Wild type-1 polio cases from Pakistan pose a significant risk of spreading internationally.

The lofty objective of eradicating wildtype poliovirus type-1 (WPV1) by 2026 appears to have become more difficult. Since 2023, WPV1, which is solely found in Pakistan and Afghanistan, has shown signals of comeback.
In 2023, Afghanistan and Pakistan each reported six WPV1 cases, compared to two in Afghanistan and 20 in Pakistan in 2022. This suggests that the total number of type-1 cases in both countries has roughly halved.
This year has seen an increase in the number of cases in Afghanistan and Pakistan.

If current trends continue, the number of recorded cases in both nations may approach or exceed 2022 levels. Concerns concerning WPV1 extend beyond the frequency of instances among children. Positive environmental samples from cities that have historically been reservoirs for the virus have been collected in Pakistan in 2023 and early June this year, indicating an increase in its circulation. Last year, 125 positive environmental samples were gathered from 28 districts in Pakistan.

119 of them corresponded to the YB3A genetic cluster, indicating they were imported from Afghanistan. As of June 1 this year, 153 positive environmental samples were collected from 39 districts. As of April 8, 2024, 34 positive environmental samples had been obtained from Afghanistan.
The World Health Organisation warns that positive environmental samples in “epidemiologically critical areas and historical reservoirs” like Karachi, Quetta, and the Peshawar-Khyber blocks in Pakistan, as well as Kandahar in Afghanistan, pose a significant risk to previous gains. Positive environmental tests indicate that polio efforts are not attaining intended coverage, and false marking without immunisation is a persistent issue.

Although most children in Pakistan’s cities are immunised, those who are not fully vaccinated face a higher chance of contracting the virus. In 2023, two of the six cases were in Karachi. WPV1 has spread from Afghanistan in 2022 to Pakistan in 2023 and 2024, suggesting a worse situation in Pakistan.
There is a significant risk of international transmission from Pakistan, especially to Afghanistan. With nearly 0.5 million Afghan refugees forced to flee Pakistan and an estimated 0.8 million set to be evicted shortly, there is a higher chance of the virus spreading across borders. Southern Afghanistan has a substantial population of unvaccinated and under-immunized youngsters, posing a risk to returning refugees.

ABHISHEK VERMA

Author: This news is edited by: Abhishek Verma, (Editor, CANON TIMES)

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