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Smallpox and polio return to Delhi – thanks to a clerical error

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Delhi, where it was announced – erroneously – smallpox and polio had returned earlier this year.

A Delhi government report has announced that two people died of smallpox and 11 died of polio in the capital last year. This announcement caused panic that two eradicated diseases had reemerged in India, though the announcement has since been declared a mistake, likely due to a clerical error.

The Delhi government has attempted to point the finger at local civic bodies, though currently there is no source for the errors. A statement issued from Delhi government’s directorate of economics and statistics, the department that released the report the report says “After getting clarification/confirmation from the local bodies, the discrepancies, if any, will be rectified accordingly,”

Adding to the evidence that the announcement is nothing more than an error is its claim of deaths occurring due to smallpox. There have been no cases of smallpox since 1977, the virus now only existing in small quantities in laboratories in both the US and Russia. Short of a biochemical attack by either nation, it is unlikely that the virus would suddenly resurge in India.

The fight against polio is one of the greatest achievements of modern medicine, reducing a once widespread disease, affecting hundreds of thousands of children each year, to just a handful of cases. The disease is caused by a virus and spread through a faecal-oral route, often through contaminated drinking water. Primarily affecting young children, polio causes fever, fatigue, vomiting and pain in the limbs.  In more severe cases, it can cause permanent paralysis.

The potential announcement of the return of polio to India is striking. India was declared polio-free in 2014. As a result scientists are remarking that the return of the disease is all but impossible. This is with the exception of vaccine derived poliovirus (VDPV), in which the weakened virus used within the vaccine can be transmitted, though at a far lower rate than the wild type virus. In areas of low immunisation coverage this can cause a small scale outbreak, though due to the low transmission rates, these cases are typically self contained.

The possibility of a recurrence of the disease due to international travel cannot entirely be ruled out. In fact one of the world’s last reservoirs for the disease is present in neighbouring Pakistan although there is very limited travel between the two countries

It is thought that, due to militant activity in some Pakistani regions, vaccinations have not been reaching the population. This has left areas where small groups of people still harbour the disease, preventing it from being truly eliminated from the world. In 2014, Pakistan saw polio numbers reach a 14 year high, illustrating that lack of vaccination in the region is allowing for the disease to once again spread amongst the population.

As of August 2017, currently circulating wild cases of polio number as low as 8, with a further 31 vaccine derived cases. It is this low number of existing polio patients that Indian scientists have pointed towards in their claims that a resurgence in Delhi is all but impossible. For 11 people to die of the disease with no record of hospital admission or treatment is highly unlikely, and indicates that the news of the resurgence of the disease is simply an administrative mistake.

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