Philippines

Philippines: Re-emergence of vaccine preventable diseases – Polio outbreak – Operation Update, DREF n° MDRPH032 (12-month update: 29 December 2020)

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Summary of major changes:

The emergence of the coronavirus (COVID-19) pandemic in the Philippines in March 2020 has to an extent, directed health system focus from vaccination campaigns for polio and measles, towards COVID-19 management. Consequently, some activities planned under the EPoA for Polio within the intended timeline had to deprioritized, as its not feasible to conduct those activities during the pandemic. Furthermore, incorporated COVID-19 safe operation to enhanced and facilitated deliverables under this Polio operation.

Changes includes provision of personal protective equipment (PPE) to protect PRC staff and volunteers from COVID-19 infection in delivery of services in this operation. WASH activities, hygiene promotion and PGI activities were downscaled.

Furthermore, there is a major downscaling of activities under Health particularly on activities under Outcome 2 due to the low income of the emergency appeal.

Any unexpended funds at the close of the Emergency Appeal will be transferred to the 2021 Operational Plan of the Philippine Country Office and earmarked to the PRC vaccine preventable diseases activities. IFRC and PRC will continue to advocate for longer term support to the Expanded Program on Immunization programme to reduce the impact of outbreaks in the future, seeking support for this initiative through the IFRC 2021 Philippines Country Plan.

Description of the disaster

On 19 September 2019, the Department of Health (DOH) confirmed the re-emergence of polio (vaccine-derived poliovirus-VDPV) in the Philippines and declared a national polio outbreak, in accordance with international health regulations. It was declared after environmental samples taken in Davao City and Metro Manila tested positive, and a human case of circulating VDPV polio was reported in Mindanao. This was quickly followed by a second case of human infection in Laguna province, south east of Manila. The re-emergence occurs almost 20 years after the Philippines was declared polio-free in 2000 and the last case of wild poliovirus was recorded in 1993.

The declaration of a polio outbreak followed a confirmed Vaccine Derived Poliovirus Type 2 (VDPV2) case in a threeyear old child in Lanao de Sur (Mindanao) reported on 16 September 2019. Subsequently, another VDPV2 case of polio was confirmed on 20 September, this time in a five-year-old boy who was immunocompromised from Laguna which is adjacent to Metro Manila.

As of June 2020, a total of 16 polio cases remain in the country including 13 cases of cVDPV2, one case with cVDPV1; one case with VDPV1; and one case with immunodeficiency related VDPV type 2 (iVDPV2). There have been no new polio cases reported after 15 February 2020.

The resurgence of polio in the Philippines came as the DOH and other partners were responding to dengue outbreaks and measles outbreaks. According to the Philippines Epidemiological Overview 2020, as of 8 February 2020, between 1 January to 8 February 2020, there was 25,502 cases of dengue and 38 deaths reported; as well as 1,433 cases of measles and 12 deaths40TP1FP40T An increasing number of cases of diphtheria are also being reported, the DOH confirming 167 cases and 40 deaths in 2019 compared to 122 cases and 30 deaths in 2018.

Since January 2020, the country, has been wrestling with the continuing spread of the COVID-19. The Philippines on 12 March 2020 raised the COVID-19 Alert System to Code Red sublevel 2 as recommended by the Inter-Agency Task Force on Emerging Infectious Diseases (ITAF-EID). This has imposed stringent measures on the country among which measures of social distancing, enhanced community quarantines and limitation of movement within the country which have had significant impact on polio outbreak response activities. On 16 March 2020, the entire Luzon was put on enhanced community quarantine until 13 April 2020, which was later extended until 15 May 2020. The DOH rapid response vaccination in selected areas of Region 3 and the third round planned for Mindanao, originally scheduled to begin on 23 March 2020 has been postponed until further notice.

These health emergencies occur while the government and its partners are also responding to the recent following natural disasters in the country: the earthquakes in Mindanao (MDRPH036), the Typhoon Kammuri (MDRPH037) in November 2019, it was then followed by Typhoon Phanfone (MDRPH038) in December 2019, then the eruption of Taal Volcano (MDRPH039) in January 2020.