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Angola

Angola - Polio DREF Operation (MDRAO009)

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Description of the Event

What happened, where and when?

In the week of May 3rd, 2024, Angolan health authorities announced that polio had been detected in Chitato Municipality, Lunda Norte province, which borders the Democratic Republic of Congo (DRC). A person infected with 'circulating vaccine-derived poliovirus type 2' (cVDPV2) was confirmed. Although a polio outbreak had already been declared by the government on February 27th, 2024, due to environmental samples found in the provinces of Luanda and Huambo, the case on May 3rd was the first human case reported.
The Government of Angola has classified the current outbreak as a Grade 2 emergency (i.e., moderate level – aligned with WHO classification) due to the high risk of virus spread, exacerbated by poor water and sanitation infrastructure and hard-to-reach populations. Additionally, there is an increased risk of cross-border transmission along the DRC-Angola border, with genetic sequencing indicating a link to a polio virus reported in the DRC's Cassai Oriental province, classified as cVDPV2 (Circulating Vaccine-Derived Poliovirus Type 2).
The detection of these cases necessitated a large-scale, rapid emergency response in line with international polio outbreak response standard operating procedures and the sub-regional emergency response plan. The Government of Angola has planned a two-round national vaccination campaign covering over 5.5 million children, scheduled for May 17-19 and June 28-30. The government verbally requested the Angola Red Cross's support for the vaccination campaign during the Ordinary Meeting of the CCI (Interagency Coordination), held on March 26th, 2024, at the National Directorate of Public Health in Luanda.
Following microplanning sessions over the past two weeks, May 10th marked the finalization of microplanning, detailing the support the NS would provide, and triggered this DREF. CVA was involved in the planning and has already participated in the first round of vaccination support.

Scope and Scale

In the week of May 3rd, 2024, a human case of vaccine-derived polio was confirmed in Lunda Norte province, Angola, marking the first human case since the 2019-2020 outbreak, which saw a total of 124 cases across 18 provinces (121 in 2019 and 3 in 2020). Additionally, four cases of Poliovirus Type 2 have been detected in environmental samples of sewage water collected in the Luanda, Huambo, and Lunda Norte provinces in 2024. The risk of outbreak spread is high, with less than 60% of children having immunity to poliovirus types 1, 2, and 3 as of 2023. Furthermore, there are 36 cases of Acute Flaccid Paralysis awaiting classification by the National Committee of Polio Experts, which may or may not be related to the polio virus. Sampling for the virus remains a challenge, as most samples fail to comply with the recommended sampling times, rendering them inadequate.
Provinces bordering the DRC are also at high risk, as cases in Angola show a link to the virus in the DRC. Angola is prone to the spread of water-borne diseases due to poor water supply and sanitation infrastructure, limited access to health facilities, and recent heavy rains.
The Government of Angola has classified three out of 18 provinces with confirmed cases (one human case and four cases in environmental samples), 11 out of 18 as high-risk provinces (Bengo, Benguela, Bié, Cabinda, Cuanza Sul, Huíla, Lunda Sul, Malanje,
Moxico, Uíge, and Zaire), and four out of 18 as medium-risk provinces.
High-risk population groups include children under five years old, unvaccinated individuals, or those who have received fewer doses of polio vaccines, particularly in urban areas and areas with poor water and sanitation infrastructure. Nationwide, the government has identified 5,549,140 children under the age of five in need of vaccination. In the provinces where the virus has been found (Luanda, Lunda Norte, and Huambo), there are 2,130,932 children under five years old.