Polio this week as of 12 October 2016

Report
from Global Polio Eradication Initiative
Published on 12 Oct 2016 View Original

•The Strategic Advisory Group of Experts on immunization (SAGE) will convene in Geneva next week (18-20 October). On polio eradication, the group is expected to review the latest global epidemiology, global supply situation of inactivated polio vaccine (IPV) and discuss long-term polio immunization policy options. More.

•WHO calls for nominations for the Global Certification Commission Containment Working Group. This working group, under the Global Commission for the Certification of Poliomyelitis Eradication (GCC), will review the national containment certification of poliovirus-essential facilities (PEFs) and make recommendations to the GCC. More.

NA: onset of paralysis in most recent case is prior to 2015. Figures exclude non-AFP sources. Madagascar, Ukraine and Lao PDR cVDPV1, all others cVDPV2. cVDPV definition: see document “Reporting and classification of vaccine-derived polioviruses” at [pdf]

  • Afghanistan

•No new cases of wild poliovirus type 1 (WPV1) were reported in the past week. The total number of WPV1 cases for 2016 remains eight. The most recent case had onset of paralysis on 11 August in Paktika province, close to the border with Pakistan.

•No WPV1 environmental positive samples have been reported in 2016. The most recent samples were collected on 27 December 2015 – one in Jalalabad district of Nangarhar province and the second in the city of Kabul.

•Efforts continue to further strengthen immunization and surveillance activities across the country.

  • Pakistan

One new case of wild poliovirus type 1 (WPV1) was reported in the past week, from Sujawal, Sindh (south-east of Karachi), with onset of paralysis on 3 September. It is the most recent case in the country, and brings the total number of WPV1 cases for 2016 to 15.

One new WPV1 positive environmental sample was reported in the past week, from Peshawar (date of collection: 15 September). Continued detection of environmental positives throughout 2016 confirms that virus transmission remains geographically widespread across the country, despite strong improvements being achieved.

Efforts continue to further strengthen immunization and surveillance activities in all provinces of the country.

  • 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. The total number of cVDPV1 cases remains three in 2016 and eight in 2015.

•Outbreaks of cVDPVs can arise in areas with low population immunity, emphasizing the importance of maintaining strong vaccination coverage.

  • Madagascar

•No cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) have been reported in 2016. The most recent case had onset of paralysis on 22 August 2015, from Sud-Ouest region. The total number of cVDPV1 cases for 2015 is 10.

•National Immunization Days (NIDs) are planned for 9-11 November using bivalent oral polio vaccine (bOPV).

  • Myanmar

•More than one year has passed since onset of paralysis of the last case of circulating vaccine-derived poliovirus type two (cVDPV2.) The most recent case was isolated from a 16-month old child in Maungdaw district of Rakhine state, with onset of paralysis on 5 October 2015. No cases have been reported in 2016. The total number of cVDPV2 cases in 2015 is two.

•An outbreak response assessment was conducted in September, and found substantial improvements both in surveillance and subnational immunity levels. Although some gaps remain, it is likely that transmission of this strain has been successfully interrupted.

  • Nigeria

•One new case of wild poliovirus type 1 (WPV1) was reported in the past week, bringing the total number of WPV1 cases for 2016 to four. It is the most recent case in the country, with onset of paralysis on 21 August, from Monguno Local Government Area (LGA), Borno, a previously-infected district.

•The detection of new cases at this stage of the outbreak response is not unusual or unexpected; it is an indicator that surveillance continues to be strengthened. It is not an indication that the current outbreak response is not effective, as it is too early to see an impact on the epidemiology of the virus circulation. This latest case had onset of paralysis in August, before the outbreak response began.

•Regional outbreak response in north-eastern Nigeria continues to be implemented, both in response to the WPV1 cases detected in August and to the circulating vaccine-derived poliovirus type 2 (cVDPV2) isolates, detected in Borno from an environmental sample (collected in March) and a healthy contact of one of the WPV1 cases (from August).

•The emergency regional outbreak response is being implemented under the guidance of the Polio Eradication Emergency Operations Center (EOC), led by the Government of Nigeria and with support from WHO and GPEI partners. The outbreak response is being coordinated with neighbouring countries and in the broader humanitarian emergency response context affecting the region. Similar approaches to outbreak response were successfully implemented in previous years in the Middle East and the Horn of Africa.

  • Lake Chad sub-region

•The recent detection of wild poliovirus type 1 (WPV1) in Borno state, Nigeria, poses a risk to the neighbouring countries of the Lake Chad sub-region and hence an outbreak response plan is being implemented as part of the response to the Nigeria outbreak.

•Health leaders at last month’s Regional Committee for Africa declared the situation to be a regional public health emergency for the Lake Chad sub-region.

•Regional emergency outbreak response is continuing across the Lake Chad sub-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. The total number of cVDPV2 cases for 2015 is seven.

•While progress in Guinea continues to be made, gaps remain sub-nationally both in population immunity and surveillance sensitivity. Undetected circulation cannot be ruled out. Efforts are continuing to rapidly filling these gaps and ensure the outbreak has been stopped.

•National Immunization Days (NIDs) are being conducted at the end of the month in Liberia, Sierra Leone and Guinea. Liberia and Sierra Leone are considered at particular risk of polio re-infection or emergence, including by potential spread of cVDPV from Guinea or WPV from Nigeria. Significant subnational immunity and surveillance gaps remain, following significant decline in health systems capacity as a result of the Ebola outbreak.