Centre may use polio network to screen for other outbreaks

The Union ministry of health and family welfare is considering making use of its vast polio surveillance network active in the country to screen for other new and emerging diseases especially infectious diseases, to catch potential outbreaks early, according to people familiar with the matter.

The health ministry tasked the National Institute of Health and Family Welfare — an autonomous organisation, under it that acts as an apex technical institute as well as a think tank for the promotion of health and family welfare programmes in the country— to conduct a feasibility study for the idea.

“We were asked to evaluate if it was possible to utilise our robust polio surveillance network that is active across the country to monitor other diseases especially with the threat of new and emerging diseases looming large. They would likely look at monitoring transmission of infectious diseases,” said Dr Dheeraj Shah, director, National Institute of Health and Family Welfare.

“We have submitted the evaluation report to the health ministry. There was a vast network established jointly by India and World Health Organisation (WHO) for polio surveillance in the 90s which is still in place. Although the country has not reported a wild polio case in a long time, still the threat is active because the disease is still present in certain neighbouring countries. Till such time the disease is not eliminated completely, the surveillance network cannot be dismantled. However, it can also be used effectively for monitoring other diseases,” he added.

The National Polio Surveillance Project (NPSP) was launched in the 90s aimed at conducting polio eradication activities in India. The network includes a large chunk of health care workers, including dedicated surveillance medical officers, community leaders, civil society members among others. There are state-of-the-art laboratories capable of testing large volumes of samples.

India reported its last wild polio case in 2011, and the World Health Organisation declared the country polio-free in 2014.

India’s success in polio eradication was largely due to its rigorous surveillance systems, including Acute Flaccid Paralysis (AFP) Surveillance and Environmental Surveillance. The focus on surveillance helped India detect and respond to any potential outbreaks quickly.

AFP surveillance system consists of monitoring cases of unexplained paralysis in children under 15, as this is a common symptom of polio. And environmental surveillance is meant to monitor sewage water to detect poliovirus strains also helped identify pockets where the virus may still be circulating.

By maintaining a high level of sensitivity in surveillance, India could track and control any residual poliovirus transmission. It is the latter— environmental surveillance— that is being looked at to be expanded for wider use that can help detect other disease-causing pathogens circulating in the environment.

There is also a possibility to use the surveillance network also for monitoring non-communicable diseases that are growing significantly in number, said Dr Shah.

“There can be a possibility but then to that to happen the capacity would need to be changed as surveillance of infectious diseases is different from non-infectious diseases,” he added.