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[2.

] Intensive pulse polio immunization (IPPI):-


 Pulse polio immunization (PPI) was started in 1988 & is now replaced by
(IPPI).
 Intensified means – covering & larger global area with micro planning with
100% immunization coverage.
 Pulse means – at a same time in whole country on national immunization
day (NID).
 NID is defined as a day on which simultaneous administration of extra close
of OPV to 100% children of older five years are, irrespective of previous
immunization status is done in single day.
 Object is to prevent occurrence of new poliomyelitis by year 2010.
 Two rounds of NIDS will be conducted in January & February every year in
all zones. 4 additional rounds in June, July, October & November in high risk
zones as SNIDS (sub-national immunization day).
 On NIDS –OPV is given at fixed posts & house to house approach. This is
followed by mop up round with aggressive door to door campaign to ensure
100% coverage.
 Acute flaccid paralysis (AFP) surveillance is necessary to pick up paralytic
poliomyelitis. It is done by SMO (surveillance medical officer). He conducts,
♦ Reporting of AFP cases.
♦ Collection of stool samples.
♦ Isolation of polio virus.
♦ Follow up of AFP case.
 If wild virus is identified than mop-up round of OPV is done in area
surrounding 10 K.M.
 AFP surveillance rate of > 1 per 100000 populations in children and < 15
years is indicator of good surveillance.
 If no new case of polio is reported for one year country is called “polio – free”
& if for 3 years it is called “polio – eradicated”. After achieving certificate of
polio eradication – IPV (injectable polio vaccine) is started & PPI is continued
for 3 years.
 In short we have adapted four prong strategies to eradicate polio.

High row
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with OPV

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up
Surveilla
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India. Of
To
AFP
Door

Supplement
ary
Immunizatio
n In form of

After achieving polio free


Certificate *3 years = eradication.

Continue
PPI for 3
years &
Polio Intro
OPV
eradicated Of
+
India. IPV
Routine
OPV
Immuniz
ation
[3.] Acute flaccid paralysis surveillance :-
 The term AFP means paralysis of acute onset involving limbs leading to
flaccidity
 Poliomyelitis is most important etiology of AFP others are –GBS (guillain –
barge syndrome), transverse myelitis , traumatic neuritis.
 AFP surveillance aims at defecting cases of AFP and reporting them
immediately to district immunization officer of area .
 After reporting workers come in 24 hours and collect two stool samples of
thumb size in sterile container and send them to central laboratory using
reverse cold chain system.
 Central does culturing and PCR of sample to identify virus.

No Vacci Wild
virus ne virus

Discard Confirm
ed, VAPP ed
No polio Vaccine Polio

Associated

Paralytic
Mop-up round
In surrounding
area

# immunization :-
 The induction of immune response by the deliberate inoculation of
appropriate immunogenic in form of vaccine is termed as active
immunization.
 Types of vaccines available in India are:-
1) Live attenuated bacteria: BCG, S.typhiTy214.
2) Live attenuated virus: OPV, measles, mumps, rubella,
varicella(chicken pox).
3) Killed bacteria: B.pertusis, S.typhi, and V.cholera.
4) Killed virus: IPV, rabies, hepatitis A, Japanese encephalitis,
influenza.
5) Toxoids: Tetanus, diphtheria.
6) Polysaccharide: Typhoid-virus, pneumococcal, meningococcal.
7) Protein conjugated: H.influenza B.
8) Viral subunit: Hepatitis.
All vaccines except polysaccharide induce complete immune
response-IgM, IgG antibodies cell mediated immunity and memory
cells. But polysaccharide antigens can only directly stimulate B-cells so
IgM, IgG and memory cells are not produced if given before age of 2
years.

Universal immunization schedule :-


1) BCG: Birth or 6 weeks.
2) OPV: Birth 6, 10, 14 weeks, 16-18months.
3) DPT: 6, 10, 14 weeks, 16-18 months.
4) Measles: 9 month plus.
5) DT: 5 year.
6) TT: 10 year and 16 years.

Newer vaccines :-
1) Hepatitis B : 0, 1, 6 months
: 6, 10, 14 weeks.
2) Hib : 6, 10, 14 weeks, 16-18 months.
3) MMR: 15-18 months.
4) Typhoid: After 2 years.
5) Varicella: After 1 year single dose.
6) Hepatitis A: After 1 year.,- 2 doses – 6 month apart.
Now we will discuss primary vaccines:
BCG vaccines:
Bacillus of Chalmette and Guerin (BCG) vaccine is
attenuated
Live vaccine obtained from the bovine strain of tubercle
Bacilli.
In India it is produced at Guindy, Chennai.
a) Age of vaccination :
At birth or 6 weeks.
b) Site :
Intra dermal at middle of deltoid left upper arm.
c) Dose :
0.05 ml of BCG vaccine
d) Reaction :
Papules appears in 2 to 3 weeks after vaccinations and by
4th week grows in size and then subsides or ulcerates which
heals by 8 to 12 weeks leading to BCG scar.
e) Complication :
BCG site abscess
Axillary lymphedenopathy (also called BCG- adenines)
Oral polio vaccines :
Oral polio vaccine is live but attenuated virus.