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)
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The World Health Organisation (WHO) received reports that twenty two cases of acute flaccid paralysis (AFP), possibly caused by the poliovirus, have been diagnosed in Deir-ez-zur in Northern Syria. Final results are awaited from the regional reference laboratory of the Eastern Mediterranean Region of WHO. These could be the first cases in Syria since 1999 and the situation is extremely worrying given the present security situation and the problems with access to those who will need to be vaccinated.
Major immunisation campaign under way now in Syria
AMMAN / GENEVA, 25 October 2013 - As Syria awaits confirmation of suspected polio cases in the east of the country, UNICEF has joined the World Health Organisation and other partners in mounting a large-scale immunisation effort aimed at protecting as many children as possible both in the country and across the region against polio, as well as other vaccine-preventable diseases.
U.N. Security Council issued a nonbinding Presidential Statement calling for Syrian authorities to facilitate the expansion of humanitarian relief operations in Syria.
Initial test results from the national polio laboratory in Damascus indicate that two cases of acute flaccid paralysis (AFP) detected in Dayr az Zawr Governorate could be positive for polio. Key actors are considering plans for a possible response.
24 October 2013 – The world is closer than ever to eradicating polio, the United Nations World Health Organization said today while warning that children continue to be at risk, particularly in the Horn of Africa where a tapering outbreak has been confirmed, and amid reports of suspected cases in Syria.
“This is no time for complacency, and efforts must be redoubled to ensure this disease is eradicated once and for all. World Polio Day marks the perfect opportunity to remind us of this fact,” the UN World Health Organization (WHO) said in its message for the Day.
World Polio Day - 24 October! Partners, governments, civil society and communities worldwide are today marking World Polio Day, as efforts to eradicate this disease once and for all are being intensified. More
In Syria, reports of suspected polio cases have emerged. A cluster of hot cases is currently being investigated, and has prompted planning for a comprehensive outbreak response across the region. See ‘Syrian Arab Republic’ section below for more.
Jordan - This week IOM, the Jordanian Ministry of Health (MoH) and partners initiated a nation-wide community mobilization and awareness-raising campaign in anticipation to the two-week measles, rubella, and polio immunization campaign scheduled to start on 2nd of November.
The national campaign will target 3.5 million individuals (under 20 years old) to be immunized against measles and German measles (MR), and against polio (children under 5 years old). The campaign will target Jordanian nationals, Syrian refugees, and people of other nationalities living in Jordan.
On 17 October 2013, the World Health Organization (WHO) received reports of a cluster of acute flaccid paralysis (AFP) cases in the Syrian Arab Republic. This cluster of ‘hot’ AFP was detected in early October 2013 in Deir Al Zour province and is currently being investigated. Initial results from the national polio laboratory in Damascus indicate that two of the cases could be positive for polio – final results are awaited from the regional reference laboratory of the Eastern Mediterranean Region of WHO. Wild poliovirus was last reported in Syria in 1999.