43rd Polio Case Reported in 2024

Pakistan's National Emergency Operations Centre confirmed the country's 43rd wild poliovirus case of 2024. For context, the total for the whole of 2023 had been six.

A year that had already gone wrong

Reaching 43 cases signalled that 2024 was no longer a bad year within normal variation. It was a full resurgence — and it arrived while the high transmission season, which runs through the second half of the year, was still in progress. The year eventually closed at 74 cases.

The distribution told its own story: 27 in Balochistan, 23 in Sindh, 22 in Khyber Pakhtunkhwa, one in Punjab and one in Islamabad. Cases in Punjab and Islamabad were the clearest signal of all — those areas had been effectively clear for years, and their reappearance meant virus was moving along routes the programme had believed were closed.

What drives a resurgence

Pakistan's record shows the same mechanism each time. A susceptible pool builds up over several years among children who are consistently missed — because of access constraints, refusals, or repeated absence. Case counts stay low while population immunity remains high enough to suppress visible paralysis. Then campaign quality slips for several consecutive rounds, or access closes in a key district, and the virus expands rapidly into that accumulated pool.

The same pattern produced 147 cases in 2019 after a low of 8 in 2017. See the 2019 reversal.

What environmental surveillance was showing

Through 2024, sewage samples were testing positive for wild poliovirus at sites across the country, including in districts with no reported cases. Because roughly one infection in two hundred causes paralysis, widespread environmental positivity alongside a rising case count indicates transmission far broader than the cases alone represent.

The response

The programme moved to intensified campaign rounds through the remainder of the season, expanded case-response vaccination around every confirmed case, and stepped up community engagement in districts with high refusal rates. 2025 closed at 31 cases — less than half the 2024 total, though still far above the single case of 2021.

For parents

Every round matters, and the rounds during a resurgence matter most. Two drops for every child under five, every time a team calls. Complete the routine EPI schedule. Call 1166 if no team reaches you.

Related: cases by province · eradication strategy