The poliovirus has been detected in sewage samples from 18 districts of Pakistan, including major urban cities like Islamabad, Lahore and Karachi, the national polio eradication program said on Monday. Polio is a paralyzing disease that has no cure. Multiple doses of the oral polio vaccine and completion of the routine vaccination schedule for all children under the age of 5 is essential to provide children high immunity against the disease. Pakistan has reported seven polio cases so far this year and has planned three major vaccination campaigns in the first half of 2025. Last year, 74 polio cases were confirmed in Pakistan. “As robust poliovirus surveillance continues in Pakistan, 38 environmental samples collected from 31 districts between Apr. 7-17 were tested at the Regional Reference Laboratory for Polio Eradication,” the lab said in a statement. “The lab confirmed detection of wild poliovirus type 1 (WPV1) in sewage samples of Loralai, Quetta, Zhob, Islamabad, Abbottabad, Bannu, DI Khan, Peshawar, Tank, North Waziristan, Lahore, Rawalpindi, Badin, Jamshoro, Hyderabad, Kashmore, Karachi, and Sukkur.” A third nationwide campaign to vaccinate children under the age of five is scheduled from May. 26 to June 1. In the early 1990s, Pakistan reported around 20,000 polio cases annually but in 2018 the number dropped to eight cases. Six cases were reported in 2023 and only one in 2021. Pakistan and Afghanistan are the last two countries in the world where polio remains endemic. Pakistan’s polio program began in 1994 but efforts to eradicate the virus have since been undermined by vaccine misinformation and opposition from some religious hard-liners who say immunization is a foreign ploy to sterilize Muslim children or a cover for Western spies. Militant groups also frequently attack and kill members of polio vaccine teams and security guards protecting them.