Pulse Polio Immunization Program: A Powerful Step Towards a Polio-Free Future

Mr. Umar

2 years ago

Discover how the Pulse Polio Immunization Program has been a game-changer in eradicating polio, ensuring every child under 5 years receives essential protection.

Pulse Polio Immunization Program: A Powerful Step Towards a Polio-Free Future

The Pulse Polio Immunization Program has played a crucial role in India’s fight against polio. By implementing this program, the government ensured that every child under 5 years received extra doses of Oral Polio Vaccine (OPV), significantly reducing the incidence of poliomyelitis.

Introduction of Polio Eradication

Polio has been eradicated from most of the world. This was achieved through key strategies like vaccination and enhanced surveillance. The Pulse Polio Program (PPI) in India played a crucial role in this effort.

Important Events in Pulse Polio Immunization

1978: Vaccination against polio began under the Expanded Program on Immunization (EPI).
1984: Around 40% of all infants received 3 doses of Oral Polio Vaccine (OPV).
1985: Universal Immunization Program (UIP) was launched under UNICEF.
1995: Pulse Polio Immunization (PPI) program launched, targeting all children below 3 years.
1996-97: Target age group expanded to all children under 5 years.
1997: National Polio Surveillance Project initiated in collaboration with WHO.

Strategies for Polio Eradication in India

Track OPV coverage at the district level and below.
Enhanced surveillance to find all cases of Acute Flaccid Paralysis (AFP).
Speed up the process of investigation and follow-up on AFP cases.
Control of epidemic through various measures.

Pulse Polio Immunization Days

Annual PPI days planned and implemented according to national guidelines until eradication.
Extra OPV doses provided to all children under 5 years every 4-6 weeks.
Extra immunization rounds, house-to-house “search and vaccinate” efforts additionally to fixed clinics.

Line Listing of Cases

Began in 1989 to avoid duplication in reporting. All AFP cases must be reported with detailed information to the medical officer.

Mopping Up Operations

Final stage of eradication, involving door-to-door immunization in high-risk districts.

PPI Implementation in India

The first round of PPI was held on 9th December 1995, targeting children under 3 years.
Later rounds included all children under 5 years.
“Pulse” refers to mass administration of OPV on a single day. It is given to all children under 5 years, regardless of earlier immunization.

Guidelines for PPI

PPI doses are supplementary and do not replace regular OPV doses.
No least interval between PPI and scheduled OPV doses.
Vaccine vial monitors were introduced in 1998 to guarantee vaccine efficacy.

India Declared Polio-Free

On 27th March 2014, India was declared a non-endemic country for polio.

Steps Taken by the Indian Government

Formation of Rapid Response Teams (RRT) for polio outbreaks.
Development of Emergency Preparedness and Response Plans (EPRP) by all states.
Tracking every newborn in high-risk areas like UP and Bihar.
Immunization efforts extended to public places like railway stations, markets, temples, etc.
High-level surveillance and improved community participation in PPI.

Surveillance in Polio Eradication

Acute Flaccid Paralysis (AFP) Surveillance
AFP surveillance is the gold standard for detecting cases of poliomyelitis. The process involves four key steps:

Identification and Reporting: Children with acute flaccid paralysis (AFP) are identified and reported. Immediate reporting is required for AFP cases in children under 15 years or for any suspected polio-related paralytic illness. Investigations should be initiated within 48 hours.
Stool Sample Collection: Two stool specimens are collected 24-48 hours apart and within 14 days of the onset of paralysis. These samples are sent to the laboratory for analysis.
Laboratory Analysis: The stool samples are analyzed to isolate and find the presence of poliovirus.
Virus Mapping: Once the poliovirus is isolated, it is mapped to decide the place of origin of the virus strain.

Environmental Surveillance
Environmental surveillance is another critical part. It involves testing sewage and other environmental samples for the presence of poliovirus. This is particularly useful in detecting poliovirus infections even in the absence of paralysis cases.

Systematic Environmental Sampling: Regular environmental sampling, for example in Egypt and Mumbai, India, provides essential supplementary data. This data supports the AFP surveillance system.
Ad-hoc Environmental Surveillance: In polio-free regions, ad-hoc environmental surveillance offers insights into the international spread of poliovirus. This helps to prevent potential outbreaks.