1. Eradication of Poliomyelitis Global & National Overview Goal : Complete interruption of wild poliovirus transmission Dr OR Goldie (State EPI Officer Punjab)

2. Acute Flaccid Paralysis (AFP) surveillance System Hospitals Clinics Community Hospitals Clinics Community AFP cases WPV (Polio) WPV (Polio) Non-Polio AFP Case Investigation and Lab Analysis Case Investigation and Lab Analysis

3. Wild Poliovirus*, 07 Jul 2009 – 13 Aug 2010 Case or outbreak following importation (0 - 6 months) Endemic countries Case or outbreak following importation (6 - 12 months) Wild virus type 1 Wild virus type 3 Wild virus type 1/3 *Excludes viruses detected from environmental surveillance and vaccine derived polioviruses. 1 WPV1 in Jammu and Kashmir, date of onset of 07 Feb 2010, does not appear on the map. Wild virus type 1 Wild virus type 3 Wild virus type 1/3 Total Cases Wild Polio Virus 2009Jan 01- 13 Aug 2009* Jan 01- 13 Aug 2010* Globally1606817608 Pakistan803136 Afghanistan381413 India 741 18427 Nigeria3883726 No of countries with virus. 23 1915

4. Location of poliovirus by type, 2009* * data as on 9 April 2010 Ludhiana Priority District For Polio Eradication Repeated Virus Importations Rapid Urbanization And Industrialization Extensive Construction Activity Labour Forces From Endemic States Highest percentage of migrants in Punjab

5. Location of poliovirus by type, 2010* Most recent virus 22 July 2010 Pakur, Jharkhand * data as on 9 Jul 2010 Maharashtra WPV : Genetically related to Khagaria strain isolated in June 2009 Jammu WPV :Genetically related to an imported strain in Punjab Sept 2009 W Bengal WPV: Genetically related to Saharsa strain isolated in June 2009 WPVs StateP1P3Total West Bengal426 Jammu & Kashmir101 Jharkhand213 Maharashtra202 Uttar Pradesh010 Bihar066 Haryana011 Total92029

6. Reduction in Genetic Diversity and Overall Burden of WPV1 20072006 Grey 1 Grey 2 Grey 3 Black 1 Black 2 Pink 1 Yellow 2 Yellow 3 Yellow 4 Grey 1 Grey 2 Grey 3 Black 1 Pink 1 Yellow 2 Yellow 3 89 38 2 11 12 459 11 14 4 29 14 1 32 3 2 Grey 1 Grey 2 2 71 Pink 1 2008 Pink 179 2009* 9 clusters7 clusters3 clusters 1 cluster

7. Number of cases 2006 Monthly incidence of polio in Punjab January 2006 – July 17 2010* 2007200820092010 J F M A M J J A S O N D J F M A M J J Very High Risk Period

8. Current Status India to date has 29 WPVs including 9 WPV type 1 and 20 WPV type 3 cases NO P1 cases reported from UP & Bihar since Oct/Nov 2009 Majority of Punjab cases in past 3 years are related to migrants. – Last case was in Oct 2009 in Ludhiana. – Low level circulation is believed to be continuing – Intensified efforts need to be sustained Punjab is entering its Very High Risk Period for virus.

10. Polio Eradication efforts : Ludhiana State level mtg chaired by Hon’ble Health minister on 16 July 2010 – DTF – Intensify monitoring – Microplanning – Improve reach in slums DTF Ludhiana 21 July 2010 –District admn support assured –Increase District level monitoring –Seek partner support in microplanning next round Polio Activity 25-27 July –Active monitoring in slums by CS, staff, state level observers, partners –Review done by DFW (26 Jul) –Evening meetings held –Feedback: Quality of activity good, supervision needs strengthening

11. Wild Virus /Compatible cases- 2009 Confirmed Polio -4 Compatible-3 PBJLD09021 Block- JLD West- Kartarpur Donset 09/09/2009 Age 4 mths - P1W Doses- RI-2 SIA- 1 UPLNO09200 Block- LDN City Donset 20/09/2009 Age 13 mths - P1W Doses- RI- 0 SIA-5 UPBJN09275 Block- Mohali Donset 28/09/2009 Age 8 mths - P3W Doses- RI- 0 SIA-6 PBLDN09043 Block- Jagraon Donset 13/10/2009 Age 15 mths - P3W Doses- RI- 0 SIA-8

12. Wild Virus /Compatible cases- 2010 No Polio Case

13. % Adequate Stool Collection Rate – Punjab 2007-2010 < 60% 60% - 69% > 80% 70% - 79% GDP HSP ASR FZP FRK MKS BTD MNS SAN LDN MGA PTL JLD KPT NSR RPN TNT MHL BNL 2007 82% 2008 79% 2009 78% 2010 82% as on week 30 ending on 7 th Aug 2010

14. GDP HSP ASR FZP FRK MKS BTD MNS SAN LDN MGA PTL JLD KPT NSR RPN TNT MHL BNL 2008 3.94 2007 3.86 < 0.70 0.70 - 0.99 1.00 – 1.99 > 2.00 Non Polio AFP Rate 2007-2010 2009 4.55 2010 3.28 as on week 30 ending on 7 th Aug 2010

15. % Cases Investigated w/in 48 hrs- Punjab 2007-2010 < 60% 60% - 69% 70% – 79% > 80% 2008 92% 2007 88% 2009 93% 2010 90% as on week 30 ending on 7 th Aug 2010

16. % Cases Notified w/in 10 Days - Punjab 2007-2010 GDP HSP ASR FZP FRK MKS BTD MNS SAN LDN MGA PTL JLD KPT NSR RPN TNT MHL BNL < 60% 60% - 69% 70% – 79% > 80% 2007 84% 2008 81% 2009 81% 2010 83% as on week 30 ending on 7 th Aug 2010

17. Weekly Summary Of Timeliness of District Reports- 2010 1 st Quarter2 nd Quarter 98% 94% 97% 84% 94% 98% 97% 91% 98% No Report received from Patiala since last 3 weeks

18. The Impact of Polio Eradication Since the Global Eradication of Polio Initiative began in 1988, over 50 Lac disabilities have been prevented worldwide.

19. THANK YOU