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Eradication of Poliomyelitis Global & National Overview Goal : Complete interruption of wild poliovirus transmission Dr OR Goldie (State EPI Officer Punjab)
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Acute Flaccid Paralysis (AFP) surveillance System Hospitals Clinics Community Hospitals Clinics Community AFP cases WPV (Polio) WPV (Polio) Non-Polio AFP Case Investigation and Lab Analysis Case Investigation and Lab Analysis
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Wild Poliovirus*, 07 Jul 2009 – 13 Aug 2010 Case or outbreak following importation (0 - 6 months) Endemic countries Case or outbreak following importation (6 - 12 months) Wild virus type 1 Wild virus type 3 Wild virus type 1/3 *Excludes viruses detected from environmental surveillance and vaccine derived polioviruses. 1 WPV1 in Jammu and Kashmir, date of onset of 07 Feb 2010, does not appear on the map. Wild virus type 1 Wild virus type 3 Wild virus type 1/3 Total Cases Wild Polio Virus 2009Jan 01- 13 Aug 2009* Jan 01- 13 Aug 2010* Globally1606817608 Pakistan803136 Afghanistan381413 India 741 18427 Nigeria3883726 No of countries with virus. 23 1915
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Location of poliovirus by type, 2009* * data as on 9 April 2010 Ludhiana Priority District For Polio Eradication Repeated Virus Importations Rapid Urbanization And Industrialization Extensive Construction Activity Labour Forces From Endemic States Highest percentage of migrants in Punjab
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Location of poliovirus by type, 2010* Most recent virus 22 July 2010 Pakur, Jharkhand * data as on 9 Jul 2010 Maharashtra WPV : Genetically related to Khagaria strain isolated in June 2009 Jammu WPV :Genetically related to an imported strain in Punjab Sept 2009 W Bengal WPV: Genetically related to Saharsa strain isolated in June 2009 WPVs StateP1P3Total West Bengal426 Jammu & Kashmir101 Jharkhand213 Maharashtra202 Uttar Pradesh010 Bihar066 Haryana011 Total92029
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Reduction in Genetic Diversity and Overall Burden of WPV1 20072006 Grey 1 Grey 2 Grey 3 Black 1 Black 2 Pink 1 Yellow 2 Yellow 3 Yellow 4 Grey 1 Grey 2 Grey 3 Black 1 Pink 1 Yellow 2 Yellow 3 89 38 2 11 12 459 11 14 4 29 14 1 32 3 2 Grey 1 Grey 2 2 71 Pink 1 2008 Pink 179 2009* 9 clusters7 clusters3 clusters 1 cluster
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Number of cases 2006 Monthly incidence of polio in Punjab January 2006 – July 17 2010* 2007200820092010 J F M A M J J A S O N D J F M A M J J Very High Risk Period
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Current Status India to date has 29 WPVs including 9 WPV type 1 and 20 WPV type 3 cases NO P1 cases reported from UP & Bihar since Oct/Nov 2009 Majority of Punjab cases in past 3 years are related to migrants. – Last case was in Oct 2009 in Ludhiana. – Low level circulation is believed to be continuing – Intensified efforts need to be sustained Punjab is entering its Very High Risk Period for virus.
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Polio Eradication efforts : Ludhiana State level mtg chaired by Hon’ble Health minister on 16 July 2010 – DTF – Intensify monitoring – Microplanning – Improve reach in slums DTF Ludhiana 21 July 2010 –District admn support assured –Increase District level monitoring –Seek partner support in microplanning next round Polio Activity 25-27 July –Active monitoring in slums by CS, staff, state level observers, partners –Review done by DFW (26 Jul) –Evening meetings held –Feedback: Quality of activity good, supervision needs strengthening
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Wild Virus /Compatible cases- 2009 Confirmed Polio -4 Compatible-3 PBJLD09021 Block- JLD West- Kartarpur Donset 09/09/2009 Age 4 mths - P1W Doses- RI-2 SIA- 1 UPLNO09200 Block- LDN City Donset 20/09/2009 Age 13 mths - P1W Doses- RI- 0 SIA-5 UPBJN09275 Block- Mohali Donset 28/09/2009 Age 8 mths - P3W Doses- RI- 0 SIA-6 PBLDN09043 Block- Jagraon Donset 13/10/2009 Age 15 mths - P3W Doses- RI- 0 SIA-8
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Wild Virus /Compatible cases- 2010 No Polio Case
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% Adequate Stool Collection Rate – Punjab 2007-2010 < 60% 60% - 69% > 80% 70% - 79% GDP HSP ASR FZP FRK MKS BTD MNS SAN LDN MGA PTL JLD KPT NSR RPN TNT MHL BNL 2007 82% 2008 79% 2009 78% 2010 82% as on week 30 ending on 7 th Aug 2010
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GDP HSP ASR FZP FRK MKS BTD MNS SAN LDN MGA PTL JLD KPT NSR RPN TNT MHL BNL 2008 3.94 2007 3.86 < 0.70 0.70 - 0.99 1.00 – 1.99 > 2.00 Non Polio AFP Rate 2007-2010 2009 4.55 2010 3.28 as on week 30 ending on 7 th Aug 2010
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% Cases Investigated w/in 48 hrs- Punjab 2007-2010 < 60% 60% - 69% 70% – 79% > 80% 2008 92% 2007 88% 2009 93% 2010 90% as on week 30 ending on 7 th Aug 2010
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% Cases Notified w/in 10 Days - Punjab 2007-2010 GDP HSP ASR FZP FRK MKS BTD MNS SAN LDN MGA PTL JLD KPT NSR RPN TNT MHL BNL < 60% 60% - 69% 70% – 79% > 80% 2007 84% 2008 81% 2009 81% 2010 83% as on week 30 ending on 7 th Aug 2010
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Weekly Summary Of Timeliness of District Reports- 2010 1 st Quarter2 nd Quarter 98% 94% 97% 84% 94% 98% 97% 91% 98% No Report received from Patiala since last 3 weeks
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The Impact of Polio Eradication Since the Global Eradication of Polio Initiative began in 1988, over 50 Lac disabilities have been prevented worldwide.
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THANK YOU
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