Detecting polio through surveillance for acute flaccid paralysis (AFP).

Accurate surveillance for polio is essential for eradication. Surveillance systems for polio has been developed under the guidance of the global polio eradication initiative. Surveillance of cases of acute flaccid paralysis among children less than 15 years of age is a key component for a well functioning polio surveillance system. The surveillance system works through a network of surveillance medical officers, the responsibility of them lies in assisting the health services departments of all states and maintaining a network of acute flaccid paralysis reporting sites and rapidly investigating the cases. Surveillance activities begin when a child comes in contact with a healthcare provider who in turn informs the officer in charge of acute flaccid paralysis surveillance. The goal of the polio network laboratories is to provide accurate and timely results of wild poliovirus detection in stool samples of cases of acute flaccid paralysis. Strong linkages have been established between the acute flaccid paralysis surveillance system and the laboratory network. Laboratories complete poliovirus isolation and if poliovirus is isolated, these are submitted for intratypic differentiations. Acute flaccid paralysis surveillance in India has demonstrated that the eradication activities implemented in India led to dramatic reduction and restriction in the number of cases and geographic spread of poliovirus transmission.

Routine immunisation in India.

Vaccine preventable diseases have been reduced in the country since the routine immunisation programme started in 1978 as the Expanded Programme on Immunisation, then in 1985 renamed as Universal Immunisation Programme. Re-emergence of some vaccine preventable disease is a concern to all and the Government of India has launched a new multiyear plan to strengthen the routine immunisation. A number of recommendations was made to address the weaknesses in the programme. Some newer initiatives were also made under the multiyear plan and National Rural Health Mission to strengthen the routine immunisation. The general practitioners can play a positive role while immunising children as per Universal Immunisation Programme. Routine immunisation is one of the key components of polio eradication.

Polio eradication in India: current status.

India has reached the final stage of polio eradication. The polio partnership in India, under the leadership of the Government of India, mounted tremendous response to the outbreak. The progress since 2003 is the most significant in the history of polio eradication in India. Surveillance sensitivity was increased to reach the goal for polio eradication. Since nearly all polio cases now occurring in India are caused by type 1 poliovirus in children, monovalent oral polio vaccine type 1 (mOPV1) was introduced in select high-risk districts of UP, Bihar and Mumbai-Thane during the April and May 2005 National Immunisation Days and the June and August 2005 in 6 sub-national immunisation rounds. Strategies were also being implemented to improve the impact of supplementary immunisation activities in the high-risk areas. As a result of supplementary immunisation activities targeted using surveillance data, India has made striking progress towards polio eradication.