Lok Sabha Question No. 826 (UNSTARRED), answered on 2015-07-24
Subject: Polio Eradication and Acute Flaccid Paralysis
Ministry: HEALTH AND FAMILY WELFARE
Asked by: YOGI ADITYANATH, CH. MALLA REDDY, KIRRON KHER, RANJANBEN BHATT, P.R. SUNDARAM, A. ARUNMOZHITHEVAN, DUSHYANT CHAUTALA, (ADV.) JOICE GEORGE

**GOVERNMENT OF INDIA**

**MINISTRY OF HEALTH AND FAMILY WELFARE**

**DEPARTMENT OF HEALTH AND FAMILY WELFARE**

**LOK SABHA**

**UNSTARRED QUESTION NO.826**

**TO BE ANSWERED ON 24** **TH** **JULY, 2015**

**Polio Eradication and Acute Flaccid Paralysis**

**826.	 SHRI YOGI ADITYA NATH:**

**SHRI CH. MALLA REDDY:**

**SHRIMATI KIRRON KHER:**

**SHRIMATI RANJANBEN BHATT:**

**SHRI P.R. SUNDARAM:**

**SHRI A. ARUNMOZHITHEVAN:**

**SHRI DUSHYANT CHAUTALA:**

**ADV. JOICE GEORGE:**

Will the Minister of **HEALTH AND FAMILY WELFARE** be pleased to state:

(a) whether the country has received/ about to receive the Polio Eradication Certificate from the World Health Organisation on account of the country being declared polio free for three consecutive years, if so, the details thereof;

(b) whether laxity in the polio eradication programmes has been reported after the country was declared a "Polio free country", if so, the details thereof and the reasons therefor and the reaction of the Government thereto;

(c) whether the Government has taken cognizance of the recent reports of suspected polio cases across the country, if so, the details thereof, State/UT-wise; and

(d) whether the symptoms of the recently reported suspected polio cases point towards the Non-Polio Acute Flaccid Paralysis (NPAFP), if so, the details thereof indicating the number of cases of NPAFP reported during each of the last three years and the current year, State/UT-wise and the remedial measures taken/being taken by the Government to rein in the spread of polio and NPAFP in the country?

**ANSWER**

**THE MINISTER OF HEALTH AND FAMILY WELFARE**

**(SHRI JAGAT PRAKASH NADDA)**

(a):	India along with ten countries of World Health Organisation(WHO) SouthEast Asia Regionhas been certified Polio free by the Regional Polio Certification Commission on the 27th March 2014.

(b):	No laxity has been reported in the polio eradication program after the country was declared “Polio free country”.

India has maintained polio-free status through the following measures:

- Two rounds of high quality national immunization day (Pulse Polio) being conducted each year.
- Sub national immunization (SNID) rounds being implemented in high risk states such as Uttar Pradesh, Bihar, Delhi and high risk population pockets in the states of Haryana, Punjab, Gujarat, Maharashtra, Rajasthan, Jharkhand, Uttarakhand  and West Bengal.
- More than 100 vaccination posts are functioning along the international borders of India with Nepal, Pakistan, Bangladesh, Myanmar and Bhutan to administer oral polio vaccine drops throughout the year to all children below five years entering India.
- India has also made polio vaccination a mandatory requirement for travellers irrespective of age coming from and going to polio infected countries.
- Certification standard surveillance for cases with acute flaccid paralysis is in place to detect importation or emergence of polio case.More than 50,000 AFP cases are being investigated annually across India.
- Environmental surveillance through testing of sewage samples for polio is functioning strategically at Mumbai, Delhi, Bihar, West Bengal and Punjab..
- State and District level task forces arein place and actively overseeing the implementation of polio immunization and surveillance activity.

(c):	Yes. The Government has taken cognizance of the recent reports of suspected polio cases across the country.All suchreported cases were investigated and discarded as non-polio acute flaccid paralysis (AFP) cases as the stool sample tested were negative for polio. The details of recent reports of suspected polio cases reported in media State/UT wise are given in annexure I. The details of measure taken on the negative reporting in media are as under:

- The Ministry of Health and Family Welfare issued a press release on 20th June through Press Information Bureau to leading newspapers and news agencies. The press release informed the media that the 208 cases reported from Bareilly (Uttar Pradesh) were of acute flaccid paralysis (AFP) and the cases received from the laboratories in 2015 are negative for poliovirus. That stringent environmental surveillance is routinely undertaken to detect any polio cases.
- In Uttar Pradesh, prompt action was taken by the Health Department in organizing a media briefing by the Chief Medical Officer and the District Immunization Officer. The media briefing was also attended by WHO-National Polio Surveillance Project (NPSP) and UNICEF Social Mobilization Net (SMNet).
- Large scale media workshops in 38 districts reaching over 600 journalists have been undertaken in Bihar by UNICEF to sensitize journalists about the surveillance process, adverse events following immunization (AEFI) and educate them about the difference between polio and AFP cases. As a result of these workshops over 350 positive articles have been published from March – July 2015. The tonality of 92% stories on polio in Bihar is positive.

(d):	The reported suspected polio cases across the country are subsequently discarded as Non-Polio Acute Flaccid Paralysis (NPAFP) cases based on symptoms and stool results.

The State/UT wise NPAFP cases reportedin the last three years and the current year is given in annexure-II.

Apart from the measure taken as detailed in para (b) above, the NPAFP cases are also advised for followup for further treatment in Hospital.

Annexure I

Table showing details of AFP cases reported in 2015 to media as suspected polio State/UT wise

| **Date of Report**   | **Media**                                     | **State/UT**              |   **No of suspect polio cases reported by media** | **Outcome following investigation**                                   |
|----------------------|-----------------------------------------------|---------------------------|---------------------------------------------------|-----------------------------------------------------------------------|
| 24 January 2015      | Local media                                   | Pataudi, Haryana          |                                                 1 | Non polio cases stool samples were negative                           |
| 23 February 2015     | Local media later picked up by national media | Darbhanga, Bihar          |                                                 2 | Non polio cases stool samples were negative                           |
| 19 May 2015          | The Telegraph, Ranchi edition                 | West Singhbhum, Jharkhand |                                                 1 | Rejected as not a  case of acute flaccid paralysis or suspected polio |
| 20 June 2015         | Times of India                                | Bareilly , Uttar Pradesh  |                                               208 | Non polio cases all stool samples were negative                       |

Annexure II

Classification of Non-polio AFP   (NPAFP)Acute Flaccid Paralysis (AFP) cases: 2012-2015*

| SNo   | State/UTs           | 2012   | 2013   |   2014* |   2015* |
|-------|---------------------|--------|--------|---------|---------|
| 1     | Andaman & Nicobar   | 1      | 2      |       1 |       0 |
| 2     | Andhra Pradesh      | 1302   | 1098   |     519 |     180 |
| 3     | Arunachal Pradesh   | 36     | 27     |      21 |       3 |
| 4     | Assam               | 585    | 519    |     470 |     146 |
| 5     | Bihar               | 15841  | 14125  |   14536 |    5034 |
| 6     | Chandigarh          | 58     | 61     |      68 |      30 |
| 7     | Chhattisgarh        | 616    | 565    |     409 |     114 |
| 8     | Dadar& Nagar Haveli | 9      | 1      |       4 |       2 |
| 9     | Daman & Diu         | 2      | 6      |       6 |       4 |
| 10    | Delhi               | 768    | 866    |     826 |     326 |
| 11    | Goa                 | 18     | 25     |      24 |       6 |
| 12    | Gujarat             | 936    | 945    |     888 |     339 |
| 13    | Haryana             | 1378   | 1250   |    1132 |     332 |
| 14    | Himachal Pradesh    | 178    | 159    |     139 |      63 |
| 15    | Jammu & Kashmir     | 271    | 184    |     167 |      76 |
| 16    | Jharkhand           | 1484   | 1414   |    1504 |     425 |
| 17    | Karnataka           | 995    | 943    |    1037 |     385 |
| 18    | Kerala              | 327    | 379    |     390 |     144 |
| 19    | Lakshadweep         | 1      | 0      |       0 |       1 |
| 20    | Madhya Pradesh      | 2918   | 2679   |    2791 |     749 |
| 21    | Maharashtra         | 3053   | 2862   |    2647 |     865 |
| 22    | Manipur             | 33     | 17     |      47 |      10 |
| 23    | Meghalaya           | 42     | 56     |      44 |      10 |
| 24    | Mizoram             | 16     | 12     |      20 |       1 |
| 25    | Nagaland            | 29     | 10     |       8 |       5 |
| 26    | Odisha              | 1980   | 1964   |    1927 |     607 |
| 27    | Pondicherry         | 15     | 18     |      23 |       7 |
| 28    | Punjab              | 727    | 637    |     522 |     207 |
| 29    | Rajasthan           | 2044   | 2214   |    1970 |     668 |
| 30    | Sikkim              | 7      | 1      |       5 |       2 |
| 31    | Tamil Nadu          | 654    | 625    |     694 |     264 |
| 32    | Telangana           | --     | --     |     307 |     102 |
| 33    | Tripura             | 90     | 60     |      71 |      22 |
| 34    | Uttar Pradesh       | 20913  | 17761  |   17235 |    5918 |
| 35    | Uttarakhand         | 422    | 372    |     367 |     120 |
| 36    | West Bengal         | 3141   | 2737   |    2884 |     974 |
| Total | Total               | 60890  | 54594  |   53703 |   18141 |

* data as on 18 July 2015