Emergency Preparedness Status in Maharashtra

(IEAG July11)

Dr D S DakhureDirector(H&FW-MH)

Maharashtra

• Part I Epidemiological risk in

Maharashtra• Part II Emergency Preparedness &

response Plan (EPRP)

WPV importation and Transmission risk in Maharashtra

MHMaharashtra Profile 2011

Population 112.6 Million

No. of Districts 34No. of

Corporations 22

No. of Blocks 396

Source: Census 2011

Maharashtra is the second most populous state after Uttar Pradesh and third largest state by area after Rajasthan & Madhya Pradesh in India. It is the richest state in India- MIGRATION RISK- PULL MIGRATION

Risk factors-Maharashtra

• High urbanization• High migration (inter/intra state)• Booming construction industry• Slums• Seasonal migrants (sugar cane cutters-Beed)• Past history of WPV importations/ transmission

Risk factors-Maharashtra

Mumbai & Thane

High migration, Construction workforce & Slums. Past h/o importations/ transmission

Bhiwandi & Malegaon

Refusals/Vaccine avoidance. Large underserved population

Rest of MH High urbanization. Seasonal migration (sugarcane cutters)

MAHARASHTRA

No. District 2003 2004 2005 2006 2007 2008 2009 2010 2011

1 NASIK 0 1 0 0 0 0 0 4  

2 BEED 0 0 0 1 0 0 0 1  

3 THANE 1 1 0 1 1 1 0 0  

4 GR. MUMBAI 0 1 0 3 0 1 0 0  

5 AMRAVATI 0 0 0 0 1 0 0 0  

6 SANGLI 1 0 0 0 0 0 0 0  

7 NANDED 1 0 0 0 0 0 0 0  

Maharashtra Total 3 3 0 5 2 2 0 5  

MAHARASHTRA WPV Cases – 2010 & 2011*

P1 Wild Case - 5 Idcode Donset1) MH-NSK-10-201 10/01/2010Mohd. Kasim Asrar Ahmad – 12 months

2) MH-NSK-10-217 21/07/2010Sultan Shaikh Akil – 24 months

3) MH-NSK-10-220 24/08/2010 Altmish Anjum Siraj Ahmad – 10 months

4) MH-NSK-10-221 10/08/2010Fareeha Mohd. Ibrahim – 22 months5) INDMHOBD10017 16/09/2010Raj Kiran Ade – 10 months

WPV Cases 2006-2010 MH

Mumbai + Thane 7Nasik (Malegaon Corp) 4

Beed 2

Amravati 1

Mumbai

WPV Cases Mumbai 1999 onwards*Year H-E G-N K-W M-E B P-N R-N1999 2 1

2000 1 1 12001 12002 2 2003 2004 12005 2006 2

12007

2008 12009

2010

High Risk Wards-Mumbai

  P/N,L,S Slums with migration

 H/W,

K/E,K/W

Highest construction sites

(70%)

 G/N,

F/N,M/E

Environmental Surveillance

Sample wards

High Risk Wards in Mumbai

9 High Risk wards in Mumbai on highest priority for SIA &

Surveillance

Additionally …..

• Industrialized areas of Thane (Bhiwandi) & Raigad are at high risk of WPV transmission due to:

1) High MIGRATION2) Construction workforce from endemic states

of UP, Bihar & West Bengal)3) Slums with migration

Risk in MH Area Risk Factors

Mumbai & Thane

Past h/o WPV transmission, Migration and Slums & Sewage sample results

Malegaon Corp(& other urban areas)

Vaccine avoidance/Refusals/Low Routine Immunization

Beed and other migratory pop. Districts

Seasonal migration

Areas at risk WPV transmission in Maharashtra

Emergency Preparedness & response Plan (EPRP)-MH status

State Emergency Preparedness & Response Group – Maharashtra formed

• Preparatory meeting was held in 3rd week of Apr.11 in Pune with Addl Director and SEPIO to finalize names of RRT team members for high risk areas.

• EPRP meeting was held on 7th May 11 at Arogya Bhavan Mumbai under chairmanship of Director (H&FW)

EPRP-Maharashtra• EPRP meeting was conducted under

chairmanship of Director-H&FW,MH with officials from all high risk areas :Mumbai, Malegaon Bhiwandi, Thane & Nasik districts.

• All members of core team were explained in detail about EPRP

• Senior experienced officials from state are identified as RRT members

EPRP-Maharashtra

• They are assigned all pre-identified high risk areas.

• Senior state officials from HQ are designated as state supervisors for RRT members.

EPRP ACTIVITIES-Maharashtra

Task Actions Status

Areas with high risk of importation & spread of poliovirus

Mumbai Metropolitan Region (MMR), all Corporations (24) and high migratory districts-Beed

Completed

Districts/blocks with low RI coverage Identified Completed

Communication Risk Analysis

Bhiwandi & Malegaon Corporation

69 Fast Track Field Volunteers (FTFVs) and 13 Field Volunteers in place coordinating with UNICEF

Media response plan Addl. Director chairman of media response Completed

EPRP ACTIVITIES-MH Task Action Status

Rapid Response Team (RRT) members

Identified by name for all high risk areas Completed

Surveillance Review

Reviewed on monthly basis and letter issued from state to defaulting districts

Completed/ Ongoing activity

Assigning senior state officials to high risk districts/blocks

Followed in all SIAs and reports submitted for corrective actions

Completed/ Ongoing

Migratory area mapping

Completed in Mumbai-Thane-Raigad and Malegaon

Rest of the state will be completed in next three months

State Senior SupervisorsSr. No. Name High Risk area assigned

1 AHO EPI Mumbai Corporation Mumbai

2Deputy Director of Health Services Mumbai Circle

Thane district and all 6 Corporations

3Deputy Director of Health Services Nasik Circle

Malegaon Corporation and Nasik district

Special Plan for strengthening Routine Immunization in

Malegaon Corporation

• Deployment of PHNs and ANMs to Malegaon Corporation to manage RI

• Has shown good results • Out of 2790 RI sessions planned 2730 (98%)

conducted

Month PHN ANM Total Staff Deputed

No. of Immunization

Sessions planned

Actual no. of Immunization Sessions held

Oct.10 10 27 37 359 351Nov.10 5 25 30 312 296Dec.10 4 23 27 277 281Jan.11 2 19 21 277 275Feb.11 0 6 6 280 275Mar.11 1 9 10 283 287Apr.11 0 9 9 328 323May.11 0 6 6 339 316June.11 0 3 3 335 326

Total 22 127 149 2790 2730

Improvement in Malegaon RI due to deployment PHN/ANMs

Summary

• Mumbai/ Thane followed by Malegaon are highest risk areas for WPV transmission

• Maharashtra is fully committed to implement Emergency Preparedness Response Plan

• SIA preparedness meetings of all key officials from high risk areas are conducted before each SIA

• Regular reviews at highest level for all HIGH RISK area during/after ALL SIAs for corrective actions.

With all good wishes from Maharashtra