Data for polio cases in Pakistan showed an increase by 57 per cent from 58 cases in 2012 to 91 in 2013. (OCHA, 15 Jan 2014) WHO declared Pakistan's northwestern city of Peshawar as the world's "largest reservoir" of polio and called for urgent action to boost vaccination. (DAWN, 2 Feb 2014)
By the end of 2014, 295 polio cases had been recorded, compared to 91 in 2013. The number of infected districts/towns had almost doubled from 22 in 2013 to 40 in 2014. (WHO, 27 Dec 2014)
In the period between July 2012 and February 2015, 80 polio workers and those protecting them have been killed whereas 54 received serious injuries. Such brazen attacks against health workers finds no precedent anywhere in the world. (Gov't of Pakistan, WHO, UNICEF, 24 Oct 2015)
The Prime Minister of Pakistan / Chairman of the National Task Force for Polio Eradication endorsed the National Emergency Action Plan for Polio Eradication in a meeting held on 11 June 2015.
Pakistan's polio cases are declining, with just 54 cases of wild polio virus reported in 2015, down more than 80 percent from 2014, when the country experienced a large spike in cases.(Gov't of Pakistan, 1 Mar 2016)
As of 29 June 2016, the Global Polio Eradication Initiative (GPEI) had confirmed 12 cases of polio in Pakistan in 2016, with the most recent case located in KPk’s Dera Ismail Khan District. During the same week in 2015, the GPEI had confirmed 25 polio cases. The GPEI also reported that no environmental samples have tested positive for polio since May 12 when a team collected a positive sample in Punjab’s Dera Ghazi Khan District. (USAID, 30 Jun 2016)
One new case of wild poliovirus type 1 (WPV1) was reported in early October, from Sujawal, Sindh (south-east of Karachi), with onset of paralysis on 3 September. It is the most recent case in the country, and brings the total number of WPV1 cases for 2016 to 15. (GPEI, 12 Oct 2016)
In November 2016, a new case of wild poliovirus type 1 (WPV1) was reported with onset of paralysis on 3 September, from Kohistan in Khyber Pakhtunkhwa (KP), in the north of the country. It brought the total number of WPV1 cases for 2016 to 16. As well, three new WPV1 positive environmental samples were reported from Balochistan (two from Quetta and one from Killa Abdullah, collected on 20 September, 14 October and 15 October). (GPEI, 09 Nov 2016)
An additional new case of wild poliovirus type 1 (WPV1) was reported in Sujawal district in central Sindh, with onset of paralysis on 3 November. It brought the total number of WPV1 cases for 2016 to 17. (GPEI, 23 Nov 2016)
The majority of the polio cases during the last six months were reported from non-reservoir areas, i.e. from ‘tier 2, 3 and 4’ districts (districts which are considered to be more vulnerable to polio re-infection or spread). There have been no paralytic cases of wild poliovirus from the traditional polio reservoirs in Pakistan since February 2016. (Gov't of Pakistan, 18 Dec 2016)
As of 21 December, 19 WPV1 cases were reported in 2016. It is the lowest number of annual cases ever reported, from the fewest number of affected areas in the country. WHO assesses the risk of international spread of WPV1 within the common reservoir between Pakistan and Afghanistan to be high (due to the historical spread of such strains across the joint epidemiological block with Afghanistan). (WHO, 27 Dec 2016)
One new wild poliovirus type 1 (WPV1) case was reported in Killa Abdullah, Balochistan, with onset of paralysis on 22 December 2016. This brought the total number of WPV1 cases for 2016 to 20. (GPEI, 17 Jan 2017)
Pakistan continues to implement the National Emergency Action Plan for polio eradication. The focus is to continue to build immunity against both type 1 and 2 poliovirus, and to address ongoing circulation of both the WPV1 and the circulating vaccine-derived poliovirus type 2 (cVDPV2) strains. (GPEI, 01 Feb 2017)
No new wild poliovirus type 1 (WPV1) cases were reported in the past week. The total number of WPV1 cases for 2017 remains two, and for 2016 remains 20. The most recent case had onset of paralysis on 13 February, from Diamir district, Gilgit Baltistan. The year 2016 saw the lowest ever annual number of polio cases in the country but poliovirus continues to be isolated through environmental surveillance over a significant geographical range. Efforts are ongoing through implementation of the national emergency action plan to address remaining gaps in coverage and surveillance, in close coordination with neighbouring Afghanistan. (GPEI, 10 May 2017)
The World Health Assembly (WHA) is meeting next week in Geneva, Switzerland. Ministers of Health and public health professionals from around the world will convene to discuss global public health issues, including the global drive to eradicate polio. Delegates are anticipated to review current status against each of the four objectives of the Polio Endgame Plan, including reviewing a report requested by the Executive Board (EB) in January 2017 on issues related to transition planning.
LAHORE - In a last push to eradicate virus, Punjab is piloting a mobile application in seven districts of the province to identify and vaccinate children possibly missed in polio immunisation drives.
The mobile application has been developed by the Punjab Information Technology Board with the technical input of the Emergency Operations Centre.
The application, downloaded in a smart phone, has been given to the polio eradication teams in selected union councils of Lahore, Rawalpindi and five South Punjab districts.
The Strategic Advisory Group of Experts on immunization (SAGE) convened last week in Geneva. On polio eradication, the group noted the progress achieved in the remaining endemic countries. Recognizing an ongoing global supply constraint of inactivated polio vaccine (IPV), the group urged countries to adopt a fractional-dose approach (1/5th of a full dose), noting that several countries which had implemented this approach are able to meet their national vaccine requirements for its populations, and to prioritize supply to routine immunization rather than to outbreak response.
ISLAMABAD: The International Monitoring Board (IMB) for global polio eradication has hailed Pakistan’s efforts towards eradicating the crippling disease.
The Polio Eradication Initiative (PEI) is a global-scale public health intervention that has made significant progress by sparing millions of children from lifelong paralysis. The number of endemic countries decreased from 123 in 1988 to two in 2015 as a consequence of global efforts. Currently, Afghanistan, Pakistan and Nigeria are the only three remaining polio-endemic countries in the world.
Polio in Afghanistan
PESHAWAR: The administration has stopped arresting parents over refusing polio vaccination to their children after community’s reaction to such action and threats to the health workers.
It is now banking on the union council level committees comprising clerics, elected representatives and members of the district administration to convince people on immunisation of their children.
ZOFEEN T. EBRAHIM
QUETTA: The air hits you like an ice-cold knife as you step into the freezer room in Quetta’s Expanded Programme on Immunization (EPI) office building.
A prohibited area which is under strict guard, the vault-like room (kept at minus 24 degrees Centigrade) is stacked from floor to ceiling with shelves upon shelves of thousands of neatly stacked sealed boxes of vaccines worth millions of rupees.
The Strategic Advisory Group of Experts (SAGE) on Immunization1 met on 25-27 April 2017 in Geneva, Switzerland.
The Strategic Advisory Group of Experts on immunization (SAGE) is meeting this week in Geneva, Switzerland. The group is expected to review the global polio eradication status and advise on additional measures that should be undertaken to fully implement the Polio Endgame Strategic Plan and secure a lasting polio-free world.
26 avril 2017 – Le Fonds des Nations Unies pour l'enfance (UNICEF) a fourni 2,5 milliards de doses de vaccins à des centaines de millions d'enfants dans près de 100 pays en 2016, atteignant près de la moitié des enfants âgés de moins de cinq ans dans le monde.
Cela fait de l'agence onusienne le plus grand fournisseur de vaccins pour les enfants dans le monde, a précisé l'UNICEF dans un communiqué de presse.
KARACHI: Experts on Tuesday said as the world marked global immunisation week, Pakistan was battling with miserably low coverage of vaccination with Sindh standing at the bottom of the ladder.
“Sindh has less than 30 per cent coverage of immunisation, which is pathetically low, and what adds to the wound is that such figures are static for years,” said Prof Jamal Raza, president, Pakistan Paediatric Association (PPA) for Sindh, at a briefing.
20 April 2017 – In a small health facility in Sakhi Sarwar, a little town in Pakistan’s Punjab province, Dr Ujala Nayyar, WHO’s Surveillance Officer for Punjab, leans over a register to review all doctors’ appointments in recent months. She is checking every record to look for symptoms that could be signs of polio, like the sudden floppiness in arms, legs or any part of the body that indicates acute flaccid paralysis (AFP).
Sakhi Sarwar, April 23, 2017 - In a small health facility in Sakhi Sarwar, a little town in Pakistan’s Punjab province, Dr Ujala Nayyar, WHO’s Surveillance Officer for Punjab, leans over a register to review all doctors’ appointments in the recent months, as District Surveillance Coordinator (DSC) stands by her side to assist her. She is checking all records that may reflect signs of polio, like sudden onset of paralysis or floppy weakness in arms, legs or any part of the body that indicate acute flaccid paralysis (AFP).
The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue covers the period 16-22 April 2017 and includes updates on influenza, cholera, poliomyelitis, measles, legionnaires' disease and yellow fever.
Over the next two weeks, key global meetings will take place to review the global polio epidemiology and examine what additional efforts must be implemented to achieve a lasting polio-free world. Next week, the Strategic Advisory Group of Experts on immunization (SAGE) will meet in Geneva, as well the next meeting of the International Health Regulations (IHR) Emergency Committee on the spread of poliovirus (via teleconference). These meetings will be followed the week after by the Independent Monitoring Board (IMB), convening in London.
Islamabad, April 16, 2017: First of the two back-to-back nation-wide immunization campaigns will be starting across Pakistan on Monday where more than 37.2 million children will be administered polio drops during the whole week.
The Polio Research Committee (PRC) is meeting this week in Geneva, to continue to provide guidance to the eradication effort’s research agenda. Research underpins polio eradication, evaluating new strategies, products and solutions to long-standing operational, epidemiological and virological challenges.
Summary of newly-reported viruses this week: two new wild poliovirus type 1 positive environmental samples from Pakistan.
165 Surveillance systems to track progress towards polio eradication worldwide, 2015–2016
175 Performance of acute flaccid paralysis (AFP) surveillance and incidence of poliomyelitis, 2017
179 Monthly report on dracunculiasis cases, January– December 2016
165 Systèmes de surveillance pour suivre les progrès accomplis dans le monde vers l’éradication de la poliomyélite, 2015-2016
175 Fonctionnement de la surveillance de la paralysie flasque aiguë (PFA) et incidence de la poliomyélite, 2017
Last week, the Technical Advisory Group Consultation on Polio Eradication in Pakistan convened in Islamabad, to review current epidemiology and strategies to eradicate remaining strains of transmission for the rest of the year. See ‘Pakistan’ section below for more.
Summary of newly-reported viruses this week: no new viruses reported this week.