This Week

Polio this week as of 16 August 2017

  • Marking Pakistan’s Independence Day this week, Canadian Prime Minister Justin Trudeau paid tribute to both countries’ ongoing collaboration, including on the effort to eradicate polio.  “Our two countries established a diplomatic relationship shortly after Pakistan was declared a sovereign nation in 1947. We continue to work together to advance shared priorities, including governance and democracy, regional security, poverty reduction, polio eradication, trade, defense, and the fight against climate change.”
  • The 14th Emergency Committee for polio eradication under the International Health Regulations met on 3 August and has made its recommendations to the WHO Director-General, who has accepted them.  The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC), and recommended the extension of revised Temporary Recommendations for a further three months.  The key change is the inclusion of DR Congo and Syria in the category ‘States infected with cVDPV2s, with potential risk of international spread’.
  • Long-time polio eradicator Iris Tetford retires:  the partners of the Global Polio Eradication Initiative (GPEI) wish Iris Tetford a well-deserved and happy retirement.  For years, Ms Tetford has been an integral part of the polio eradication team at WHO in Geneva.  She contributed substantially to the creation of the weekly global update, and  continuously close coordinated with regional and country counterparts to manage the weekly data analysis and public reporting process.  Many thanks for your tremendous engagement and contribution to the global eradication effort, Iris!  We wish you all the best for your well-deserved retirement.
  • Summary of newly-reported viruses this week:  Afghanistan:  one new wild poliovirus type 1 (WPV1) case; Pakistan:  one new WPV1-positive environmental sample; Syrian Arab Republic:  three new circulating vaccine-derived polio type 2 (cVDPV2) from Syria, two from Deir-Ez-Zour and one from Homs governorates.  Details in country-specific sections below.

NA: onset of paralysis in most recent case is prior to 2016. Figures exclude non-AFP sources. Lao PDR cVDPV1, all others cVDPV2. cVDPV definition: see document “Reporting and classification of vaccine-derived polioviruses” at [pdf]

Weekly country updates as of 16 August 2017

  • One new wild poliovirus type 1 (WPV1) case was reported in the past week, bringing the total number of WPV1 cases for 2017 to six. It is the most recent case in the country, and had onset of paralysis on 10 July, from Zabul province, neighbouring Kandahar province and Pakistan.
  • Afghanistan continues to coordinate activities with neighbouring Pakistan, to address both cross-border transmission and focus on reaching mobile populations with oral polio vaccine (OPV). Transmission linking both countries runs primarily across three corridors, namely: eastern Afghanistan and Khyber-Peshawar, Pakistan; greater Kandahar/Hilmand and Quetta, Pakistan; and, Paktika/Patkya/Khost and Khyber Pakhtunkhwa/Federally Administered Tribal Areas, Pakistan.
  • No new wild poliovirus type 1 (WPV1) case was reported in the past week; the total number of WPV1 cases for 2017 remains three. The most recent case in the country had onset of paralysis on 11 June, from Killa Abdullah, Balochistan.
  • One new WPV1-positive environmental sample was reported in the past week, collected on 28 July, from Quetta, Balochistan.
  • A special vaccination round is being implemented during August 2017 targeting areas with recent polio cases and positive environmental samples. These include Rawalpindi / Islamabad and demographically connected areas of Khyber Pakhtunkhwa, Quetta Block and parts of Karachi.
  • Under the National Emergency Action Plan for polio eradication, the country is planning to implement two nation-wide and two sub-national vaccination rounds from September to December 2017.
  • No new cases of wild poliovirus type 1 (WPV1) were reported in the past week.  The total number of WPV1 cases for 2016 remains four and no cases have been reported in 2017.  The most recent case had onset of paralysis on 21 August 2016 in Monguno Local Government Area (LGA), Borno.
  • Nigeria continues to implement emergency response to the detected WPV1 strain and circulating vaccine-derived poliovirus type 2 (cVDPV2) strains affecting the country (last detected in 2016).
  • Detection of the polio cases in Nigeria underscores the risk posed by low-level undetected transmission and the urgent need to strengthen subnational surveillance.
  • The detection of wild poliovirus type 1 (WPV1) (Borno,Nigeria in 2016) and circulating vaccine-derived poliovirus type 2 (cVDPV2) (Borno and Sokoto provinces in Nigeria in 2016) continue to pose a risk to the neighbouring countries of the Lake Chad basin and hence an outbreak response plan is being implemented as part of the response to the Nigeria outbreak.
  • Emergency outbreak response efforts continue across the Lake Chad basin, together with activities to fill subnational surveillance gaps across the region.
  • No new cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) were reported in the past week in the Democratic Republic of the Congo (DR Congo). The total number of cVDPV2 cases this year remains seven, in two separate outbreaks: in Haut Lomami province (five cases, with onset of paralysis of the most recent case on 13 June); and in Maniema province (two cases with onset of paralysis on 26 March and 18 April, with an additional isolate detected in a healthy individual with sample collection on 2 May).
  • Confirmation of additional cases is not unexpected at this time. Outbreak response is taking place, including use of monovalent oral polio vaccine type 2 (mOPV2) in line with internationally-agreed outbreak response protocols, targeting more than 750,000 children under the age of five across the two provinces.
  • The first mOPV2 round was implemented on 27-29 June in the two affected provinces; and the second mOPV2 round ran from 13-15 July in Haut Lomami and 20-22 July in Maniema.
  • Surveillance and immunization activities are being strengthened in neighbouring countries.
  • In Syria, three new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were officially reported in the past week. The total number of cases in this outbreak is 33. Onset of paralysis of these cases is between 3 March and 10 July. Thirty-one of the cases are from Deir-Ez-Zour governorate (29 from Mayadeen district, one from Deir-Ez-Zour district and one from Boukamal district); one case is from Talabyad district, Raqqa governorate; and, one is from Tadmour district in Homs governorate.
  • Confirmation of additional cases is not unexpected at this time and would not change the operational situation, as outbreak response plans are being finalized and implemented, in line with internationally-agreed outbreak response protocols. Two vaccination campaigns are planned for both Deir-Ez-Zour and Raqqa governorates. If there is geographic spread, the extent of these campaigns will have to be adjusted.
  • The first mOPV2 round in Deir-Ez-Zour was successfully carried out between 22-26 July. Independent post-campaign monitoring reflected coverage of 88.4% (based on caregiver recall). The second round is planned for 19-23 August, and will include mOPV2 and IPV.
  • Raqqa Governorate started mOPV2 campaigns on 12 August.
  • Plans are being finalized to mitigate the risks of further spread from the outbreak zone to neighbouring areas and countries, including immunization of at-risk populations in northwest Syria, Turkey and Lebanon. Following confirmation of the case in Homs, discussions are ongoing to further extend the geographic reach of the outbreak response.