If India’s Health Ministry and the Meghalaya State government have till date refused to reveal all the details of the polio case in a two-year-old boy in Meghalaya’s West Garo Hills district who was found with symptoms of polio in the first week of August this year, the WHO too has been cagey about making any kind of official announcement of the case till now.

On September 16, Dr Roderico H. Ofrin, WHO Representative to India, told The Hindu in an email that the ICMR-NIV Mumbai unit, which is a WHO-accredited polio laboratory, had confirmed that the polio case detected in Meghalaya was a type-1 vaccine-derived poliovirus (VDPV), and that the ICMR lab shared the results with the Health Ministry, the Meghalaya State government and the WHO on August 12. He also said that CDC Atlanta too had confirmed it as a type 1 VDPV.

According to him, follow-up tests conducted by ICMR-NIV Mumbai unit and surveillance confirmed that the immunological profile of the child was normal and that there was no evidence that the virus was circulating in the community. The follow-up test thus confirmed that it was not a case of immunodeficiency related vaccine-derived poliovirus (iVDPV). Since the child was not immunocompromised, the polio was caused by the live, weakened type-1 virus strain used in the bivalent oral polio vaccine that had undergone mutations and gained the ability to cause polio in the child who was not fully immunised. Since there was no evidence that the virus was circulating in the community or isolated from healthy community members, the Meghalaya case is called as VDPV type-1 and not as circulating VDPV (cVDPV) type-1.

Dr. Ofrin also said that it generally takes three-four weeks to assess the immunological profile of the child from whom the virus was isolated and to also assess if there is any evidence of circulation of the virus in the community. These assessments were completed and the results were shared with the Health Ministry, the Meghalaya State government, and the WHO before September 16, according to Dr. Ofrin’s email.

While Dr. Ofrin had shared all the details of the case with The Hindu even when the Health Ministry had not, it is surprising that the WHO has till date not posted any details of the case on its website or made an announcement of the case. WHO did not respond to queries from The Hindu that were emailed on October 8 and a reminder email on October 15 about the delay in posting the details of the Meghalaya polio case on its website. Like the WHO, no official announcement of the case has been made by the Global Polio Eradication Initiative (GPEI) either. Global Polio Eradication Initiative is a public-private partnership led by national governments with six partners, including the WHO.

Nearly 75 days after the ICMR-NIV Mumbai unit first shared the results with the WHO on August 12 and more than 45 days after the immunological profile of the child was tested and evidence of circulation of the virus in the community was assessed and results shared with the WHO, both the WHO and the Global Polio Eradication Initiative have maintained radio silence about the Meghalaya polio case.

In contrast, in 2022, the Global Polio Eradication Initiative made an official announcement of a type-3 circulating vaccine-derived poliovirus (cVDPV3) case in Israel on March 17, just 10 days after the case was confirmed in an unvaccinated girl aged three years and nine months. Similarly, on July 21, 2022, an updated statement by the GEPI mentioned about a type-2 VDPV case in New York, U.S. The announcement by the GPEI was made just three days after the U.S. CDC was notified about the results. While the GPEI announced the type-2 VDPV case in New York and the cVDPV3 case in Israel almost immediately, it took 45 days and 38 days, respectively for the WHO’s Disease Outbreak News to announce them.

Though the WHO Disease Outbreak News website says that as per the International Health Regulations (2005), “WHO may make information on acute public health events available… if there is a need for the dissemination of authoritative and independent information”, no information about the Meghalaya polio case has been posted on the site till date.

In contrast, on May 26, 2017, WHO posted the details in the Disease Outbreak News site about the three Zika virus cases in Gujarat between November 2016 and January 2017, just 11 days after the Health Ministry informed the WHO. Zika virus was no longer in circulation in Gujarat when WHO published the news, and just like the Meghalaya polio case, the Health Ministry was secretive about the Zika cases in Gujarat. The question therefore is this: why has WHO not shown the same alacrity in publishing the details of the Meghalaya polio case?