Syria/Iraq: Polio Outbreak - Oct 2013
On 28 Oct 2013, the Minister of Health of the Syrian Arab Republic announced that, after a 15-year absence, polio had returned to the Middle East. Thirteen cases were confirmed from Syria's Deir Al Zour province. The occurrence of an outbreak reflects declining immunization rates due to the severe interruption of public health services and to the conditions in which the people are living. A comprehensive outbreak response will need to be implemented across the region, with seven countries and territories to conduct mass polio vaccination campaigns targeting more than 22 million children aged under 5 years. (Strategic Plan for Polio Outbreak Response in the Middle East)
As of 8 Feb 2014, 17 confirmed polio cases had been reported from Syria's Deir ez-Zour Governorate, three from Aleppo Governorate, one from Al. Hasakeh Governorate and two from Idleb Governorate (WHO/UNICEF, 8 Feb 2014).
By 20 Mar, a total of 37 cases had been reported: 25 cases by the Syrian Arab Republic Ministry of Health, and 12 cases from contested areas (Aleppo, Edleb and Deir Al Zour) not yet reflected in official figures. The most recent case had onset of paralysis on 17 Dec 2013. Further evidence of regional spread was confirmed by notification of a case from Iraq, the first polio case in the country since 2000. The case, a six-month old boy from Baghdad who had not been immunized, developed paralysis on 10 Feb 2014. Genetic sequencing indicates the virus is most closely related to virus detected in the Syrian Arab Republic. (WHO, 21 Mar 2014)
By 8 Oct, three cases had been reported in the Middle East with onset of paralysis in 2014 - two in Iraq and one in Syria. The most recent case reported from Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 Apr. Syria’s most recent case had onset of paralysis on 21 Jan. The fact that six months had passed with no new cases being reported indicates that transmission of the virus has been interrupted. (Global Polio Eradication Initiative, 8 Oct 2014)
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.
By the end of 2014, significant progress had been made towards each of the Endgame Plan’s four objectives; the world has never been in a better position to eradicate polio.
As the GPEI enters 2015, efforts are being intensified to build on this progress and stop polio once and for all.
Capitalizing on progress in Nigeria, against outbreaks in central Africa and the Horn of Africa, and against two out of three strains of wild poliovirus
Abu Dhabi, 29th April, 2015 (WAM) - Two years after the historic Global Vaccine Summit in Abu Dhabi, leaders of the Global Polio Eradication Initiative (GPEI) returned to the UAE for the Independent Monitoring Board (IMB) meeting to discuss progress and challenges in the final stretch to end polio.
- 12 April marked 60 years since Jonas Salk’s inactivated polio vaccine (IPV) was launched, enabling children to be protected against polio for the first time. Read more.
- The Strategic Advisory Group of Experts on Immunization (SAGE) is meeting this week in Geneva, and will review the current epidemiological situation for polio and provide updates on readiness for oral polio vaccine withdrawal.
27 February 2015
The fourth meeting of the Emergency Committee under the International Health Regulations (IHR) (2005) regarding the international spread of wild poliovirus in 2014 - 15 was convened via teleconference by the Director-General on 17 February 2015. The following IHR States Parties submitted an update on the implementation of the Temporary Recommendations since the Committee last met on 13 November 2014: Cameroon, Equatorial Guinea, Pakistan and the Syrian Arab Republic.
Snapshot 3–9 December
Philippines: Category 5 Typhoon Hagupit, locally known as Ruby, made landfall on 6 December over the town of Dolores in Eastern Samar province (Eastern Philippines). At least 49 of 81 provinces are potentially at high risk. The typhoon is moving very slowly, potentially subjecting each community in the path of the typhoon to high winds and torrential rainfall for much longer. 1.1 million people are affected.
On 13 November, the Director-General of WHO accepted the recommendation of an International Health Regulations (IHR) Emergency Committee of Experts on polio that the international spread of polio continues to constitute a Public Health Emergency of International Concern (PHEIC) under the IHR, and extended the existing Temporary Recommendations to prevent the international spread of polio for countries affected by the disease for another 3 months.
The third meeting of the Emergency Committee under the IHR (2005) regarding the international spread of wild poliovirus in 2014 was convened by the Director-General through electronic correspondence from 2 through 7 November 2014.1 The following IHR States Parties submitted an update on the implementation of the Temporary Recommendations since the Committee last met on 31 July 2014: Cameroon, Equatorial Guinea, Pakistan and the Syrian Arab Republic.
In Madagascar, a circulating vaccine-derived poliovirus type 1 (cVDPV1) has been confirmed. The virus was isolated from one case of acute flaccid paralysis (AFP) with onset of paralysis on 29 September, and from three healthy contacts. An estimated more than 25% of children remain under-immunized against polio in the country. Madagascar was previously affected by a cVDPV2 outbreak in 2001/2002 (resulting in five cases) and in 2005 (resulting in three cases). Emergency outbreak response is being finalized, with campaigns to be held in December and January.
Two new cases of circulating vaccine derived polio virus (cVDPV) have been reported in South Sudan, constituting an outbreak. Immunization activities are planned in November and December in order to stop the spread of cVDPV.
Immunization campaigns in Iraq in September reached 88% of children under 5. Around 20 million children were vaccinated across the Middle East in October. These activities are helping to protect the gains made against the virus in the region, with no case reported for nearly 7 months.
Snapshot 29 October – 4 November
Yemen: As a government was agreed by Houthi and other opposition parties, the Southern Movement announced a merger to represent all southerners in the campaign for independence. Houthi insurgents attacked the Sunni opposition Al Islah party headquarters in Ibb, while Al Qaeda killed 18 Yemeni troops during an attack in Hudaydah.
Central African Republic: In Ouaka prefecture, fighting among rival militias persists. Attacks on a number locations, including Bambari, have left dozens of people dead, and civilians have been executed. 3,000 people remain displaced from Bangui after violence began in the middle of the month.
The Global Polio Eradication Initiative’s 2013-18 Strategic Plan set a clear first objective: to stop wild polio virus transmission globally by the end of 2014. To deliver this formidable goal, the polio-infected countries and their partners made huge financial and operational pledges to complete the job they had started 25 years previously.
With just weeks to go until the end of 2014, this global target will not be achieved. The virus continues to thrive in two parts of the world that it has never been dislodged from.
DRC: A resurgence of ADF-NALU attacks in North Kivu are thought to have displaced 100,000 people, and killed at least 80. In South Kivu, there has been a significant increase in IDPs, mainly due to insecurity in Shabunda and Fizi territories. 7.3 million people across the country are estimated to be food insecure.
Central African Republic: 5,600 people have fled Bangui after a new wave of violence killed at least eight and injured 56. WASH and health are priority needs among the IDPs. A UN peacekeeper was ambushed and killed on the outskirts of the capital. In Kemo, IDPs have been slow to return as tensions have increased: ex-Seleka attacked Dekoa market on 11 October.
More than 6 months has passed since a case of wild poliovirus was reported in Syria or Iraq. This is testimony to the dedication of local health workers and the significant efforts of many partners to reach all children with supplementary immunization activities. Over 22 million children have been vaccinated against polio multiple times in the past year, in the midst of active conflict and a humanitarian crisis.