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Polio this week as of 20 August 2014

 

  • The Horn of Africa Technical Advisory Group (TAG) met last week to review the current epidemiological situation, the impact of outbreak response and to determine additional strategies needed to rapidly interrupt residual transmission in the region. Plans were developed to increase access to mobile populations, to improve community surveillance and to strengthen campaign quality. Read more in the Horn of Africa section below.

 

  • China, India and Australia have joined Saudi Arabia in requiring proof of polio vaccination for visa applications for travellers coming from polio endemic and outbreak countries to mitigate the risk of international spread of polio.

 

  • In Cameroon, genetic sequencing of the recently-reported cases confirms continued wild poliovirus circulation, gaps in surveillance resulting in undetected transmission and geographic expansion to new areas of the country. See ‘central Africa’ section below for further information

  

 

  


Wild Poliovirus (WPV) cases

Total cases

Year-to-date 2014

Year-to-date 2013

Total in 2013 

Globally

146

192

416

- in endemic countries

128

71

160

- in non-endemic countries

18

121

256

  


Case breakdown by country


Countries

Year-to-date 2014

Year-to-date 2013


Total in
 2013

Date of most 
 recent case

 WPV1  WPV3   W1W3  Total   WPV1  WPV3  W1W3  Total 
Pakistan 115     115 24  
24 93 27-Jul-14
Afghanistan 8     8 4     4 14 17-Jun-14
Nigeria 5     5 43
  43 53 27-May-14
Somalia 4     4 108
  108 194 03-Jun-14
Equatorial Guinea 5     5       0  0 03-May-14
Iraq 2     2       0 0 07-Apr-14
Cameroon 5     5       0 4 09-Jul-14
Syria 1     1       0 35 21-Jan-14
Ethiopia      1     1
    0 9 05-Jan-14
Kenya
    0 12     12 14 14-Jul-13
Total 146 0 0 146 192 0   192 416
Total in endemic countries      128 0 0 128 71 0
71 160   
 Total outbreak 18    0   0 18 121 0 0 121 256  

Data in WHO as of 20 August 2013 for 2013 data and 19 August 2014 for 2014 data.

Afghanistan

  • No new WPV1 cases were reported in the past week. The total number of WPV1 cases in 2014 remains eight. The most recent WPV1 case had onset of paralysis on 17 June, from Khost province (linked to virus in North Waziristan, Pakistan).
  • Khost province borders Pakistan, where communities displaced by military action have been leaving North Waziristan. Health authorities in surrounding districts of Pakistan and across the border in Afghanistan have been vaccinating displaced children: more than 35,000 displaced children under the age of 10 are reported to have received a dose of bivalent oral polio vaccine (bivalent OPV) as they entered the Afghan provinces of Paktika and Khost.
  • National Immunization Days (NIDs) are being implemented this week (17-19 August) with trivalent OPV, to be followed by subnational activities in September.

Nigeria

  • No new WPV1 cases were reported in the past week. The most recent case had onset of paralysis on 27 May in Kano state; Nigeria’s total case count for 2014 is five.
  • No new cVDPV2 cases were reported in the past week. The total number of cVDPV2 cases for 2014 remains 18. The most recent cVDPV2 case had onset of paralysis on 22 June, from Kano.
  • The most recent supplementary immunization activities (SIAs) took place last week in parts of Borno and Yobe, using inactivated polio vaccine (IPV) and OPV, and in other parts of the country using trivalent OPV. The next subnational immunization days (SNIDs) are planned for late September. 

Pakistan

  • Seven new WPV1 cases were reported in the past week, all from Federally Administered Tribal Areas (FATA), from North Waziristan, South Waziristan and Khyber, bringing the total number of WPV1 cases for 2014 to 115. One of the newly-reported cases from North Waziristan is the most recent WPV1 case in the country, with onset of paralysis on 27 July.
  • No new cVDPV2 cases were reported in the past week. The country has reported 16 cases of cVDPV2 to date in 2014 and the most recent case had onset of paralysis on 27 May in FR Bannu, FATA.
  • Immunization activities are continuing with particular focus on known high-risk areas.

Central Africa

  • No new WPV1 cases were reported this week. In 2014, ten cases were reported in central Africa: five in Cameroon and five in Equatorial Guinea.
  • Following recent confirmation of two cases in Cameroon (from Est province), genetic sequencing confirms continued WPV circulation, gaps in surveillance resulting in undetected transmission and geographic expansion to new areas of the country.
  • The outbreak in Cameroon has been ongoing since at least October 2013, with international spread to Equatorial Guinea in 2014. In March 2014, WHO elevated the risk assessment of international spread of polio from Cameroon to very high, due to expanding circulation and influx of vulnerable refugee populations from Central African Republic (CAR).
  • In Cameroon, the next activities are planned for 23-26 August, targeting extended age groups, including in refugee camps in border areas with CAR.
  • In Equatorial Guinea, SIAs are planned for 28-31 August and later in September.

Horn of Africa

  • No new WPV1 cases were reported in the past week. Five cases have been reported in the Horn of Africa to date in 2014: one WPV1 in Ethiopia (14 January) and four WPV1s in Somalia (the most recent on 3 June in Mudug, Puntland).
  • The Horn of Africa TAG met from 12-14 August to review the current epidemiological situation and the impact of the outbreak response and to determine additional strategies needed to rapidly interrupt residual transmission in the region.
  • Strategies were proposed to improve operations and strengthen surveillance including targeted tactics for reaching mobile populations in Somalia and Ethiopia, considering new communication channels and opportunities to reach these groups. The need to sustain the sense of urgency until the outbreak is stopped was highlighted.
  

Israel and West Bank and Gaza

  • WPV1 is not being detected in environmental samples in Israel, the West Bank and Gaza Strip in recent months; the most recent positive sample was collected in southern Israel on 30 March. Samples collected from April to July have been negative. Fourteen positive samples were collected from January to July 2014 in Israel, following 136 positive samples in 2013.

Middle East

  • No new cases were reported in the past week. There have been three cases of WPV1 reported in the Middle East in 2014 - two in Iraq and one in Syria. The most recent case reported from Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 April. Syria’s most recent case had onset of paralysis on 21 January.
  • In the Middle East, the second phase of the comprehensive outbreak response is being implemented across the region.
  • WHO and UNICEF are committed to working with all organizations and agencies providing humanitarian assistance to Syrians affected by the conflict. This includes vaccination of all children no matter where they are, whether in government or contested areas of the country, or outside Syria.
  • SNIDs will start on 31 August in high-risk governorates of Syria where over the past several SIAs coverage has been lower than in other areas. Technical support is being maximized to these areas.
  • On 6-7 September, there will be a review of the Phase 2 outbreak response in the Middle East so far.

West Africa

  • No WPV1 cases have been reported in West Africa in 2014. The most recent WPV1 case in the region occurred in Tahoua province, Niger, with onset of paralysis on 15 November 2012. In addition, a single case of cVDPV2 was reported in Niger on 11 July 2013.
  • Polio staff across West Africa are supporting efforts to control the Ebola outbreak affecting the region. The Ebola outbreak will impact the planned multi-country polio campaigns in September in the Ebola affected countries with campaigns in Liberia, Sierra Leone, and Guinea being postponed until the Ebola outbreak is brought under control. Preparations for large scale multi-country campaigns in countries across the rest of West Africa in mid-September are proceeding as planned.