conditions were sent to the NIH. The Lab confirmed presence of crippling virus in both the ill fated kids on Thursday, taking the cases in 2019 to 136. In Punjab, 12 new cases were reported in 2019. The 14-year-old from Okara developed symptoms on December 8 (paralysis of left upper and lower limbs) and 54 month (4.5 year) old female child from Lahore on December 28, 20019 (paralysis of all four limbs). Victim of poliovirus from Lahore had lost her life on January 11, 2020, about 40 days before confirmation from the IPH.

Girl child from Okara getting polio at the age of 14 year has raised questions on the logic of confining immunization campaigns to children under five. “Getting polio at the age of 14 is rare but not unusual.

Virus can attack any individual regardless of his/her age. Usually children under five are at greater risk of getting polio due to weak immunity. Immunization at an early age usually provides shield till the later stage”, said Dr Abdul Rauf, a family physician running clinic at Usman Gunj, congested locality in Northern Lahore.

These two cases have also reignited the debate that whether improved vaccination coverage and multiple campaigns were enough to achieve the goal of making Pakistan polio-free as both the kids had received more than seven doses of oral polio vaccine (OPV).

“Vaccine provides much-needed shield, but it is not a guarantee to protect children until and unless other preconditions are fulfilled. First four doses in routine immunisation are vital and these cannot be covered through multiple doses at a later stage”, Dr Rauf said.

“Malnutrition and co-morbidities like diarrhoea, dysentery and fever are major reasons behind children getting polio even after receiving multiple doses of vaccine. These children with weak immunity fail to produce antibodies (shield against polio) from the vaccine. As such they are not immune and can get polio if attacked by the virus”, he said. He stressed the need of carrying extensive research to find out why children get polio even after multiple doses of OPV.

“Until proper research, there is a need of maintaining cold chain, improving diet and monitoring condition of children before and after administering polio vaccine. Vaccine is useless if administered to a child with bad stomach or if he/she vomits after getting the dose. Proper training of vaccinators is a key to achievement of desired results from vaccination,” he said.

During 2016 and 2018, no polio case was reported in Punjab. While in 2015 as many as seven polio cases were reported from the province. Pakistan, Afghanistan, and Nigeria are the three countries left globally which are still endemic.