Blame game heats up in Pakistan over new cases of extinct Type 2 polio virus

According to reports, Pakistan has been trying to cover up on new cases of p2 poliovirus that had been eradicated in 2014.

Polio vaccination
Polio vaccination Reuters

At least seven new cases of extinct type 2 poliovirus – for which vaccination in Pakistan was stopped in 2014 -- have been detected in the northern areas of the country, an official confirmed. According to sources, officials concerned have been reluctant to admit there is any case of the vaccine-derived poliovirus type 2 of crippling disease Polio as the strain had been announced to be eradicated and vaccination for the same was stopped almost half a decade earlier.

"It is not a wild poliovirus outbreak. It is an outbreak of Sabin-Like Type 2 Derived (SLT2D)," The Dawn quoted Special Assistant to the Prime Minister on Health Dr Zafar Mirza as saying. The Guardian has, however, put the figure of affected at least a dozen and cited sources as accusing the country of covering up an outbreak of the most dangerous strain of polio.

The source said the new cases were allegedly kept hidden from the government and from international donors, including the UK's Department for International Development, which has donated millions to Pakistan's polio eradication programme, under direct instruction from Babar Bin Atta, the prime minister's focal representative on polio eradication.

The source said every new case of polio under Pakistani law has to be officially registered with the government, which then alerts international health bodies, but Babar Bin Atta, who was forced to resign last month over charges of corruption, decided not to disclose the cases to anyone to hide the negligence and poor performance.

The re-emergence of P2 would be a dramatic step back in Pakistan's fight against Polio, and any evidence of "terrible mismanagement" by Pakistani authorities in eradicating the crippling virus. Babar bin Atta, taking to twitter and terming The Guardian report as "baseless", said: "I shall pursue my legal options. I shall be sending relevant documents to @guardian to prove their report wrong. Enough of this slander."

According to Mirza, similar outbreaks have been recently reported in the Philippines, China, Indonesia, Nigeria, Democratic Republic of Congo and several other countries in Africa which have completely eradicated all three serotypes of wild poliovirus type 1, type 2, and type 3 -- each with a slightly different capsid protein.

This comes as the South Asian nation has been battling Type 1 and Type 3 viruses by administering the strains in Oral Polio Vaccines (OPVs), but administration of Type 2 vaccine and the virus had been stopped back in 2014 and the virus could not be found even in environmental samples since 2016. An environmental sample is declared positive if the virus is found in sewage water.

Mirza said concerned health officials had sent samples to the lab of Centres for Disease Control and Prevention (CDC) in Atlanta, and began polio campaigns after getting confirmation that children were paralysed because of Type 2 poliovirus. He said the virus had caused seven cases, mainly in Diamer district, and the only way to reduce the risks of further transmission was to address gaps in immunisation coverage.

"The polio programme is working on a comprehensive outbreak response that includes rounds of vaccination in the area to protect every child under the age of five years. The programme has also enhanced its acute flaccid paralysis surveillance by an active search for additional cases, increasing testing of contacts of cases and strengthening environmental surveillance," the official explained.

He said children in Pakistan received routine immunisation against 10 vaccine-preventable diseases, including Poliovirus, under the Expanded Programme on Immunisation (EPI). Pakistan and Afghanistan are the only two countries in the world that have not entirely eradicated polio.