Polio in Maharashtra boy may be ‘accidental finding’

May be due to under-immunisation; not primary cause of paralysis: doctors

Rajabhau Shelke,28,father of 11-month-old Rohit,who is the latest case of Vaccine Derived Polio Virus (VDPV) in India (third since March 2012),sits helplessly in Government Medical College Hospital,Latur,wondering why his son is unable to move his limbs.

While medical science points to under-immunisation as the prime cause,the family believes it is the vaccine that turned against the boy. On April 2,we gave Rohit a dose after which he developed a tumour in the leg with fever. While the tumour subsided,the fever has not been cured till date. On April 7,Rohit folded his leg while playing and never stretched it again. My mother has been cursing me for giving Rohit that dose, says Shelke,even as doctors maintain that the dose Shelke may be referring to is an intravenous DPT vaccine and has no connection with polio dose.

Till about two days ago,the doctors were treating Rohit for encephalitis (an acute inflammation of the brain) which was diagnosed by two medical colleges as the cause of paralysis. Dr S M Saraf,Surveillance Medical Officer,Latur,told The Indian Express that the presence of VDPV could well be an accidental finding and that it might not have been the real cause behind Rohits paralysis.

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Doctors are also investigating if Rohits is an isolated case or one known as circulated VDPV (cVDPV),wherein according to WHO website Oral polio vaccine (OPV) contains an attenuated vaccine-virus,activating an immune response. The vaccine-virus is also excreted. If a population is seriously under-immunised,an excreted vaccine-virus can circulate for an extended period of time. The longer it is allowed to survive,the more genetic changes it undergoes. In very rare instances,the vaccine-virus can genetically change into a form that can paralyse.

Kanhapur village,to which the Shelkes belong,was declared free from open air defecation three years ago. But even today,it is a norm. Dr Saraf says the toilets constructed by the government are used as bathrooms by the villagers.

Behind Rohits infection is a lifestyle synonymous with almost all the causes of VDPV. Rohits father Rajabhau and mother Malati are both sugarcane labourers who work for six months a year. The familys annual income is Rs 40,000,and many a times they manage only one meal a day.

Dr H V Wadgave,district reproductive and child health officer maintains that Shelkes belong to a migrant community which makes it difficult to keep a track of the childs vaccination record.

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Since May 7,when Rohit was first admitted to a private hospital in Ambejogai,the family has not been home. They claim their medical bills have crossed Rs 15,000. While the medical facilities in the present hospital are available for free,the couple owes Rs 3,000 to the medical shop.

We both wanted a daughter and a son. My daughter was born deaf and dumb. I had planned that I will send my son to Kolhapur akhadas to make him a pehelwan (wrestler). I had thought that my daughter would go to a good school and get educated,both now look impossible, Shelke says resting his hopes on goddess Laxmi and a goat that he plans to sacrifice,even as his son remains the epicentre of attention of the medical fraternity.

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