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Polio this week as of 16 July 2014

  • Momentous opportunity for Africa: In its 2-3 July meeting, the Central African Technical Advisory Group noted that there is now a “momentous opportunity” for Africa to be polio-free and warned that there is a lack of urgency to capitalize on this opportunity.
  • New case in Afghanistan of Pakistan origin: A child who had onset of polio-paralysis in Khost Province of Afghanistan is a member of the displaced community from Pakistan’s North Waziristan Agency, where children have not had access to vaccination for two years. Ahead of and during military action in that Agency, the population has largely left the area and moved into surrounding areas of Pakistan and into Afghanistan. Massive vaccination operations are taking place at the transit points out of North Waziristan in order to protect Waziri children and the rest of Pakistan from polio.
  


Wild Poliovirus (WPV) cases

Total cases

Year-to-date 2014

Year-to-date 2013

Total in 2013 

Globally

123

132

416

- in endemic countries

107

59

160

- in non-endemic countries

16

73

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 94     94 21  
21 93 24-Jun-14
Nigeria 5     5 35
  35 53 27-May-14
Afghanistan 8     8 3     3 14 17-Jun-14
Equatorial Guinea 5     5       0  0 3-May-14
Iraq 2     2       0 0 07-Apr-14
Cameroon 3     3       0 4 31-Jan-14
Syria 1     1       0 35 21-Jan-14
Ethiopia      1     1
    0 9 05-Jan-14
Somalia 4     4 65
  65 194 03-Jun-14
Kenya
    0 8     8 14 14-Jul-13
Total 123 0 0 123 132 0   132 416
Total in endemic countries      107 0 0 107 59 0
59 160   
 Total outbreak 16    0   0 16 73 0 0 73 256  

Data in WHO as of 016 July 2013 for 2013 data and 15 July 2014 for 2014 data.

Afghanistan


  • One new case of wild poliovirus type 1 (WPV1) was reported in the past week, from Khost Province. The child is from a Pakistani family from polio-endemic North Waziristan who fled to Afghanistan to escape conflict at home. Already ill with fever when leaving Pakistan, the child developed paralysis on 16 June, 2014, in Khost province, one day after arrival from N. Waziristan. Including this most recent case, Afghanistan has reported eight polio cases to date in 2014, compared to three at this time in 2013.
  • Khost Province borders Pakistan, where communities displaced by military action have been leaving North Waziristan Agency. In preparation for the displacement of people – and possible movement of the virus – ahead of the Pakistan military’s actions in 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 (bOPV) as they entered the Afghan provinces of Paktyka and Khost.
  • No Supplementary Immunization Activities (SIAs) are planned during the holy month of Ramadan. The next SIAs are scheduled for 17-19 August, nationwide.

Nigeria

    • No new cases of wild poliovirus type 1 (WPV1) 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.
    • Two new cVDPV2 cases were reported in the past week, from Borno and Kano states. The total number of cVDPV2 cases for 2014 is now 13, and for 2013 is four. The most recent cVDPV2 case was the one from Damboa in Borno, which had onset of paralysis on 9 June. The continuing circulation of cVDPV2, as evident both from AFP and environmental surveillance , reflects very low levels of routine coverage with tOPV (and therefore very low immunity against type 2 poliovirus) in the north of the country and the need for increased use of type-2 containing vaccine (tOPV) during SIAs. It is also urgent that the quality and coverage of SIAs in northern Nigeria continue to improve this year.
    • Mop-up vaccination activities took place in parts of four northern Nigerian states from 12-15 July. Larger subnational activities are planned for the country’s north during 9-12 August (tOPV) and 20-23 September (bOPV).

    Pakistan

    • Four new wild poliovirus type 1 (WPV1) cases were reported in the past week, bringing the country’s total case count to 94. The most recent cases had onset of paralysis on 24 June, one from Khyber Agency of the Federally Administered Tribal Areas (FATA), one from Peshawar in Khyber Pakhtunkhwa province and one from Sanghar in Sindh province.
    • No new cVDPV2 cases were reported in Pakistan 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.
    • In order to protect those displaced by the military action in North Waziristan, people of all ages continue to be vaccinated against polio at transit points within the country (over 394,000 vaccinated to date) and during several rounds of house-to-house immunization campaigns in the host communities (over 500,000 vaccinated in the first two rounds, with a third round just concluded).
    • The country’s next vaccination campaign will be a subnational activity focusing on the highest risk districts and will take place after the holy month of Ramadan from 18-20 August. Further subnational activities are planned for September and October.

    Central Africa

    • No new cases were reported in Central Africa this week. Equatorial Guinea has reported five wild poliovirus type 1 (WPV1) cases in 2014 and Cameroon has reported three cases of WPV1. The most recent case for the entire sub-region had onset of paralysis on 3 May, in Mbini district, Litoral province, Equatorial Guinea. Cameroon’s most recently reported case occurred more than five months ago, with onset of paralysis on 31 January.
    • In its 2-3 July meeting, the Central African Technical Advisory Group noted that there is now a “momentous opportunity” for Africa to be polio-free, given the decline in cases in Nigeria, and warned that there is a lack of urgency to capitalize on this opportunity. The group recommended systematic engagement with the Heads of State and a region-wide alert on the potential spread of polio to ensure countries reduce their vulnerability and are prepared to deal with importation of poliovirus.
    • The entire population of Equatorial Guinea, regardless of age, will be vaccinated starting 23 July. A house-to-house search for acute flaccid paralysis cases will be conducted during the campaign; a similar search is currently taking place in Gabon. Cameroon, the Central African Republic, the Democratic Republic of the Congo (DR Congo), Gabon and the Republic of Congo also have mass vaccination campaigns planned for July. DR Congo, Equatorial Guinea and Gabon are also planning to carry out campaigns in August.

    Horn of Africa

    • Three new cases of wild poliovirus type 1 were reported in the past week. Five cases have been reported in the Horn of Africa to date in 2014 – one WPV1 in Ethiopia and four WPV1 in Somalia. The most recent case had onset of paralysis on 3 June in Mudug, Somalia.
    • The three new cases reported from Mudug in Somalia bring the total no. of cases reported from the Mudug Region (Jariban) this year to four and indicate that the polio outbreak in Somalia continues. The cases are caused by virus closely related to that previously detected in Mogadishu in July 2013. No cases have been detected in the epicentre of the outbreak, in Mogadishu, Banadir region, since 19 July 2013.
    • The most recent immunization activities took place in accessible districts of Somalia on 15-18 June, except for Puntland (which includes Mudug), which followed on 21-24 June. A short-interval additional dose campaign took place on 5-9 July, followed by further campaigns planned for 20-25 July (targeting children under 10) and 5-8 August.
    • Mudug is a remote area with challenging conditions to plan and implement immunization campaigns and with hard-to-reach, under-served nomadic populations. While the proportion of children with three or more doses of oral polio vaccine has risen since 2012, it is still below 80%. None of the children paralyzed in Mudug had ever been vaccinated against polio.
    • Special outreach is currently taking place to reach and vaccinate nomadic communities, as well as to map of these communities to ensure their inclusion in vaccination plans.
    • Djibouti, Ethiopia, Kenya and Somalia all conducted mass vaccination campaigns in June. Ethiopia is also planning to hold a campaign in July and, along with Yemen and Kenya, will conduct a campaign in August.
    • Environmental samples collected in Somali neighbourhoods of Nairobi, Kenya, continue to test negative for WPV since October 2013.
      

    Israel and West Bank and Gaza

    • WPV1 has no longer been detected in 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 in April and May have been negative. Fourteen positive samples have been collected from January to March 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, 2014.
    • In the Middle East, the second phase of the comprehensive outbreak response is being implemented across the region. Iraq, Jordan and Syria are all planning to hold vaccination activities in August.
    • 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. 

    West Africa

    • No cases have been reported in West Africa in 2014. The most recent case in the region was due to WPV1 and 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.
    • Multi-country, synchronized immunization campaigns continue to be implemented across the region with activities planned for Guinea and Niger in July, and in 15 countries in September (Benin, Burkina Faso, Cape Verde, Cote d'Ivoire, Ghana, Guinea, Gambia, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Senegal, Sierra Leone, Togo).