Horn of Africa: Polio Outbreak - May 2013
In 2013, an outbreak of wild poliovirus type 1 (WPV1) began in the Horn of Africa. Six cases have been confirmed, four from Somalia (Banadir and Bay region) and two from Kenya (Dadaab in north-‐eastern Kenya). The first case was confirmed in Somalia on 9 May 2013 and in Kenya on 22 May. This was the first outbreak in Somalia since 2007 and in Kenya since 2011. Outbreak campaigns have been launched in both countries. Immunization campaigns are planned and being conducted in neighboring Ethiopia and Yemen to boost population immunity levels and minimize the risk of spread of the outbreak. (Global Polio Eradication Initiative, 30 May 2013)
As of 1 Jul, 25 cases had been reported from Somalia (primarily from Banadir region) and six from Kenya (Dadaab in north-eastern Kenya) (Global Polio Eradication Initiative, 1 Jul 2013). As of 14 Aug, Somalia had the worst outbreak in the world in a non-endemic country with 105 cases confirmed. About 10 cases of wild polio had been confirmed in Kenya. (OCHA, 15 Aug 2013) As of 14 Oct, six cases of polio had been confirmed in Ethiopia (IFRC, 25 Oct 2013). Three cases had been reported in South Sudan, but were retracted on 26 Oct due to laboratory error (IFRC, 29 Oct 2013).
As of the end of 2013, the polio outbreak in the Horn of Africa was on the decline and the total number of polio cases stood at 203 (183 from Somalia, 14 from Kenya and six from Ethiopia). The most recent case in the region had onset of paralysis on 9 Oct (from Lower Shabelle, Somalia). (Global Polio Eradication Initiative, 24 Dec 2013)
By 18 Jun 2014, the total number of cases in the region was 219 since the beginning of the outbreak in Apr 2013 (195 from Somalia, 14 from Kenya and 10 from Ethiopia). (Global Polio Eradication Initiative, 18 Jun 2014)
Two new cases of circulating vaccine derived poliovirus type 2 (cVDPV2) were reported in South Sudan in the week of 4 Nov. Both were from Rubkona district of Unity province. The most recent onset of paralysis was on the 12 Sep. (Global Polio Eradication Initiative, 4 Nov 2014)
By 18 Feb 2015, it had been six months since the most recent case of wild poliovirus on the African continent had onset of paralysis, in Somalia on 11 Aug 2014. Twelve months of absence of wild poliovirus, with certification-quality surveillance, will be necessary for the Horn of Africa outbreak to be declared as closed. (Global Polio Eradication Initiative, 18 Feb 2015)
In the second half of 2014, the outbreaks in the Horn of Africa, central Africa and the Middle East that spanned 2013 and the first half of 2014 were brought to the verge of being stopped. Thanks to regionally-coordinated outbreak responses in all three regions, one case was reported in this six-month period, in Somalia on 24 August. No case has been reported from any of the outbreaks since then. Status Report July - December 2014: Progress against the Polio Eradication and Endgame Strategic Plan 2013-2018, published 15 May 2015 (Global Polio Eradication Initiative, WHO)
As the world edges closer to becoming polio-free, keeping up the guard in countries at high risk of polio importation is more of a priority than ever. With polio continuing to circulate in the three remaining polio-endemic countries – Afghanistan, Pakistan and Nigeria ‒ any country is at risk of the virus returning.
Vulnerable to the Virus
In 2013, Somalia was affected by an outbreak of poliovirus type 1 (WPV1) with 194 cases followed by five cases in 2014. Although the last case of WPV1 in Somalia prior to this outbreak was reported six years ago, the country has experienced a continuous transmission of circulating vaccine-derived poliovirus type 2 (cVDPV2) since 2008. The last outbreak of WPV1 initiated in May 2013 and has resulted in 199 WPV1 cases in South Central zone and Puntland including the five cases in Jariban district of Mudug region in 2014 in the months of May and June.
For a long time, no person in Kenya suffered the devastating disability that is caused by polio. In fact, the only reminder in the early 2000s was the victims in the streets of Nairobi, many of whom had been paralyzed as children and adults. Their lives were ravaged by this terrible, vaccine-preventable disease.
A National Islamic Advisory Group has been established in Somalia to support polio eradication and routine immunization.
Somali Islamic scholars held a two day meeting in December to discuss the state of polio eradication and how to protect Somali children from all vaccine-preventable diseases.
18 September 2016 - In August 2016, Somalia marked two years since its last case of wild poliovirus, a child from Hobyo District of Mudug region who was paralyzed on 11 August 2014. Since then, no new cases of wild poliovirus have been reported. This major achievement was made possible as a result of intensive collaboration between the Somali Health Authorities, WHO and UNICEF, working with regional and zonal polio eradication officers and a network of hundreds of village polio volunteers at the community level across the country.
Somalia Total affected population: 4.9 million
Total affected children (under 18): 2 million
Total people to be reached in 2016: 3.6 million
Total children to be reached in 2016: 1.5 million 2016 programme targets
•110,000 children under 5 years suffering from SAM admitted to therapeutic treatment programmes
•2.3 million people in high-risk areas accessed basic health services
•445,000 children under 1 year immunized against measles
Joint Press Release: The Federal Government of Somalia/Gavi, The Vaccine Alliance/ United Nations Children’s Fund (UNICEF) and World Health Organization (WHO)
MOGADISHU 16 November 2015 – The Somali authorities have launched a new polio vaccine aimed at ensuring that Somalia remains free of polio – fifteen months after the last confirmed case was detected.
The number of cases of polio that have occurred so far in 2015 is at its lowest point in history.
Since the last report of the Independent Monitoring Board (IMB), Nigeria has been removed from the list of polio endemic countries. Only two now remain: Pakistan and Afghanistan. No Wild Polio Virus (WPV) Type 3 has been reported anywhere in the world since November 2012, no WPV2 has arisen since 1999, and no WPV1 has been found in Africa since August 2014 in Somalia. These are major achievements.
JOINT PRESS RELEASE
NAIROBI, 22 October 2015 - The 2013-2014 polio outbreak in Somalia, which affected nearly 200 people, most of them children, has officially been declared over, 14 months after the last polio case was identified.
Experts say this remarkable achievement is the result of the enormous efforts and commitment shown by governments, health workers, and parents to ensure that their children receive the vaccine.
The Global Polio Eradication Initiative (GPEI) leadership agreed at the time of the 2013–2018 Polio Eradication and Endgame Strategic Plan (PEESP) development that the programme would regularly assess progress, reflect on the lessons learned, plan for the risks ahead, and make needed adjustments to the activities and costs of the plan going forward. This midterm review (MTR) was conducted by a team from the GPEI partners under the guidance of the Strategy Committee (SC) from March-May 2015.
Surveillance Officers like Amina Ismail in Kenya spend their days chasing the poliovirus to its final hiding places, so that it can be stopped forever.
Eradicating polio from the world forever will be one of the biggest public health achievements of our time. Surveillance Officers like Amina Ismail, working for the World Health Organization, know that it is not just vaccinating every last child but being able to trace every last virus that will take us over the finishing line to eradication.
Continent is on the way to finally being rid of the disease, but violent conflicts, particularly in Somalia and Nigeria, pose threat to immunisation programme
Africa has achieved a year without any new cases of wild polio for the first time, but experts warn that violent insurgencies could yet prove their “achilles heel” in finally eradicating the disease.
14 August 2015 – 11 August 2015 marked the one-year anniversary of the last reported case of polio in Somalia. To mark the occasion, the Federal Minister of Health of Somalia Dr Hawo Hassan Mohamed, joined by the Deputy Special Representative of the United Nations Secretary-General (DSRSG), UN Resident and Humanitarian Coordinator for Somalia Mr Peter de Clercq and WHO Representative for Somalia Dr Ghulam Popal, participated in the vaccination of children under the age of 5 in the largest internally displaced persons camp in Mogadishu.
Mogadishu, 11 August 2015 — Today marks the one-year anniversary of the last reported case of polio in Somalia. To mark the occasion, the Deputy Special Representative of the Secretary-General for Somalia and Humanitarian Coordinator, Peter de Clercq, participated in a vaccination campaign for children at the Medina IDP Camp in Mogadishu.
Joined by representatives of the World Health Organization and UNICEF, Mr de Clercq praised the work of national health authorities, Somali volunteers and the international community to stop the outbreak of Polio in Somalia that began in 2013.
A high-level visit to Selam Health Centre in Addis Ababa this month marked continuing commitment to keeping Ethiopia polio-free
• Acute food insecurity and high levels of malnutrition: 3 million people are in need of life-saving assistance and livelihood support, of which 731,000 are unable to meet their basic food requirements. 203,000 children are acutely malnourished, with around 38,000 of these children at risk of death without health and nutrition support.
In this issue:
How Surveillance Works
Containing a Polio Outbreak: Horn of Africa and Central Africa
Review of the Polio Eradication and Endgame Strategic Plan
Global Voices in Support of Polio Eradication
- 309 Update on vaccine-derived polioviruses worldwide, January 2014–March 2015
- 309 Le point sur les poliovirus dérivés de souches vaccinales détectés dans le monde, janvier 2014-mars 2015
An Independent Outbreak Response Assessment in Equatorial Guinea took place last week with over a year since the most recent case of polio on the 3 May 2014. They concluded that there is no evidence that wild poliovirus continues to circulate in the country and that there has been a significant improvement in surveillance. Strengthening routine immunization was identified as the highest priority for sustaining the gains of the outbreak response.