Syria: Polio Outbreak - Jun 2017Ongoing
A circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak has been confirmed in the Deir-Ez-Zor Governorate of the Syrian Arab Republic. The virus strain was isolated from two cases of acute flaccid paralysis (AFP), with onset of paralysis on 5 March and 6 May, as well as from a healthy child in the same community. (GPEI, 8 Jun 2017)
Since the confirmation of the first VDPV2 during May 2017, AFP surveillance has been intensified in the Governorate, especially in the Al Mayadeen district. As of 6 June 2017, a total of 58 AFP cases have been reported from the Governorate this year. In addition to the two cases that have tested positive for VDPV2, a further 11 have tested negative for polioviruses, with the remaining samples being under process in the laboratories or being transported to the laboratories. (WHO, 13 Jun 2017)
15 new cases of [cVDPV2] were reported in the past week, bringing the total number of cVDPV2 cases in the country to 17. Sixteen of the 17 cases are from Mayadeen district, Deir-Al-Zour governorate, and one case is from Raqua district, Raqua governorate. All cases had onset of paralysis between 3 March and 23 May. (GPEI, 21 Jun 2017)
A response task force has been established at the national level to follow-up on the Syria cVDPV2 outbreak. A national response plan for the cVDPV2 outbreak and a micro plan for rural Deir-ez-Zoir campaigns have been developed to conduct two immunization rounds in Deir-ez-Zor with monovalent oral polio vaccine type-2 (mOPV2 targeting 328,000 children under five years of age and Inactivated polio vaccine (IPV) will be used in the secondround targeting 114,500 children aged between 2-24 months). (OCHA, 26 Jun 2017)
Two new cases of [cVDPV2] were reported in the past week, bringing the total of cVDPV2 cases to 24...Although access to Deir-Al-Zour is compromised due to insecurity, the Governorate has been partially reached by several vaccination campaigns against polio and other vaccine-preventable diseases since the beginning of 2016. Most recently, two campaigns have been conducted in March and April 2017 using the bivalent oral polio vaccine (OPV). However, only limited coverage was possible through these campaigns. In response to the isolation of cVDPV2 from Raqua governorate, the Syrian Ministry of Health in collaboration with WHO and UNICEF is considering adding the area to the outbreak response. This is under discussion due to ongoing military operations. (GPEI, 4 Jul 2017)
One of the previously-reported cases from Raqua, on re-testing, has been confirmed as negative for circulating vaccine-derived poliovirus type 2 (cVDPV2), and has been removed from the list of cases. The total number of cVDPV2 cases is now 23 (22 from Deir-Al-Zour and one from Raqua). (GPEI, 12 July 2017)
Monovalent type-2 oral polio vaccine (mOPV2) was shipped with 350 vaccine carriers dispatched by MoH to Deir Ez-Zor governorate on 11 July to prepare for the first immunization campaign in the area. An mOPV2 campaign in affected areas of Raqqa governorate is now planned. (WHO, 12 July 2017)
Adding Raqqa Governorate to the outbreak response will increase the target population by almost 120,000 children under 5 years of age. In addition to the outbreak, sector partners are increasingly concerned about limited capacities to provide adequate trauma care particularly in areas close to hostilities. Discussions are taking place amongst health partners seeking to mobilize additional resources and capacities to respond to needs. (OCHA, 14 Jul 2017)
As of 18 July, twenty seven cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) have been confirmed. This is an increase of 4 cases, since the last situation report dated 12 July. The total number of acute flaccid paralysis (AFP) cases detected in Deir Ez - Zor governorate since the beginning of 2017 is 87 ( 66 from Mayadeen, 10 from Deir Ez - Zor, and 11 from Boukamal districts). Raqqa governorate has reported 14 AFP cases (6 from Raqqa, 7 from Tell Abyad, and 1 from Thawra districts). (WHO, 18 July 2017)
An immunization campaign was conducted in Deir-ez-Zor from 22 to 26 July by the Ministry of Health with support from UNICEF and the World Health Organization. A total of 259,950 children under the age of five (U5) were vaccinated (79 per cent of the children to be reached in 2017), including 62,864 children aged 0-11 months (24 per cent of the planned reach) and 2,862 children above the target age group. (UNICEF, 31 Jul 2017)
As of 30 August, six new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were officially reported within the past week from Deir-Ez-Zour governorate, bringing the total number of cases in this outbreak to 39. Onset of paralysis of these cases is between 3 March and 10 July. The bulk of all cases are from Deir-Ez-Zour, the epicentre of this outbreak.
The first mOPV2 round in Deir-Ez-Zour was successfully carried out between 22-26 July. Independent post-campaign monitoring reflected coverage of 88.4% (based on caregiver recall).
The second immunization round for Deir-Ez-Zor governorate started on 22 August and is ongoing. Monovalent OPV2 is being provided for children between 0-59 months of age, and inactivated polio vaccine (IPV) for children 2-23 months. In addition to polio vaccines, Aqua Tabs are being provided to families for water purification – 2.5 tons of water purification tablets for 400,000 people have been disseminated at health centers. (GPEI, 30 Aug 2017)
As of 3 October, Seven (7) new cases of cVDPV2 have been confirmed in last week of September —5 cases from Mayadeen and 1 from Boukamal districts, Deir Ez-Zor governorate, and 1 case from Thawra district (newly infected), Raqqa governorate. Isolates from some cases had been laboratory pending for some time. The most recent case, a child from Boukamal with no history of polio vaccination, had onset of paralysis on 5 August. (WHO, 3 Oct 2017)
As of 10 October, one new case of cVDPV2 have been confirmed in the first week of October from Mayadeen district, Deir Ez-Zor governorate. The case, a 19-month-old child with no history of polio vaccination, had onset of paralysis on 19 August. The second immunization round for Raqqa commenced 7 October. mOPV2 is being administered to children 0-59 months of age, and IPV to children aged between 2-23 months. Aqua tabs are being provided to families together with vaccination. (WHO, 10 Oct 2017)
Four (4) new cases of cVDPV2 were reported this week— three (3) from Mayadeen district and one (1) from Boukamal district, Deir Ez-Zor governorate.
The total number of confirmed cVDPV2 cases is 52.
The second immunization round for Raqqa concluded on 13 October.
According to administrative data, a total of 144,414 children aged 0-59m were vaccinated with mOPV2. The numbers of children reported vaccinated represented 96% of a revised estimated target calculated according to updated micro-plans.
The offensive on Raqqa, in northern Syria, which started in June 2017, ended on 17 October when the Syrian Democratic Forces(SDF), supported by the international coalition, took control of the city that had been cleared of fighters from Islamic State (IS) group. The end of the battle to control Raqqa however, doesn’t mean that the war in this part of Syria is over, or that people are no longer suffering.
How did people flee from Raqqa?
Over 588,500 Syrian children were enrolled in temporary education centres (TECs) and Turkish public schools across the country as of end September, representing a 23% increase compared to September 2016.
More than 64,500 refugee children received a conditional cash transfer for education (CCTE) payment in September, bringing the total number of children benefitting from the CCTE to over 136,500.
Up to 7,000 civilians remain trapped in Ar-Raqqa city and face increasingly deteriorating humanitarian conditions and protection concerns. Despite the risks of exposure to mines, snipers and military operations, some civilians have fled. ** The UN is aware of reports – at time of issuing - that the Syria Democratic Forces (SDF) have reportedly taken control of Raqqa city, with the last remaining civilians evacuated over the past few days. The UN is not able to verify first-hand the situation in the city due to lack of access.
- During this week 4 AFP case was reported from Rural Damascus 2 cases, from Damascus one case, and one case from Aleppo.
- (24) Suspected Measles cases were reported during this week; mostly from Deir-ez-Zor (4) cases, and (3) cases from each of Aleppo, Hama and Dar’a.
Completeness& Timeliness of Reporting
The Humanitarian Situation Overview in Syria (HSOS) project is a monthly data collection exercise that aims to gather multi-sectoral information about the humanitarian situation inside Syria. The factsheets present information gathered in September 2017 referring to the situation in August 2017.
Ar Raqqah offensive displaces nearly 268,800 people since April; up to 8,000 people remain in two neighborhoods in city of Ar Raqqah
Humanitarian convoys reach city of Dayr az Zawr following SARG military advances into the city in September
USG humanitarian assistance to Syria reaches nearly $7.5 billion since start of Syria crisis
17 October, 2017, Damascus, Syria – A WHO shipment of health supplies delivered through the Syrian Arab Red Crescent to besieged Deir-Ez-Zor governorate in Syria has helped struggling health facilities deliver life-saving health services to thousands of people.
The 14–ton shipment includes medicines for trauma care, treatment of burns, antibiotics; anti-allergens; cardiovascular medicines; and oral rehydration salts. In total, the supplies are sufficient for almost 1800 trauma cases and 260,000 medical treatments.
13 OCTOBER 2017 | GENEVA - The World Health Organization has received reports of an attack on medical facilities in eastern Syrian Arab Republic that has destroyed the only vaccines cold room in al-Mayadeen district, Deir Ezzor Governorate.
More than 100,000 doses of measles vaccines and 35,000 doses of polio vaccines were stored in these facilities, alongside equipment, syringes, and stocks for all vaccine-preventable childhood diseases.
Likely setback to immunization campaign in area where 48 children have been paralyzed by polio
Statement by Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa
AMMAN/DAMASCUS, 12 October, 2017 – UNICEF has received reports that ongoing violence in Deir ez-Zor in eastern Syria has destroyed a UNICEF-supported vaccine cold room in al-Mayadin district, with at least 140,000 doses of vaccines lost, including some planned for the ongoing vaccination drive in the area. UNICEF is currently verifying this alarming report.
11 October 2017, Islamabad, Pakistan -- On the first day of the regular session of the 64th Regional Committee of the Eastern Mediterranean, the Regional Director’s annual report for 2016, health emergencies and polio eradication were at the core of the discussions.
One (1) n case of cVDPV2 was reported this week from Mayadeen district, Deir Ez-Zor governorate. The case, a 19-month-old child with no history of polio vaccination, had onset of paralysis on 19 August.
The total number of confirmed cVDPV2 cases is 48.
The second immunization round for Raqqa commenced 7 October. mOPV2 is being administered to children 0-59 months of age, and IPV to children aged between 2-23 months. Aqua tabs are being provided to families together with vaccination.
- During this week one AFP case was reported from Rural Damascus.
- (30) Suspected Measles cases were reported during this week; mostly from Deir-ez-Zor (11) cases, and from Quneitra (4) cases.
Completeness& Timeliness of Reporting
- The overall completeness of reporting was 77%; (881 out of total 1148 EWARS sentinel sites). (14) Governorates have reported this week. Timeliness of reporting is 90%.
New on polioeradication.org: Expanding Social Mobilization Approaches To Protect Every Last Child.
Seven (7) new cases of cVDPV2 have been confirmed this week —5 cases from Mayadeen and 1 from Boukamal districts, Deir Ez-Zor governorate, and 1 case from Thawra district (newly infected), Raqqa governorate. Isolates from some cases had been laboratory pending for some time. The most recent case, a child from Boukamal with no history of polio vaccination, had onset of paralysis on 5 August.
The total number of cVDPV2 cases is 47.
Violence continues to impact civilians across the country although there has been overall reduction of civilian casualties in areas where de-escalation zone agreements have been put in place.
Situation in Numbers
5.1 million children in need out of 11 million people affected (OCHA, HRP 2017)
3.25 million internally displaced people (IDP)
2.17 million people returned to newly-accessible areas (IOM, Displacement Tracking Matrix, 31 August 2017)
Target population in 2017: