Syria cVDPV2 Outbreak Situation Report #30 - 16 January 2018

Situation Report
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Key highlights

  • No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 74.

  • The most recent case (by date of onset of paralysis) is 21 September 2017 from Boukamal district, Deir Ez - Zor governorate.

  • The first round of the second phase of the outbreak response started in Deir Ez-Zor city and in Hasakah and Homs governorates on 14 January. The round will commence in other parts of Deir Ez-Zor and in Raqqa in the coming days.

Immunization response

  • Vaccination activities have started in Deir Ez-Zor city and in Hasakah and Homs governorates. Intra - campaign monitoring is taking place.

  • On 14 January, WHO conducted a mission to Deir Ez-Zor city and Hasakah to monitor the implementation of activities.

  • Vaccination teams have adjusted the timing of daily activities according to the prevailing security situation in Deir Ez-Zor city.
    Teams are beginning activities at sunrise and are returning empty mOPV2 vials on the morning of the next campaign day, to allow more time for vaccination visits.

  • Outbreak response teams continue to refine microplans in Deir Ez-Zor and Raqqa to account for population movements.

  • A meeting of district coordinators in high risk areas of Mayadeen district, Deir Ez-Zor, where the majority of cases have been reported, was held on 14 January to adjust microplans.

  • Preparation for the subsequent IPV round continues.

  • Efforts to revitalize routine immunization services in Idleb, Aleppo,
    Hama and Raqqa governorates continue.

Phase one activities

  • Since the start of the outbreak, more than 350,000 resident, refugee and internally displaced children have been reached with mOPV2 through two mass vaccination rounds in Deir Ez-Zor and Raqqa governorates.

  • Additionally, World Health Organization and UNICEF have coordinated with the Government of Syria and local authorities to reach children aged 2 - 23 months with IPV in infected and high risk areas of Deir Ez-Zor, Raqqa, Aleppo, Idleb, Hama and Homs governorates and areas of Damascus, Rural Damascus and Hasakah.

Communication for development (C4D)

  • Pre-campaign social mobilization activities started a few days before the campaign and will continue throughout. Activities include: orientation of health workers and community mobilizers, meetings with community and religious leaders, house - to - house visits, mosque announcements, mothers’ group awareness sessions, street announcements with cars with megaphones and dissemination of print materials in different locations, including in bread bags.

  • A few refusals case were documented in Raqqa. Caregiver concerns are being addressed.

Vaccine management

  • The shipment process for IPV, for use in the second round, is underway.

Coordination and surge support

  • WHO and UNICEF continue to monitor the outbreak situation, exchange information, and assist in the response through the joint Emergency Operations Centers (EOCs) in both hubs (Gaziantep and Damascus).

Surveillance summary

  • To bolster surveillance, training of 20 new AFP surveillance officers recruited from Deir Ez - Zor, Hasakah, Daraa, Hama and Rural Damascus was held 12 - 13 January. Two AFP surveillance orientation sessions to sensitize 25 private physicians in Damascus took place on 15 January.

  • In 2017, Syria and all governorates but four are meeting both key indicators for AFP surveillance: 3* or more non - polio AFP cases per 100,000 children below 15 years of age, and 80 percent or above AFP cases with adequate specimens. Deir Ez-Zor (77%), Raqqa (67%), Rural Damascus (76%) and Sweida (63%) are missing the 80% target for stool adequacy. (*NB: In an outbreak setting, the target is 3 or more non - polio AFP cases per 100,000 children below 15 years).

  • The total number of AFP cases detected in Deir Ez - Zor governorate since the beginning of 2017 is 159 (108 from Mayadeen, 23 from Deir Ez - Zor, and 28 from Boukamal districts). Raqqa governorate has reported 30 AFP cases (12 from Raqqa, 16 from Tell Abyad, and 2 from Thawra districts). Homs governorate has reported 50 AFP cases (25 from Homs city, 20 from Rastan, 1 from Tadmour, 1 from Moukahrram and 3 from Talkalakh districts).

  • Activities to strengthen AFP surveillance are ongoing. Contact sampling from all AFP cases continues and stool samples are being taken from healthy children arriving from known infected areas as well as from silent districts (districts that have no t reported AFP cases in 2017). Activities to sensitize physicians operating in camps in Raqqa and Hasakah governorates, on re-porting of AFP cases, continue.

  • Following the recent establishment of environmental surveillance in Syria, Damascus and Deir Ez - Zor environmental surveil-lance teams are working to a collection schedule with sampling taking place on a monthly basis. Initial samples collected fro m Damascus and Deir Ez - Zor are still under processing.

  • Planning continues for the expansion of environmental surveillance in Syria.