Pulse Polio and Polio eradication

Pulse Polio and Polio eradication

Q. 1

Pulse Polio immunization was introduced in ‑

 A

1995

 B

2000

 C

1999

 D

2001

Q. 1

Pulse Polio immunization was introduced in ‑

 A

1995

 B

2000

 C

1999

 D

2001

Ans. A

Explanation:

Ans. is ‘a’ i.e., 1995 

Pulse polio immunization (PPI)

o Goverment of India conducted the first round of PPI consisting of two immunization days 6 weeks apart on 9th Dec 1995 and 20th Jan 1996.

o The first PPI conducted targeted all children under 3 years of age.

  • Later on, as recommended by WHO, it was decided to increase the age group from decided to increase the age group from under 3 to under 5 years So, now PPI targets children under 5 years of age.

o The term pulse has been used to describe this sudden, simultaneous, mass administration of OPV on a single day to all children 0-5 years of age, regardless to previous immunization status.

o PPIs occur as two rounds about 4 to 6 weeks apart during low transmission season of polio, i.e. between november to february (In India, peak transmission is from june to september).

o The dose of OPV during PPIs are extra doses which supplement, and do not replace the doses received during routine immunization schedule.

  • Intensive pulse polio immunization (IPPI) is the intensification of PPI by adding additional rounds at fixed booths followed by ‘house – to – house search-and-vaccinate’ component.

Q. 2

All of the following are true regarding acute attack of Polio, except-

 A

Fecal sample is carried in cold box

 B

Three consecutive stool samples are positive

 C

Investigation done in 48 hours

 D

Throat swab is taken for diagnosis

Q. 2

All of the following are true regarding acute attack of Polio, except-

 A

Fecal sample is carried in cold box

 B

Three consecutive stool samples are positive

 C

Investigation done in 48 hours

 D

Throat swab is taken for diagnosis

Ans. B

Explanation:

Ans. is ‘b’ i.e., Three consecutive stool samples are positive 

WHO recommends the immediate reporting and investigation of every case of AFP in children aged less than 15 years, and collection of 2 stool samples (not 3 samples) for analysis.

About other options

J Fecal samples are collected from suspected case of polio and transported to laboratory. The sample need to be maintained at 4 – 8°C or stored at -20°C from the moment of collection. This is done in cold boxes. This process is known as Reverse cold chain.

o In India, even a single case is treated as an outbreak and preventive measures are initiated, usually within 48 hours of notification of the case.                   Park 182

o Throat swab (pharyngeal swab) and stools are the samples from which poliovirus can be isolated for diagnosis.


Q. 3

Criteria for defining polio epidemic are all except ‑

 A

2 or more cases

 B

Cases should occur in same locality

 C

Caused by same virus type

 D

Cases occurring during 6 month period

Q. 3

Criteria for defining polio epidemic are all except ‑

 A

2 or more cases

 B

Cases should occur in same locality

 C

Caused by same virus type

 D

Cases occurring during 6 month period

Ans. D

Explanation:

Ans. is ‘d’ i.e., Cases occuring during 6 month period 

o An epidemic of polio is defined as 2 or more local cases caused by same virus type in any 4 week period.

  • So, it has following features –

i)           2 or more cases of polio

ii)          Caused by same virus type

iii)        Within 4 week period


Q. 4

Polio is said to be eradicated if no case of polio by wild poliovirus occurs in an area for ‑

 A

1 year

 B

2 years

 C

3 years

 D

4 years

Q. 4

Polio is said to be eradicated if no case of polio by wild poliovirus occurs in an area for ‑

 A

1 year

 B

2 years

 C

3 years

 D

4 years

Ans. C

Explanation:

Ans. is ‘c’ i.e., 3 years

Certification of polio eradication is conducted an regional bases.

Each region can consider certification only when all countries in the area demonstrate the absence of wild poliovirus transmission for at least three consecutive years.


Q. 5

Polio case definition for AFP surveillance ‑

 A

Onset of AFP

 B

Residual paralysis

 C

Stool specimen positive for virus

 D

All of the above

Q. 5

Polio case definition for AFP surveillance ‑

 A

Onset of AFP

 B

Residual paralysis

 C

Stool specimen positive for virus

 D

All of the above

Ans. D

Explanation:

Ans. is `d’ i.e., All of the above

AFP Surveillance

  • Acute flaccid paralysis (AFP) surveillance is carried out to identify all remaining infected areas, monitor progress towards eradication and target supplementary immunization appropriately.
  • The term AFP means paralysis of acute onset involving limbs leading to flaccidity. Poliomylelitis is most important etiology of AFP, other causes are – GBS (Guillain-Barre syndrome), transverse myelitis and traumatic neuritis.
  • AFP surveillance aims at detecting cases of AFP and reporting them immediately to district immunization officer.
  • Surveillance is carried out for all cases of AFP and not just for poliomyelitis. All cases of AFP are reported, regardless of the final diagnosis. As paralytic poliomyelitis is one cause of AFP, maintaining a high sensitivity of AFP reporting will ensure that all cases of paralytic poliomyelitis are detected, reported and investigated, resulting in preventive central measures to interrupt the transmission of disease.
  • The aim of AFP surveillance is to detect polio virus transmission, and the earlier the stool is collected, the greater the chance of detecting polio virus.
  • WHO recommends the immediate reporting and investigation of every case of AFP in children less than 15 yrs (As AFP in a person > 15 yrs is unlikely to be polio. Still, AFP surveillance must be flexible enough to report any case of AFP in an adult, if suspected to be due to poliomyelitis)
  • Cases ofAFP are classified as Polio if :
  • Wild polio virus is isolated from any stool specimen.
  • Cases of AFP without isolation of wild polio virus may be classified as ‘polio compatible’ if :
  • Stool specimens were inadequate and
  • Residual weakness was present 60 days after onset of paralysis or 60-day follow-up was not done (due to death or absence) and ‘Expert review’ concludes that these cases could not be discarded as ‘non-polio’ based on available data.

Q. 6

India was removed from the list of polio endemic courts in 

 A

2006

 B

2008

 C

2010

 D

2012

Q. 6

India was removed from the list of polio endemic courts in 

 A

2006

 B

2008

 C

2010

 D

2012

Ans. D

Explanation:

Ans. is ‘d’ i.e., 2012

  • India has not reported any poliocase since January 2012, and has been considered polio-free since February 2012. The last confirmed case caused by wild polio virus-3 (WPW-3) was on 22nd Oct 2010 in Pakur, Jharkhand and WPW­1 on 13 Jan 2011 in Howrah, West Bengal. As of 25th Feb 2012 India was removed from the list of polio endemic countries by the WHO. It has to remain polio free for another 2 years to achieve the goal of polio eradication and to be certified as polio free country.


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