Polio Re-Appears in Indonesia After Immunization Decreasing, Aceh - The Indonesian Ministry of Health (Kemenkes) has determined the finding of Polio in Aceh as an Extraordinary Event (KLB). The decision came after Polio re-appeared in Indonesia after WHO declared Indonesi was free of Polio in 2014.

Unexpectedly, in 2022, Indonesia found another Polio patient in Aceh province. The government admits that the immunization for polio has been low. The government has now mobilized immunization in Aceh.

"Each discovery of Polio case is an extraordinary event," said Director General of Disease Prevention and Control (P2P) of the Ministry of Health Maxi Rein Rondonuwu during an online press conference, Saturday (19/11/2022).

He explained that polio immunization coverage in recent years has been low. Polio immunization, both drip polio (OPV) and injectable polio (IPV), has decreased.

In 2021 there was a decrease in OPV4 immunization to 80.2 percent compared to the previous year. However, for IPV vaccination there was an increase to 66.2 percent of the prior year's 37.7 percent.

Unfortunately, immunization rates are not evenly distributed. There are 30 provinces and 415 regions/cities in the high-risk category for Polio because of low immunization rates.

Lower immunization rates have occurred in regions/cities of Aceh in 2022 as well. The province is then categorized as "red" level.

"In 2022 for OPV4, all Aceh is red, especially for the IPV, almost all of which did not operate in Aceh," said Maxi.

The World Health Organization (WHO) had given Indonesia a polio-free certificate in 2014. Indonesia is the 16th country to report a type 2 polio case this year.

"So, one case must be reported as an outbreak (KLB), because in Indonesia (the virus) had been declared eradicated but it turns out that there is still wild polio virus," explained Maxi.

Currently, the whole world is trying to eradicate polio cases before 2026. And thus, even one case finding of withered paralysis in any country and for any reason must be reported for examination, said Maxi.


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The Patient Suffers Paralysis

The announcement of Polio as the Extraordinary Event (KLB) followed the discovery of one polio case in Aceh. The patient is a 7-years-old and lives in Mane Village, Pidie, Aceh province.

Director General of Disease Prevention and Control (P2) Maxi Rein Rondonuwu said the child had experienced initial symptoms and then paralysis in his left leg.

"The child started to get sick on October 6. He felt common illness, there was a fever, then flu, those were the initial symptoms," said Maxi.

Three days later, on 9 October 2022, the child began to experience weakness in his left leg. Then on 18 October 2022, the child was sent to the hospital in Sigli city.

Doctors began to suspect the child was infected with polio on 21-22 October 2022 and took a sample specimen, said Maxi. The sample was then sent to the provincial level on 25 October 2022 and then forwarded to Jakarta.

In Jakarta, the result of the sample was received by the Health Development Policy Agency (BKPK) on 28 October 2022 and examined.

"On November 7, the results came out via PCR Type 2 Polio and there was Type 3 from Sabin," said Maxi.

Apart from being examined by the BKPK, the sample was also sent to the Biofarma laboratory for sequencing.

"It has turned out that it's indeed the type 2. The result of the sequencing was type 2 polio. The child was experiencing shrinking in the thigh and calf muscles," explained Maxi.

According to Maxi, the case in Aceh has no history of immunization and no history of travel or contact with travelers abroad.

Maxi said that he personally visited the polio patient at the kid's house in Pidie, Aceh, to see his condition.

"We can see that he is already walking even though he is still limping," he said.

Maxi said there is no medicine to treat polio infection so the child patient will undergo physiotherapy to maintain muscle mass.