Emergency Preparedness Status in Maharashtra (IEAG July11) Dr D S Dakhure Director(H&FW-MH)

Maharashtra Part I Epidemiological risk in Maharashtra Part II Emergency Preparedness & response Plan (EPRP)

WPV importation and Transmission risk in Maharashtra

MH Maharashtra Profile 2011 Population Million No. of Districts34 No. of Corporations 22 No. of Blocks396 Source: Census 2011

Maharashtra is the second most populous state after Uttar Pradesh and third largest state by area after Rajasthan & Madhya Pradesh in India.second most populousUttar Pradeshthird largest state by It is the richest state in India- MIGRATION RISK- PULL MIGRATION

Risk factors-Maharashtra High urbanization High migration (inter/intra state) Booming construction industry Slums Seasonal migrants (sugar cane cutters-Beed) Past history of WPV importations/ transmission

Risk factors-Maharashtra Mumbai & Thane High migration, Construction workforce & Slums. Past h/o importations/ transmission Bhiwandi & Malegaon Refusals/Vaccine avoidance. Large underserved population Rest of MH High urbanization. Seasonal migration (sugarcane cutters)

MAHARASHTRA No.District NASIK BEED THANE GR. MUMBAI AMRAVATI SANGLI NANDED Maharashtra Total

MAHARASHTRA WPV Cases – 2010 & 2011* P1 Wild Case - 5 Idcode Donset 1) MH-NSK /01/2010 Mohd. Kasim Asrar Ahmad – 12 months 2) MH-NSK /07/2010 Sultan Shaikh Akil – 24 months 3) MH-NSK /08/2010 Altmish Anjum Siraj Ahmad – 10 months 4) MH-NSK /08/2010 Fareeha Mohd. Ibrahim – 22 months 5) INDMHOBD /09/2010 Raj Kiran Ade – 10 months

WPV Cases MH Mumbai + Thane 7 Nasik (Malegaon Corp) 4 Beed 2 Amravati 1 Mumbai

WPV Cases Mumbai 1999 onwards* Year H-EG-NK-WM-EBP-NR-N

High Risk Wards-Mumbai P/N,L,S Slums with migration H/W, K/E,K/W Highest construction sites (70%) G/N, F/N,M/E Environmental Surveillance Sample wards High Risk Wards in Mumbai 9 High Risk wards in Mumbai on highest priority for SIA & Surveillance

Additionally ….. Industrialized areas of Thane (Bhiwandi) & Raigad are at high risk of WPV transmission due to: 1) High MIGRATION 2) Construction workforce from endemic states of UP, Bihar & West Bengal) 3) Slums with migration

Risk in MHAreaRisk Factors Mumbai & Thane Past h/o WPV transmission, Migration and Slums & Sewage sample results Malegaon Corp(& other urban areas) Vaccine avoidance/Refusals/ Low Routine Immunization Beed and other migratory pop. Districts Seasonal migration Areas at risk WPV transmission in Maharashtra

Emergency Preparedness & response Plan (EPRP)-MH status

State Emergency Preparedness & Response Group – Maharashtra formed Preparatory meeting was held in 3 rd week of Apr.11 in Pune with Addl Director and SEPIO to finalize names of RRT team members for high risk areas. EPRP meeting was held on 7 th May 11 at Arogya Bhavan Mumbai under chairmanship of Director (H&FW)

EPRP-Maharashtra EPRP meeting was conducted under chairmanship of Director-H&FW,MH with officials from all high risk areas :Mumbai, Malegaon Bhiwandi, Thane & Nasik districts. All members of core team were explained in detail about EPRP Senior experienced officials from state are identified as RRT members

EPRP-Maharashtra They are assigned all pre-identified high risk areas. Senior state officials from HQ are designated as state supervisors for RRT members.

EPRP ACTIVITIES-Maharashtra Task Actions Status Areas with high risk of importation & spread of poliovirus Mumbai Metropolitan Region (MMR), all Corporations (24) and high migratory districts- Beed Completed Districts/blocks with low RI coverage IdentifiedCompleted Communication Risk Analysis Bhiwandi & Malegaon Corporation 69 Fast Track Field Volunteers (FTFVs) and 13 Field Volunteers in place coordinating with UNICEF Media response plan Addl. Director chairman of media response Completed

EPRP ACTIVITIES-MH Task Action Status Rapid Response Team (RRT) members Identified by name for all high risk areas Completed Surveillance Review Reviewed on monthly basis and letter issued from state to defaulting districts Completed/ Ongoing activity Assigning senior state officials to high risk districts/blocks Followed in all SIAs and reports submitted for corrective actions Completed/ Ongoing Migratory area mapping Completed in Mumbai- Thane-Raigad and Malegaon Rest of the state will be completed in next three months

State Senior Supervisors Sr. No. NameHigh Risk area assigned 1 AHO EPI Mumbai Corporation Mumbai 2 Deputy Director of Health Services Mumbai Circle Thane district and all 6 Corporations 3 Deputy Director of Health Services Nasik Circle Malegaon Corporation and Nasik district

Special Plan for strengthening Routine Immunization in Malegaon Corporation Deployment of PHNs and ANMs to Malegaon Corporation to manage RI Has shown good results Out of 2790 RI sessions planned 2730 (98%) conducted

MonthPHNANM Total Staff Deputed No. of Immunization Sessions planned Actual no. of Immunization Sessions held Oct Nov Dec Jan Feb Mar Apr May June Total Improvement in Malegaon RI due to deployment PHN/ANMs

Summary Mumbai/ Thane followed by Malegaon are highest risk areas for WPV transmission Maharashtra is fully committed to implement Emergency Preparedness Response Plan SIA preparedness meetings of all key officials from high risk areas are conducted before each SIA Regular reviews at highest level for all HIGH RISK area during/after ALL SIAs for corrective actions.

With all good wishes from Maharashtra