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Tireless vaccination on to keep India polio free (Oct 24 is World Polio Day)

New Delhi, Oct 23 (IANS) India will complete two years of polio-free status in another three months but there is no slackening of the relentless vaccination drive, including at the borders, experts say.

"India continues to be zero-polio. This is an unprecedented progress," Ajay Khera, deputy commissioner in the health and family welfare ministry, told IANS.

India has not reported any polio case since Jan 13, 2011 when an 18-month old girl was declared a victim in West Bengal's Howrah district.

The World Health Organisation (WHO) in February removed India from the list of polio-endemic countries. But to be declared polio free by WHO, India will have to remain free of the virus for two more years.

India saw the fear of polio virus returning when a suspected case was detected at Darbhanga in Bihar Oct 11. But within hours, the WHO said the test was negative.

According to Khera, "the risk of polio persists as long as poliovirus transmission continues anywhere in the world." Two of India's neighbours, Pakistan and Afghanistan, are polio endemic. So is Nigeria.

Khera said the polio eradication programme has stepped up measures to ensure that all children under the age of five years are protected against polio, "while at the same time mitigate risks of polio importation".

During each of the two yearly national immunization days, 172 million children under five years in the country are given the "do boond zindagi ki (two drops of life)" Oral Polio Vaccine (OPV).

Nearly 2.3 million vaccinators under the direction of 155,000 supervisors fan out across the country, visiting 209 million homes to administer the vaccine.

To prevent the import of the virus, polio immunization is being carried out at five border points along the Pakistan border - Baramulla and Poonch in Jammu and Kashmir, Attari and Wagah in Punjab and Munabo in Rajasthan, said Khera.

Besides the two national days, six subnational supplementary polio immunisation rounds are carried out in high risk states - especially Bihar and Uttar Pradesh - and other areas.

"An extremely robust monitoring mechanism is in place to ensure the immunization rounds are of the best quality," he added.

The high-risk groups such as migrant and mobile populations are especially targeted to ensure they get the routing immunization.

The government's partners in the endeavor are WHO's National Polio Surveillance Project, UNICEF's Social Mobilization Network and Rotary.

"One of the biggest risk to the programme is complacency," warned Lieven Desomer, Chief Polio, UNICEF India Country Office.

"UNICEF's 6,500 strong Social Mobilization Network (SMNet), working in the highest risk areas of Uttar Pradesh and Bihar, continue to counsel parents on the need to protect children against polio and address risk factors like hygiene, sanitation, nutrition and diarrhoea management," Desomer told IANS.

The SMNet was focusing on strengthening routine immunization through door-to-door counselling, community meetings as well as tracking and counselling of the drop-out families, the UNICEF official added.

Nata Menabde, WHO Representative to India, told IANS: "While India has not had a polio case since January 2011, the risk of an importation of polio virus from countries where polio is being detected remains."

As part of the surveillance system, more than 37,000 health care facilities in the public and private sector participate in surveillance by reporting cases of acute flaccid paralysis.

"More than 60,000 (such) cases are reported annually. They are investigated and followed up to rule out polio. Since the last case of polio, all acute flaccid paralysis cases have tested negative," she added.

India saw 42 cases of polio in 2010, a sharp drop compared to 2009 (741 cases). In 1991 there were 6,028 cases and in 1985 India recorded 150,000 cases.