Only a single polio case was reported in Karachi in 2018, a historic low, but all six districts of the city are being classified as ‘districts of high risk’.
Sindh Chief Minister Murad Ali Shah called for strict measures to reduce polio prevalence to zero and has declared polio vaccinations mandatory at all public and private schools. Schools that refuse will be liable to strict action.
Chairing a meeting of the provincial task force for polio eradication at CM House in Karachi on Thursday, Shah said in 2018, 12 polio cases were reported in Pakistan. So far in 2019, a single polio case has been reported in Bajaur. Of the 12 cases reported in 2018, one was reported in Sindh, one in Punjab, three in Balochistan, two in Khyber Pakhtunkhwa and six in the former tribal districts.
In Sindh, all six districts of Karachi are still classified as Tier 1 Core Reservoir — districts of high risk. The chief minister said this is worrisome but they will “take drastic measures with proper planning and focus”.
The 2018 case was reported in Karachi’s Gadap Town. The virus has been isolated from environmental sites (taken from the sewage system), which indicated on-going virus transmission.
The chief minister was informed that in Karachi, samples are taken from 11 sites every month to test for polio strains. In January, three sites in Gadap, Sohrab Goth, Khamiso Goth, Machhar Colony, Baldia, SITE and Saddar were declared positive. In rural areas of Sindh, samples were taken from six sites and one site in Sukkur was declared polio positive.
The CM was told that the epidemiological (spread of diseases) situation in Karachi is becoming worse as six sites tested positive, four were negative and one is pending.
Even though the quality of the campaign has improved, eradication levels are still not consistently achieved because of the high number of missed children due to refusals, he was informed.
Shah said that after the outbreak in three districts of lower Sindh — Badin, Thatta, Sujawal — between September and December 2016, the teams were provided significant human resources and a monitoring and supervision system that resulted in the subsequent improvement in performance quality. This improvement has been sustained.
In northern Sindh, all polio eradication activities were well managed. We have to work hard in Karachi and make it sustainable, the chief minister said.
One of the points raised during the meeting was that routine immunisation needs to be intensified because too many young children are left without immunity against polio.
Between September 2018 and January 2019, 96% of children were vaccinated against polio, said Provincial EOC Coordinator Umer Farooque Bullo. In January 2019, 88,472 children were not at home while 86,863 children refused to take the vaccine.
This means that of 7.3 million children, 175,000 were not administered vaccines. The CM said the number may not be very high but “we cannot tolerate this refusal”. He directed the chief secretary to take drastic measures to ensure that no one dares to refuse to immunise their children.
“This is a jihad for saving our future generation and our people and even schools refused to immunize their children,” he said, expressing his surprise.
The chief minister said that continuous positive environmental samples and community resistance to polio vaccine were big challenges. He directed the police chief to provide adequate security to the polio teams.