Pakistan: New polio cases cast shadow on vaccinations

LAHORE, 19 October 2008 (IRIN) - Confirmation that three children in Punjab Province, the most developed in the country, have contracted polio takes the total number of cases detected this year to 80.

So far 22 cases have surfaced in Punjab, 31 in the North West Frontier Province, 15 in the southern province of Sindh, seven in the southwestern province of Balochistan, and five in the federal capital, Islamabad.

According to the World Health Organization (WHO), 32 cases of polio were detected in 2007, and 40 in 2006.

The high incidence in the Punjab is leading to concerns about the vaccine itself, with newspaper reports alleging it is of low-quality, or that expired vaccines are being used.

Each of the three children who have become the latest victims of the potentially crippling polio virus - Zunaira aged 14 months in Okara, Saima, aged two years in Bahawalpur, and Asad Ali, aged 18 months in Kasur - had reportedly received multiple doses of the vaccine.

Diarrhoea could be to blame

H. B. Memon, national programme manager for the Expanded Programme on Immunisation (EPI), however, said the vaccine itself is safe.

"This is a WHO approved vaccine," he told IRIN. Memon said "management issues" and the fact that if "a child suffers from diarrhoea the polio drops are not absorbed in the intestine" are key factors in the emergence of so many cases.

He said that in many cases parents do not realise that sickness could detract from the immunising effect of the vaccine.

Health Minister Sherry Rehman has already expressed concern about the situation, and an urgent consultation of the WHO's Regional Office for the Eastern Mediterranean took place in Cairo earlier this month to review the situation.

"The problem could in part be the high levels of diarrhoea. The problem is endemic among children here, especially in the summer season when large amounts of water are consumed," said Omar Mansoor, who works at a rural health centre in Lahore District.

Key health concern

But concerns about the situation are rising rapidly. "We have a newborn son, but we are still considering whether to get him vaccinated as we have read that the polio drops the government teams give may not be safe," said Faiza Bibi, 25, in Shahdara on the outskirts of Lahore, the provincial capital of Punjab.

News of this kind spreads rapidly, with Pakistan's popular cable TV channels also taking up the issue. The problem is that the accounts of children who have received dosages becoming sick may lead parents to conclude the amber-coloured anti-polio drops are useless, say health experts.

"Maybe the drops are fake," said Dilawar Ahmed, 28, Faiza's husband.

The high number of cases reported this year is becoming a key health concern for Pakistan. As Memon said, "we are taking urgent measures to deal with the situation."

However, these measures will need to be adopted swiftly to prevent the reliability of the anti-polio campaign coming under serious doubt and thereby adding to the growing problems that are holding back efforts to eradicate the disease from the country, according to public health specialists.