Poliomyelitis in India: prospects and problems of control.

Based on many surveys of residual paralysis and limited surveillance, the incidence of acute paralytic poliomyelitis in India has been calculated to be 20-40 per 100,000 population per year; thus greater than 200,000 cases occur annually, or 500 every day. Although oral polio vaccine ( OPV ) has been highly effective in controlling outbreaks, its introduction in routine immunization programs has not succeeded in controlling poliomyelitis in India. This failure is the result of inappropriate immunization strategy and low rates of antibody response to vaccine virus. Injectable polio vaccine, although found to be highly effective in routine immunization programs, is very costly and in short supply. The annual immunization of the susceptible age group with OPV during a short period (pulse immunization) has been found to be highly effective; this strategy is recommended for national control of poliomyelitis.