MPSC 2021 Prelims Paper-I · Question 61 of 100

The Commission cancelled this question. It carries no answer in the final key of the 2021 State Services Preliminary Examination, and this card therefore names none — nothing written here should be read as an indication of what the withdrawn answer was, and the four statements are deliberately not scored one by one. What the question was reaching for is standard syllabus material and is worth learning properly. Polio, or poliomyelitis — the English column prints it as 'Poliomylitis' — is caused by the poliovirus, which belongs to the family Picornaviridae and the genus Enterovirus and carries a single-stranded, positive-sense RNA genome of about 7,500 nucleotides. It exists in three serotypes, PV-1, PV-2 and PV-3, and immunity to one does not protect against the others, which is why the vaccines have always had to cover more than one type. Transmission is faecal-oral: the virus is swallowed, multiplies in the gut, and is shed in the faeces of an infected person to reach the next through contaminated water, food or hands. In the great majority of infections nothing dramatic happens, but in a small fraction the virus invades the nervous system and destroys the motor neurons of the spinal cord, producing the sudden, asymmetric, floppy weakness known as acute flaccid paralysis, which is permanent in the survivor and can kill when the muscles of breathing are affected. There is no cure, which is precisely why the disease has been attacked by vaccination rather than by treatment. Two vaccines are in use — the oral polio vaccine, a live attenuated preparation given as drops, and the inactivated polio vaccine, a killed preparation given by injection. The global campaign the stem alludes to is the Global Polio Eradication Initiative, launched in 1988 by the World Health Organization together with Rotary International, UNICEF and the United States Centers for Disease Control and Prevention. India's own contribution to it is the Pulse Polio immunisation programme, launched in 1995, which set out to reach every child under the age of five with oral polio vaccine on National Immunisation Days, running vaccination booths across the country and going house to house in remote areas, and pairing that with active surveillance for cases of acute flaccid paralysis. India's last case of wild poliovirus was reported on 13 January 2011, and on 27 March 2014 the World Health Organization certified the whole of its South-East Asia Region, India included, free of wild poliovirus. Two of the three wild serotypes have since been declared eradicated worldwide — type 2 in September 2015 and type 3 in October 2019 — and wild poliovirus transmission has never been interrupted only in Afghanistan and Pakistan. One point of vocabulary is worth carrying away from all this, because it is the sort of thing an examiner plays on: in World Health Organization usage 'eradication' means the permanent reduction of a pathogen to zero everywhere in the world, an achievement recorded for exactly one human disease, smallpox, which was declared eradicated in 1980, whereas what a country or a region receives after three years without a case is certification that wild poliovirus transmission has been interrupted there. Ordinary writing uses the two words interchangeably; a candidate should not.

Poliomyelitis is a vaccine-preventable viral disease and the second human disease to be targeted for worldwide eradication. The agent is the poliovirus, an RNA virus of the family Picornaviridae and the genus Enterovirus, with three serotypes; it spreads by the faecal-oral route, multiplies in the intestine, and in a small proportion of infections crosses into the central nervous system to destroy the motor neurons of the anterior horn of the spinal cord, causing acute flaccid paralysis. Because no treatment reverses that damage, control has always rested on vaccination and on sanitation. Two vaccines exist. The oral polio vaccine, developed by Albert Sabin, uses live attenuated virus, is given as drops, is cheap, needs no syringe, and produces immunity in the gut itself so that a vaccinated child stops transmitting the virus — which is what makes it the instrument of a mass campaign. The inactivated polio vaccine, developed by Jonas Salk, uses killed virus, is injected, and carries no risk of vaccine-derived disease. The international machinery is the Global Polio Eradication Initiative of 1988, a partnership of the World Health Organization, Rotary International, UNICEF and the United States Centers for Disease Control and Prevention; the national machinery in India is the Universal Immunization Programme together with the Pulse Polio immunisation programme of 1995, whose National Immunisation Days aimed at every child under five. Surveillance is the other half of the system: every case of acute flaccid paralysis in a child is investigated and stool samples are tested, because a country cannot be declared free of a virus it is not actively looking for.

Seven questions in this paper were withdrawn by the Commission after the examination, more than in any other MPSC edition prepared here, and this is the last of the seven. A cancelled question is not permission to skip the topic. The material behind it stays in the syllabus and returns in later papers in better-drafted forms, so the sensible response is to learn the ground the question stood on rather than to note the cancellation and move past it. Public health is a standing theme in MPSC's science and current-affairs sections because it joins biology to administration: the same body of material yields questions on the causative organism, on the vaccine and who developed it, on the year a national programme began, on the international agency behind it, and on the status of a disease in India today. The habit the Commission rewards here is dated precision — knowing that the Pulse Polio programme began in 1995 rather than 'in the mid-nineties', that the Global Polio Eradication Initiative dates from 1988, that India's last wild case was in January 2011 and the certification came in March 2014. The second habit is terminological care, since public-health writing distinguishes eradication from elimination and from control, and an examiner can build an entire question on that distinction alone.

• The Commission cancelled this question and published no answer for it in the final key; the topic it was set on — poliomyelitis and the international eradication programme — remains part of the syllabus and is examined regularly in other forms.
• Poliovirus is an RNA virus of the family Picornaviridae and the genus Enterovirus, with a single-stranded positive-sense genome of about 7,500 nucleotides and three serotypes, PV-1, PV-2 and PV-3; it spreads by the faecal-oral route.
• The Global Polio Eradication Initiative was launched in 1988 by the World Health Organization with Rotary International, UNICEF and the United States Centers for Disease Control and Prevention.
• India's Pulse Polio immunisation programme was launched in 1995 and gives oral polio vaccine to every child under five on National Immunisation Days, through vaccination booths and house-to-house visits, alongside surveillance for acute flaccid paralysis.
• India's last case of wild poliovirus was reported on 13 January 2011, and on 27 March 2014 the World Health Organization certified its South-East Asia Region free of wild poliovirus; wild type 2 was declared eradicated in September 2015 and wild type 3 in October 2019, and only Afghanistan and Pakistan have never interrupted wild poliovirus transmission.
• In World Health Organization usage 'eradication' means the permanent reduction of a pathogen to zero worldwide — declared for exactly one human disease, smallpox, in 1980 — while a country or region that has gone three years without a case is certified as having interrupted transmission.

• Using 'eradicated' loosely, when in public-health usage it means worldwide permanent reduction to zero and has been certified for only one human disease, smallpox
• Confusing the year a national programme began with the year an international initiative began — Pulse Polio in India dates from 1995, the Global Polio Eradication Initiative from 1988
• Confusing the last case of wild poliovirus in India, in January 2011, with the certification that followed it in March 2014; certification requires a run of years without a case
• Mixing up the two polio vaccines and their inventors, and assuming an injected vaccine is used for a mass door-to-door campaign when the oral drops are what such a campaign runs on

MPSC asks public health in several shapes from one small body of material: the organism behind a named disease, the route by which it spreads, the vaccine and the scientist associated with it, the year a national programme was launched, and the international agency that supports it. Polio has the additional attraction for an examiner of a clean set of dates — 1988 for the Global Polio Eradication Initiative, 1995 for Pulse Polio in India, January 2011 for the last wild case, March 2014 for the certification of the South-East Asia Region — so questions frequently come as a statement list in which one date has been altered. The Commission also links the topic to current affairs, since the eradication endgame, vaccine-derived poliovirus and the two remaining endemic countries are live news. The efficient preparation is a single sheet carrying, for each major communicable disease, the causative organism and its type, the mode of transmission, the vaccine if there is one, and the Indian programme that addresses it.

No directly related past PYQ was found.

• practice — not a real PYQ

  The Global Polio Eradication Initiative was launched in 1988 by the World Health Organization along with which of the following partners ?

  • (a)The World Bank, the Food and Agriculture Organization and UNESCO
  • (b)Rotary International, UNICEF and the United States Centers for Disease Control and Prevention
  • (c)The International Red Cross, the World Trade Organization and UNDP
  • (d)Medecins Sans Frontieres, the Gates Foundation and the International Labour Organization

  Answer(b) Rotary International, UNICEF and the United States Centers for Disease Control and Prevention — the Initiative was set up in 1988 as a partnership between the World Health Organization and these three bodies, with the original target of eradicating polio by the year 2000. Rotary International had begun immunising children against polio some years earlier and remains a major funder; UNICEF handles vaccine supply and communication; the Centers for Disease Control supply laboratory and epidemiological support. The other option sets name real international organisations, none of which founded this particular initiative.

• practice — not a real PYQ

  India's Pulse Polio immunisation programme, launched in 1995, administers oral polio vaccine on National Immunisation Days to

  • (a)all children under the age of five years
  • (b)all children under the age of one year only
  • (c)all persons under the age of eighteen years
  • (d)pregnant women and infants under six months

  Answer(a) All children under the age of five years — the programme's design point is universal coverage of the under-five age group on fixed National Immunisation Days, delivered through vaccination booths and followed up house to house in remote areas, and paired with surveillance for acute flaccid paralysis. Restricting the drops to infants would leave a large pool of susceptible children who could keep the virus circulating, which is exactly what a campaign aimed at interrupting transmission cannot afford.