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Paralytic poliomyelitis 1976-1988: report from a Sentinel Centre
Insights
Despite widespread vaccination, acute poliomyelitis incidence in Delhi has not declined. The disease is increasingly affecting fully vaccinated children, indicating a need for new strategies to combat polio.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Kalawati Saran Children's Hospital, New Delhi, serves as a sentinel center for poliomyelitis surveillance in Northern India.
- The hospital registers a significant majority (52-76%) of acute poliomyelitis cases from the Union Territory of Delhi.
Purpose of the Study:
- To analyze 13 years of poliomyelitis data from Kalawati Saran Children's Hospital, Delhi.
- To conduct a detailed epidemiological analysis of 1874 acute poliomyelitis cases from 1987.
Main Methods:
- Retrospective analysis of hospital records spanning 13 years.
- Epidemiological assessment of poliomyelitis cases, including incidence rates and vaccination status.
Main Results:
- The incidence of acute polio in Delhi remained stagnant between 1976 (14.7/100,000) and 1988 (15.25/100,000).
- The proportion of poliomyelitis cases among fully vaccinated children rose significantly from 1.3% in 1979 to 13.9% in 1988.
- No significant reduction in disease incidence was observed despite a decade of oral polio vaccine use.
Conclusions:
- Current oral polio vaccine strategies have not led to a significant decline in poliomyelitis incidence in Delhi.
- The increasing occurrence of polio in vaccinated children suggests potential issues with vaccine efficacy or widespread transmission.
- Urgent development and implementation of alternative strategies are necessary to control poliomyelitis in the region.
Abstract:
Kalawati Saran Children's Hospital, New Delhi, is the Sentinel Centre for poliomyelitis in the Northern region and 52-76% of cases of acute poliomyelitis from the Union Territory of Delhi are registered here. In this paper, data from this hospital for the last 13 years is presented. A detailed analysis of 1874 cases seen during the year 1987 is also presented. Inspite of large scale vaccination being carried out, the total number of cases have not shown a corresponding decline. The incidence of acute polio in Delhi has not declined over the years: it was 14.7/100,000 population in 1976 and 15.25 100,000 in 1988. There has been no change in the epidemiology of the disease over the years, except that the disease among the fully vaccinated children has increased from 1.3% in 1979 to 13.9% in 1988. Inspite of a decade of use of the oral polio vaccine there has been no significant reduction in the incidence of the disease, and urgent alternative strategies are needed.