As a preventive measure to stop polio virus from coming into India, all travelers from and to Afghanistan, Ethiopia, Syria, Kenya, Somalia, Nigeria and Pakistan would be required to take the Oral Polio Vaccine (OPV). All travelers coming from these countries to India would need to take OPV six weeks before departure from their country. Polio vaccine will also be administered to all travelers from India to these polio-affected countries. The new polio vaccination regime comes into effect from March 1, 2014.
“Years of efforts and huge financial resources have been invested by India for stopping polio in India. We cannot risk importation of polio virus, which is getting bigger and bigger with the recent outbreaks in the Middle East and earlier in the horn of Africa region. This new preventive measure has been initiated as per the recommendations of the national and international expert bodies and the guidelines of the World Health Organization,” said Anuradha Gupta, additional secretary, Ministry of Health and Family Welfare, Government of India.
India has not reported any case of polio for over three years. Next India, along with the remaining countries of WHO’s South East Asia region will be certified polio-free. However, the risk of polio persists as Afghanistan, Pakistan and Nigeria continue to be polio-endemic, re-infecting six countries in 2013 and causing major polio outbreaks in the Horn of Africa region and the Middle East.
In view of the persisting threat of polio virus importation, the Independent Monitoring Board of the Global Polio Eradication Initiative, recommended in its October 2013 report that the International Health Regulations (IHR) should be used to ensure all people travelling from polio-endemic country are required to have vaccination prior to travel, and this should be extended to any persistently affected country.
As per the WHO guidelines, until polio is eradicated globally, the risk of introduction of polio virus in polio-free areas through travellers remains. All travelers, to and from polio virus-infected areas, are advised to be adequately vaccinated.
WHO Representative to India, Dr Nata Menabde, said, “WHO supports the Government of India initiative for making polio immunization a requirement for travelers from and to the polio-affected countries. This is also in line with the recommendation of the Independent Monitoring Board of the Global Polio Eradication Initiative.”
Earlier, in May 2013, the India Expert Advisory Group (IEAG) on Polio Eradication recommended that the Government of India should strongly promote the current WHO polio immunization recommendations for travelers to and from endemic or infected areas. The expert body had said that the most significant risk is the importation of polio virus from remaining countries with endemic circulation. Additionally, the possibility of outbreaks in non-endemic countries leading to spread that threatens India could not be discounted.
India is taking several other measures to mitigate the risk of polio virus importation. Continuous polio immunization posts have been set up along the international borders with Pakistan, Nepal, Bangladesh, Myanmar and Bhutan. Initiated in 2011, the number of posts has gone up to 102 this year with nearly 4.2 million children immunized at these posts in the last two years. All efforts are being made to maintain population immunity against polio through high quality polio immunization campaigns and increased routine immunization coverage. Two national and six sub-national polio campaigns were held in 2013.
High quality surveillance is in place to detect any untoward importation of the polio virus into India. The Government of India has declared that any case of polio virus would be treated as an emergency. The emergency preparedness and response capacity is being reviewed on an ongoing basis and nearly 200 Rapid Response Team members have been trained to roll out emergency response to polio.