ISLAMABAD / LAHORE: The country has reported the sixth polio case of the year, this time from Sindh, amid an ongoing controversy over the detection of a case in Punjab.
Prime Minister’s Focal Person on Polio Ayesha Raza Farooq defended the country’s polio eradication efforts, particularly in Punjab, which she said leads in routine immunisation and vaccination coverage.
“Given Punjab’s impressive vaccination efforts, it is difficult for health authorities in the province to believe that a polio case could emerge despite such measures,” she told Dawn.
The controversy arose after a polio case was reported in Mandi Bahauddin last month. Punjab’s Minister for Primary and Secondary Healthcare Khawaja Imran Nazeer held a press conference on Friday, disputing the case. He claimed that a special team of paediatricians examined the child and found no neurological defects, concluding that the case should not be classified as poliomyelitis.
Punjab health authorities also challenged a polio case in Chakwal last year, saying the child was healthy. Mr Nazeer played videos of children previously suspected of suffering from polio playing and running and asserted that cases were being reported without proper verification.
The minister also claimed that the percentage of underperforming union councils had been reduced from 6pc to 2pc in Punjab.
However, a senior official of the National Institute of Health (NIH), speaking on condition of anonymity, dismissed the debate over the Punjab case as unnecessary.
“The fact of the matter is that a qualified doctor suspected the patient as a possible polio victim using standard case definition, and the National Reference Lab isolated wild poliovirus from her stool sample confirming an infection,” the official said. “For all practical purposes, it’s a confirmed polio case and needs to be tackled accordingly.”
He added, “While attempting for the eradication (not control), it’s imperative to maintain optimally sensitive surveillance system that is capable of picking the polio virus both in humans (Acute Flaccid Paralysis or AFP surveillance) as well as the sewage samples (environmental surveillance). It is indeed reassuring to see Pakistan maintaining eradication level surveillance capable of picking atypical and mildly symptomatic cases.”
The official, an epidemiologist, explained that detecting such cases wasn’t unusual towards the endgame when most of the children have attained high immunity levels.
“To stay ahead of the virus and mitigate risks there and then, scientific norms must be respected, and challenges must be embraced with full vigilance and utmost courage without indulging in unproductive debates. What may seem like bad news today is actually good news for tomorrow,” he emphasised.
According to medical records, the child developed fever and sudden weakness in both lower limbs on Feb 10.
A paediatrician at THQ Malakwal identified it as an Acute Flaccid Paralysis case the following day. Subsequent tests confirmed the presence of poliovirus in stool samples.
Clinical examinations showed normal muscle tone in all limbs, with slight weakness in both lower limbs (power rated at 4/5), intact sensations and normal reflexes. The child had travelled to Lahore before symptom onset and had received vaccinations.
Ayesha Raza Farooq said she talked to Mr Nazeer by phone and will meet him and the Punjab health secretary on March 10.
“I told them that, as per protocols, a medical expert identified the child, collected the sample, and sent it to the NIH… As the girl was vaccinated, so she had very mild symptoms of paralysis. However, it needs to be understood that although 74 cases of polio were reported in 2024, the majority of them were mild paralysis, and they are living a normal life,” she claimed.
Ms Farooq insisted that it was a good sign in terms of mild symptoms and surveillance that even a mild case was being detected, which showed that the surveillance system was very effective.
“I think some things have been misinterpreted. I am not contesting the Punjab government, but in case of weak paralysis, children overcome the disease. Imran Nazeer sent me videos of children and I agree that it happened. I will again say that the detection of cases is the evidence that we have a very good surveillance system,” she said.
It may be recalled that the Regional Reference Laboratory for Polio Eradication at the National Institute of Health had on Thursday claimed that two polio cases have been reported from Kambar district of Sindh and in Mandi Bahauddin in Punjab.
On Friday, the Punjab health minister also shared an inquiry report of five senior pediatricians of the province who had investigated the particular case and declared the girl quite stable.
Talking to Dawn, he said the Punjab government had constituted a fact-finding panel of five consultant pediatricians, asking them to investigate the case when the NIH Islamabad, World Health Organisation and Unicef unanimously reported that the girl was suffering from the crippling disease.
“The committee unanimously declared that the reported case is clinically normal with no neurological deficit and this is not the case of Poliomyelitis,” reads the finding of the report.
The health minister declared it an attempt to defame Pakistan across the world, raising questions over the laid-down criteria of investigating the polio cases in the country.
New polio case
Meanwhile, the Regional Reference Laboratory for Polio Eradication confirmed a polio case from Thatta district in Sindh.
“This is the fourth polio case from Sindh and the sixth case from Pakistan at large this year. In 2024, a total of 74 cases were reported. Of these, 27 were from Balochistan, 23 from Sindh, 22 from Khyber Pakhtunkhwa, and one each from Punjab and Islamabad,” the lab official said.
Published in Dawn, March 2nd, 2025
