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Bangladesh + 8 more

WHO South-East Asia Region Epidemiological Bulletin, 2nd edition (2024), 24 January 2024 | Reporting period: 8 - 21 January 2024

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Key events and updates

Circulating vaccine-derived poliovirus type 2 (cVDPV2): Indonesia

Situation Summary (As of 23 January 2024)

  • In December 2023 and January 2024, the Indonesian Ministry of Health (MOH) reported three cases of acute flaccid paralysis (AFP) with cVDPV2 and nine healthy children with cVDPV2. Three AFP cases were: o a six-year-old female from Klaten district, Central Java province, with a history of recent ravel to Sampang district, East Java province and onset of paralysis on 20 November 2023;
  • a one-year-old male from the Pamekasan district, East Java province, with an onset of paralysis on 22 November 2023; and
  • a three-year-old male from Sampang district, East Java province, with an onset of paralysis on 6 December 2023.
  • Environmental samples taken in Bangkalan district, East Java province, on 7 December 2023, also tested positive for cVDPV2.

  • Active door-to-door surveillance was undertaken in Central and East Java Provinces to identify AFP cases, assess immunization coverage and obtain samples to monitor the spread of VDPV2. Active case finding was conducted in at least 200 households in respective communities where the cases were detected and neighboring areas.

  • Two rounds of large-scale supplementary immunization activities (SIAs) using nOPV2 are being implemented – the first round on 15 January and the second round planned on 19 February. It targets 8.4 million children (0 - 7 years) in East Java, Central Java, and Yogyakarta (only Sleman Regency) provinces.

  • Prior to these three AFP cases with cVDPV2 in Central Java and East Java provinces, four AFP cases of cVDPV2 infection had been reported previously from Aceh and West Java provinces of Indonesia between October 2022 and February 2023.

Dengue: Global Situation

  • On 21 December 2023, WHO published a Disease Outbreak News of the global situation of dengue.

  • From 2000 to 2019, WHO documented a ten-fold surge in reported cases of dengue worldwide, increasing from 500 000 to 5.2 million with a peak in 2019.

  • Following a slight decline in cases between 2020 and 2022, an upsurge was reported in 2023 with multiple outbreaks and spread into areas previously unaffected by dengue.

  • Since the beginning of 2023, over five million cases and more than 5000 dengue-related deaths were reported in over 80 countries/territories in five WHO regions.

  • Several factors are associated with the increasing risk of spread of the dengue epidemic including the changing distribution of the vectors; the consequences of the El Niño phenomena in 2023 and climate change leading to increasing temperatures and high rainfall and humidity; fragile health systems in the midst of the COVID-19 pandemic; and political and financial instabilities in countries facing complex humanitarian crises and high population movements.

  • Weaknesses in the surveillance systems in many affected countries may have led to delayed reporting and response.

  • WHO has assessed the risk to be high globally considering the increasing risk of transmission and the upsurge of cases and deaths.