On April 28th 2014 WHO emergency committee met with officials from various countries with polio virus endemic and it came to the conclusion that Pakistan, Syria and Cameroon are causing the spread of wild polio virus strain. The other countries while being affected are not causing the spread. On 5th May Pakistan was slapped with travel restrictions.
Mostly children get affected by polio virus while adults are the carriers. The committee had reasons to believe that last year 60 per cent of polio was spread by adult international travelers.
Pakistan has been polio free for a while. It broke its record of the past 10 years by having 58 new polio cases only in the first quarter of the year 2014. The minister of state for National Health Services, Saira Afzal Tarrar addressing the WHO concerns stated that government will take drastic measures to check the spread so by the next WHO assessment, the decision has to be reviewed in 3 months, the travel restrictions are reversed.
The WHO has recommended Pakistan to make sure that travelers taking urgent travel, who have not received OPV or IPV in the last 4 weeks to 12 months must receive a dose by the time they travel. Moreover, the frequent travelers are to be provided with an International Certificate or Prophylaxis as record of their vaccination and serve as the proof of their vaccination. Furthermore all 3 states are directed to meet the given criteria: i) at least 6 months have passed without new exportation’s and (ii) there is documentation of full application of high quality eradication activities in all infected and high risk areas; in the absence of such documentation these measures should be maintained until at least 12 months have passed without new exportation’s.
Saudi Arabia in 2000, made it compulsory for every Pakistani to have taken the OPV by the time of entry in the country. India made it mandatory for all Pakistanis to have taken the OPV at least six weeks before the visit.
The state has ensured that before any international travel, Pakistani citizens or any foreign citizens who have been in Pakistan for more than 4 weeks need to get a dose of polio vaccine. The polio dosage should be received 4 weeks before travel date. Polio vaccinations are available at all government hospitals in Pakistan, free of cost. Travelers will also receive a vaccination certificate that will need to be shown to security officials at airports before embarking the plane. This certificate will be valid for 1 year after the dosage was given.
For domestic travel, as Punjab has the lowest cases of polio, all domestic travelers coming from Sind, FATA, KPK and Baluchistan will need to present proof of immunization or will need to take polio drops at polio kiosks at all airports.
The government is dealing with the issue on emergency basis but the inefficacy of the drugs being used to vaccinate is also a problem as is the internal displacement due to which children tend to have missed doses. The hostility among people in FATA and KPK against polio vaccinators is due to the fact that the US has used undercover agents disguised as vaccinators. The government has stressed on US to ensure no such episodes occur in future.