Pakistan: Polio Outbreak - 2014-2017

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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)

As of 7 June 2017, there were two WPV1 cases for 2017. There were 20 cases in 2016. 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, 07 June 2017)

Pakistan’s Polio Eradication Programme launched the offensive campaign against the virus. The intense preparations were underway for a special targeted campaign in vulnerable pockets of 73 districts / towns / agencies across the country. The program targeted a total of 10.44 million children under the age of five. (Gov't of Pakistan, 4 July 2017)

One new wild poliovirus type 1 (WPV1) case was reported, bringing the total number of WPV1 cases for 2017 to three. It was the most recent case in the country, and had onset of paralysis on 11 June, from Killa Abdullah, Balochistan. Meanwhile, the Pakistan and Afghanistan National Emergency Operation Centre teams put together a joint response plan for new wild poliovirus type 1 (WPV1) cases / isolates in the southern corridor (comprising Quetta Block / Greater Kandahar). (GPEI, 12 July 2017)

No new wild poliovirus type 1 (WPV1) case was reported in the past week; the total number of WPV1 cases for 2017 remains three. Six new WPV1-positive environmental samples were reported in the past week, all collected in July, from Killa Abdullah, Balochistan; Gadap, Gulberg, Kamari, greater Karachi, Sindh; Islamabad; and, Rawalpindi, Punjab. Five country-wide vaccination campaigns had been held in Pakistan since October 2016, preparing for the 2017 high season for poliovirus transmission, which ran from June until September. (GPEI, 27 July 2017)

The Federally Administered Tribal Areas (FATA) achieved a milestone as it completed a year without reporting a single case of polio. According to a statement issued by FATA Secretariat, the last polio case in Fata was reported on July 27, 2016. In line with the National Emergency Action Plan 2017-18, female vaccination teams are being hired with renewed focus on developing accurate micro plans so that the space for missing a single child is eliminated. Immunisation efforts have in the past been hampered by militants. (Gov't of Pakistan, 1 Aug 2017)

As of 13 September, the total number of WPV1 cases for 2017 was four. The most recent case was reported from Karachi. Meeting of the Provincial Task Force Sindh Province reviewed the situation in Karachi and agreed for an action plan to improve the SIAs quality in Karachi. (GPEI, 13 Sep 2017)

The first country-wide immunization campaign of the current low season for poliovirus transmission took place from 18-22 September 2017. More than 38 million children under 5 years were vaccinated by a team of 250,000 dedicated frontline workers. According to the independent post-campaign monitoring, the September National Immunization Days (NIDs) have been one of the best campaigns this year, with 96% of children nationally found vac­cinated and finger marked. So far this year, the number of polio cases reported in Pakistan is five, including the most recent case from Lakki Marwat district of Khyber Pakhtunkhwa, reported in Sep­tember 2017. All these cases are being contained through aggressive outbreak responses. (Gov't of Pakistan, 30 Sep 2017)

Pakistan has launched the first sub-national immunization days (SNIDs) campaign of the current low transmission season on 30 October 2017, targeting more than 21 million children under the age of 5. The campaign has taken place in a total of 95 districts. The current polio epidemiology in the country is best ever observed. The number of wild poliovirus cases has declined from 306 in 2014 to 54 in 2015 and only 20 in 2016. Momentum is maintained in 2017 where the current case count of 5 compares to 18 at same point in time during 2016. (WHO, 2 Nov 2017)

In November 2017, three new polio cases were reported, bringing the total national cases count to eight, compared to 19 this time last year. Two of the three new cases were from Baluchistan, and one from Karachi. Meanwhile, more than 38 million children under 5 years of age were vaccinated under the second country-wide immunization campaign. (Gov't of Pakistan, 30 Nov 2017)

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