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)
1.0. EXECUTIVE SUMMARY
1.1 Status of health care facilities
As of June 2017, according to WHO’s Health Resources Availability Mapping System (HeRAMS), over half of Syria’s 111 public hospitals and half its 1802 public health care centres were either closed or functioning only partially.
1.2 Access to people in need
Three (3) new cases of cVDPV2 were reported this week from three new districts: 1 case from Deir Ez-Zor district, Deir Ez-Zor governorate; 1 from Boukamal district, Deir Ez-Zor governorate; and 1 from Tadmour district, Homs governorate.
Five districts in three governorates are now infected.
Displacements from and within Ar-Raqqa Governorate continued due to heavy fighting and airstrikes. An estimated 224,250 people have been displaced since 1 April, including 45,486 since 1 June.
Up to 25,000 people are estimated to remain inside Raqqa city, amid heavy fighting between ISIL and the Syria Democratic Forces (SDF).
(14) AFP cases were reported during this week, most cases were;(6) cases from Deir-ez-Zor, (2) cases from Aleppo, (2) case from Damascus, one case from Homs, one case from Tartous, and one case from Deir-ez-Zor.
(37) Suspected Measles cases were reported during this week; mostly from Lattakia (13) cases, from Deir-ez-Zor (7) cases, and from Homs (4) cases.
Completeness& Timeliness of Reporting
WHO statement 3 August 2017
The fourteenth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened by the Director General on 3 August 2017 at WHO headquarters with members, advisers and invited member states attending via teleconference.
144,000 additional doses of Inactivated Polio Vaccine procured through funding from the European Union and the Government of the United States.
Beirut, August 10, 2017 – The Ministry of Public Health announced today the acceleration of Inactivated Polio Vaccine (IPV) provision to all children under 5 in Lebanon. IPV will be available free of charge for all children, regardless of nationality at, Primary Health Care centres across Lebanon in addition to border points and UNHCR reception centres.
No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 30 (29 cases are from Mayadeen district, Deir Ez-Zor governorate, and 1 case from Tell Abyad district, Raqqa governorate).
USG announces $140 million in additional humanitarian assistance for refugees from Syria and host communities in Lebanon
SDF-led offensive continues to drive displacement from and within Ar Raqqah, with more than 45,000 displacements recorded in June and July
WHO launches poliovirus vaccination campaign in Al Hasakah, Ar Raqqah, and Dayr az Zawr
This update provides a summary of recent displacement, along with developments from the UNHCR co-led Sector/Clusters of Protection, Camp Coordination and Camp Management (CCCM) and Shelter/Non Food Items (SNFI).
KEY DISPLACEMENT STATISTICS (AS OF 25 JULY 2017)
938,054 displacements recorded by the CCCM Cluster in the last 12 months from affected areas of northern and southern Syria:
Three (3) new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases is 30 (29 cases are from Mayadeen district, Deir Ez-Zor governorate, and 1 case from Tell Abyad district, Raqqa governorate).
Poliovirus type-2 (PV2) has been isolated from an additional 6 stool samples collected from acute flaccid paralysis (AFP) cases in Deir Ez-Zor. These samples have been sent to polio reference laboratories for further testing and sequencing.
- One acute watery diarrhoea case was reported from Lattakia national hospital.
- (5) AFP cases were reported during this week, (2) cases from Damascus, (2) cases from Deir-ez-Zor, and (1) case from Dar’a.
- (29) Suspected Measles cases were reported during this week: (8) from Deir-ez-Zor, (6) from Lattakia, and (5) from Homs.
27 JULY 2017
SECURITY COUNCIL 8015TH MEETING (AM)
Permanent Representative Criticizes Secretary-General’s Reports, Sanctions, Saying Aid Convoys Go to Armed Groups, Not Those in Need
Despite declining violence in some parts of Syria in recent months, the country’s humanitarian and protection situation remained extremely difficult for civilians, Deputy Emergency Relief Coordinator Ursula Mueller told the Security Council today.
New York, 27 July 2017
As delivered by Assistant Secretary-General and Deputy Emergency Relief Coordinator Ursula Mueller
Mr President and distinguished representatives,
The first report of the Transition Independent Monitoring Board (TIMB) has now been published, following the group’s first meeting last month. The TIMB has been established at the request of the Polio Oversight Board (POB) to independently monitor and guide the polio transition process, especially in the 16 countries prioritized for transition planning. The group’s next meeting will be held in London,
United Kingdom, on 2-3 November. More.
1. The present report is the forty-first submitted pursuant to paragraph 17 of Security Council resolution 2139 (2014), paragraph 10 of resolution 2165 (2014), paragraph 5 of resolution 2191 (2014), paragraph 5 of resolution 2258 (2015) and paragraph 5 of resolution 2332 (2016), in which the Council requested the Secretary-General to report, every 30 days, on the implementation of the resolutions by all parties to the conflict in the Syrian Arab Republic.
No new cVDPV2 cases reported this week. The total number of cVDPV2 cases remains 27 (26 cases are from Mayadeen district, Deir Ez-Zor governorate, and 1 case from Tell Abyad district, Raqqa governorate).
The first mOPV2 vaccination round in Deir Ez-Zor started on 22 July. A total of 59,051 children under the age of five were vaccinated on the first day of the campaign.
Given high temperatures, WHO has arranged for local ice-cream factories to assist in the daily freezing of ice packs.