ReliefWeb

• The Somalia Polio Programme has not confirmed any new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) in children with acute flaccid paralysis (AFP) since 8 May 2019.

• The last case of circulating vaccine-derived poliovirus type 3 (cVDPV3) in a child with AFP was detected and confirmed on 7 September 2018.

• A total of three cVDPV2 cases have been reported in Somalia across 2019.

• In total, 15 children with polio have been detected in Somalia since the onset of the ongoing concurrent cVDPV2 and cVDPV3 outbreaks in 2017.

• Sequencing results of four PV2 cases were reported during the last week. Index SOM-SAH-BER-19-007 and one contact from Berbera district in Sahil region, index SOM-WGB-HAR-19-016 from Hargeisa district in Galbeed region, and community sample SOM-BRI-ALU-19-CC-3, were confirmed as PV2-Sabin.

Upcoming vaccination activities

An integrated measles and polio campaign will start to be implemented from 24 to 28 November in South and Central Somalia. During week 43, a total of 102 new suspected measles cases were reported across Somalia. This brings the number of suspected measles cases reported since January 2019 to 3616. Of these cases, 78% are among children under the age of five.

This integrated campaign will assist with stemming transmission of measles and reducing the likelihood of future measles outbreaks in Somalia. The adding of the polio vaccine to this campaign supports the country’s effort to maintain high levels of protection against polio viruses types 1 and 3 amongst all Somali children.

Surveillance

Surveillance for Acute Flaccid Paralysis

• As of week 43, a total of 297 children with acute flaccid paralysis (AFP) have been reported by Somalia’s surveillance network during 2019. Of these, 283 children have tested negative for polioviruses, three children have been confirmed positive for the cVDPV2 virus, one for PV2, and 11 stool samples from children with AFP are still undergoing laboratory testing.

• Analysis of reported vaccination history of the 217 children aged 6 – 59 months presenting with non-polio AFP shows that 20% (44) of these children were under-immunized, having received less than three doses of OPV from National Immunization Days and routine EPI combined.

• Of the 33 children presenting with AFP who are reported as never having received a polio vaccine, 23 of these children are within the 6 – 59 month age group. Twenty two of these 23 children come from from the access-compromised regions of South and Central zones of Somalia where traditional polio campaign activities are not conducted. This highlights that there are still children with absent or low protection against polio and underlines the need to ensure campaigns reach every child and routine immunization services are invigorated.

Environmental Surveillance

In 2019 to date, 47 sewage samples have been collected from four sites in Mogadishu and sent to the laboratory for testing. Of these, 25 samples have tested negative for polioviruses, 14 samples are confirmed to contain enterovirus (EV); one sample is confirmed to hold an ambiguous strain of vaccine-derived poliovirus (aVDPV); four samples are confirmed to contain Sabin-Like virus (SL3); and three samples are in the lab. Environmental Surveillance (ES) sampling frequency shifted from once every month to bi-weekly from October. Open Data Kit (ODK) software has been introduced to collect ES data and enhance field supervision during sampling.