The Executive Board of the World Health Organization at its meeting in Geneva last week noted that the world is closer than ever to being polio-free, and urged for increased support to the remaining endemic countries. At the same time, ministries commended efforts made on containment and to manage an ongoing global inactivated polio vaccine (IPV) supply constraint. The Board also encouraged plans to transition the polio infrastructure for the long-term, to ensure it continues to benefit broader public health efforts even after the disease is gone. To this effect, the Board adopted a ‘decision’, requesting the GPEI to present a strategic roadmap towards polio transition and the development of a post-certification strategy at the May World Health Assembly. Closing the discussion, Rotary International addressed the ministries with a clear call to action: “We must protect the gains. An additional US$1.3 billion is needed through 2019. Together, we can end polio and forever build a better future for all children.”
Summary of newly-reported viruses this week (see country-specific section below for further details): Pakistan – five environmental wild poliovirus type 1 (WPV1) samples.
Weekly country updates as of 1 February 2017
No new wild poliovirus type 1 (WPV1) cases were reported in the past week. The total number of WPV1 cases for 2016 remains 13. The most recent case had onset of paralysis on 16 December 2016, from Bermal district, Paktika province. More than half of the country’s cases in 2016 are from Bermal district.
Paktika province is close to the border with Pakistan, and with parts of the Federally Administered Tribal Areas (FATA), and close coordination is ongoing between both country teams to further strengthen both immunization and surveillance operations in a joint, cross-border manner.
No new wild poliovirus type 1 (WPV1) cases were reported in the past week. The total number of WPV1 cases for 2016 remains 20. The most recent case had onset of paralysis on 22 December 2016, from Killa Abdullah, Balochistan.
Five new environmental WPV1 positive samples were reported in the past week, from Balochistan (Quetta and Pishin), Sindh (Karachi-Gadap and Jacobabad) and Khyber Pakhtunkhwa (Peshawar), collected between 1 and 10 January 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, in order to address ongoing circulation of both WPV1 and cVDPV2 strains.
No new cases of wild poliovirus type 1 (WPV1) were reported in the past week. The total number of WPV1 cases for 2016 remains four. The most recent case had onset of paralysis on 21 August in Monguno Local Government Area (LGA), Borno.
Nigeria continues to implement emergency outbreak response, both in response to the detected WPV1 strain and circulating vaccine-derived poliovirus type 2 (cVDPV2) strains affecting the country.
Lake Chad Basin
The detection of wild poliovirus type 1 (WPV1) and circulating vaccine-derived poliovirus type 2 (cVDPV2) in Nigeria poses a risk to the neighbouring countries of the Lake Chad basin and hence an outbreak response plan is being implemented as part of the response to the Nigeria outbreak.
Emergency outbreak response efforts continue across the Lake Chad basin, together with activities to fill subnational surveillance gaps across the region.
Guinea and West Africa
No circulating vaccine-derived poliovirus type two (cVDPV2) cases have been reported from Guinea in 2016. The most recent case was reported from Kankan district with onset of paralysis on 14 December 2015. The total number of cVDPV2 cases for 2015 is seven.
While signs are positive in Guinea, and it has been more than a year since the last case had onset of paralysis, gaps remain sub-nationally both in population immunity and surveillance sensitivity. Undetected circulation cannot be ruled out. Efforts are continuing to rapidly fill these gaps and ensure the outbreak has been stopped. A recently-conducted surveillance review in the country found significant improvements to surveillance sensitivity, though some remaining subnational gaps.
A third Outbreak Response Assessment (OBRA) is currently underway in Guinea.
Lao People's Democratic Republic
No new cases of circulating vaccine-derived poliovirus type one (cVDPV1) were reported in the past week. The most recent case was reported in Fuang district of Vientiane province, with onset of paralysis on 11 January 2016. The total number of cVDPV1 cases remains three in 2016 and eight in 2015.
While no new cases have been detected for over one year, subnational surveillance gaps persist and efforts to strengthen surveillance are therefore ongoing.
Outbreaks of cVDPVs can arise in areas with low population immunity, emphasizing the importance of maintaining strong vaccination coverage.