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Compatible poliomyelitis cases in India during 2000
Kathryn A Kohler1, W Gary Hlady, Kaushik Banerjee
1Global Immunization Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. kik9@cdc.gov
Objective:
To describe the characteristics of compatible poliomyelitis cases and to assess the programmatic implications of clusters of such cases in India.
Methods:
We described the characteristics of compatible poliomyelitis cases, identified clusters of compatible cases (two or more in the same district or neighbouring districts within two months), and examined their relationship to wild poliovirus cases.
Findings:
There were 362 compatible cases in 2000. The incidence of compatible cases was higher in districts with laboratory-confirmed poliomyelitis cases than in districts without laboratory-confirmed cases. Of 580 districts, 96 reported one compatible case and 72 reported two or more compatible cases. Among these 168 districts with at least one compatible case, 123 had internal or cross- border clusters of compatible cases. In 27 districts with clusters of compatible cases, no wild poliovirus was isolated either in the same district or in neighbouring districts. Three of these 27 districts presented laboratory-confirmed poliomyelitis cases during 2001.
Conclusion:
Most clusters of compatible cases occurred in districts identified as areas with continuing wild poliovirus transmission and where mopping-up vaccination campaigns were carried out. As certification nears, areas with compatible poliomyelitis cases should be investigated and deficiencies in surveillance should be corrected in order to ensure that certification is justified.
Insights
Clusters of compatible poliomyelitis cases in India often occurred in areas with ongoing wild poliovirus transmission. Investigations and improved surveillance are crucial for polio eradication certification.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Surveillance
Background:
- Poliomyelitis remains a global health concern, necessitating robust surveillance systems.
- Identifying and understanding compatible poliomyelitis cases is vital for polio eradication efforts.
- India's progress towards polio-free certification requires meticulous attention to surveillance data.
Purpose of the Study:
- To characterize compatible poliomyelitis cases in India.
- To evaluate the implications of compatible case clusters on polio eradication programs.
- To analyze the relationship between compatible case clusters and wild poliovirus circulation.
Main Methods:
- Descriptive analysis of compatible poliomyelitis cases.
- Identification of compatible case clusters (≥2 cases in proximity within 2 months).
- Comparison of compatible case incidence in districts with and without laboratory-confirmed wild poliovirus cases.
Main Results:
- 362 compatible cases were reported in 2000.
- Higher incidence of compatible cases in districts with laboratory-confirmed poliomyelitis.
- 123 out of 168 districts with compatible cases had internal or cross-border clusters.
- 27 districts with compatible case clusters showed no wild poliovirus isolation, but 3 had confirmed cases in 2001.
Conclusions:
- Compatible case clusters frequently overlap with areas of wild poliovirus transmission and vaccination campaigns.
- Thorough investigation of compatible case clusters is essential.
- Addressing surveillance deficiencies is critical for justifying polio-free certification.